Preparing thoroughly ensures a smooth hospital stay and rapid recovery:

• Pre-Operative Preparation: Attend your pre-assessment clinic for blood tests, MRSA swabs, and ECG. Stay active with gentle quad exercises ("pre-habilitation"), stop smoking, and follow exact fasting instructions given for the night before surgery.
• On the Day of Surgery: You will arrive at the hospital admissions unit, be met by your nursing team, consultant anesthetist, and Mr. Rohman to mark your leg and confirm consent. Surgery typically takes 1 to 2 hours under spinal anesthesia with light sedation.
• On the Ward: You will be transferred to the orthopedic ward with a bulky knee dressing. Your physiotherapist will get you out of bed to stand and walk with a frame or crutches within hours of returning to the ward to encourage blood flow and early joint extension.

Discharge home occurs as soon as you meet all safety criteria (often same-day or 1 to 2 days post-op):

• Discharge Criteria: Pain controlled with oral tablets, ability to safely walk with crutches/sticks, negotiate steps/stairs independently, bladder function fully recovered, normal blood tests and X-rays.
• Home Adjustments: Remove loose rugs, clear walkways of trip hazards, place frequently used items at waist height, and ensure a sturdy chair with armrests is available. A toilet seat raiser may be provided by occupational therapy.
• Family & Carer Support: Arrange for a family member or friend to stay or assist you for the first 1 to 2 weeks home to help with meal preparation, shopping, ice pack changes, and medication schedules.

A stationary exercise bike is one of the single best tools to regain knee flexion (bending), muscle strength, and flush out joint swelling after total knee replacement:

• When to Start: Usually around 2 to 4 weeks post-op, once your wound is dry/healed and you have achieved at least 90 degrees of knee bend. Always get clearance from your physiotherapist first.
• Bike Setup: Raise the seat slightly higher than normal so your knee does not bend too sharply at the bottom of the pedal stroke. Start with zero pedal resistance.
• Technique: Begin by gently rocking the pedals backward and forward. Once you can make a full backward revolution smoothly, attempt your first full forward revolution. Start with 5-minute sessions once or twice daily and gradually build up duration before adding light resistance.

Post-operative pain management after total knee replacement relies on analgesia cycling—taking prescribed medications at staggered, regular intervals to maintain steady blood levels rather than waiting for severe pain to spike.

• Base Layer: Take regular simple analgesics (such as Paracetamol) and prescribed anti-inflammatories at set time intervals as directed.
• Breakthrough Relief: Use prescribed stronger medications (e.g., codeine or tramadol) as required for breakthrough pain, especially 30 to 45 minutes prior to performing your physical therapy exercises.
• Tip: Keep a written log of the time and dose of each medication you take to prevent accidental double-dosing or missed intervals.

Ice packing helps reduce internal joint inflammation, surgical swelling, and muscle inhibition after total knee replacement:

• Apply a gel ice pack or a bag of frozen peas wrapped in a damp tea towel over your knee for 15 to 20 minutes per session.
• Repeat this 3 to 5 times daily, particularly immediately following your rehabilitation exercise routine.
• Safety Warning: Never apply ice directly to bare skin, as this can cause cold burns or skin breakdown near surgical incisions.

Achieving early knee extension (straightening) and flexion (bending) is vital during the first 6 weeks following total knee replacement:

1. Ankle Pumps: Repeatedly point and flex your feet up and down to promote venous circulation and help prevent DVT blood clots.
2. Static Quadriceps (Knee Presses): Lie flat on your back, push the back of your knee down firmly into the bed, tighten your thigh muscle, and hold for 5 seconds.
3. Heel Slides: Lie down and gently slide your heel up toward your buttocks, bending the knee as far as comfortable, holding for 5 seconds, then sliding back straight.
4. Straight Leg Raises: Tighten your thigh and lift your leg 6 inches off the bed, hold for 3–5 seconds, and slowly lower.

You can access video guides for every stage of your total knee replacement recovery through our recommended NHS physiotherapy links:

• Hospital Stay: Most total knee replacement patients return home within 1 to 2 days after surgery (or same-day for selected day-case pathways).
• Walking Aids: Crutches or frames are used for the first 2 to 4 weeks until quadriceps strength recovers and walking without a limp is possible.
• Driving After Knee Replacement: You may resume driving once you are off strong opioid medications, can perform a safe emergency stop, and have been formally cleared by your consultant (typically 6 weeks post-op).
• Return to Work: Sedentary or desk work can usually be resumed at 6 weeks; heavy manual labor may require 3 months.