Taking care of your new knee joint

After you have knee replacement surgery, you will need to be careful how you move your knee, especially for the first few months after surgery.

In time, you should be able to return to your previous level of activity. But even then, you will need to move carefully so that you do not injure your new knee replacement.

When You Are Getting Dressed

  • Avoid putting your pants on while standing up. Sit on a chair or the edge of your bed, so it is more stable.
  • Use helpful devices so that you do not bend too much. Use a reacher, a long-handled shoehorn, elastic shoe laces, and an aid to help you put on your socks.
  • When you are getting dressed, first put pants, socks, or pantyhose on the leg that had surgery.
  • When you undress, remove clothes from your surgery side last.

When You Are Sitting

  • Try not to sit in the same position for more than 45 - 60 minutes at a time. Sit with your feet about 6 inches apart.
  • Keep your feet and knees pointed straight ahead, not turned in or out. Your knees should be either stretched out or bent in the way your therapist told you to.
  • Sit in a firm chair with a straight back and armrests. Avoid soft chairs, rocking chairs, stools, or sofas in the beginning. Avoid chairs that are too low.
  • When getting up from a chair, slide toward the edge of the chair, and use the arms of the chair or your walker or crutches for support to get up.

When You Are Bathing or Showering

  • You may stand in the shower if you like. You can also use a special tub seat or a stable plastic chair for sitting in the shower.
  • Use a rubber mat on the tub or shower floor. Be sure to keep the bathroom floor dry and clean.
  • Do not bend, squat, or reach for anything while you are showering. Use a shower sponge with a long handle for washing. Have someone change the shower controls for you if they are hard to reach. Have someone wash the parts of your body that are hard for you to reach.
  • Do NOT sit down in the bottom of a regular bathtub. It will be too hard to get up safely.
  • Use an elevated toilet seat to keep your knees lower than your hips when you are using the toilet, if you need one.

When You Are Using Stairs

  • When you are going up, step first with your leg on the side that did NOT have surgery.
  • When you are going down, step first with your leg on the side that had surgery.
  • You may need to go up and down one step at a time until your muscles get stronger.
  • Avoid long flights of stairs for the first 2 months after surgery.

When You Are Lying in Bed

  • Lie flat on your back. This is a good time to do your knee exercises.
  • Do not place any pad or pillow behind your knee when lying down.
  • If you need to raise or elevate your leg, keep your knee straight.

When You Are Getting into or Riding in a Car

  • When getting into a car:
    • Get into the car from street level, not from a curb or doorstep. Have the front seat moved back as far as possible.
    • Car seats should not be too low. Sit on a pillow if you need to. Before you get into a car, make sure you can slide easily on the seat material.
    • Turn around so the back of your knee is touching the seat and sit down. As you turn, have someone help lift your legs into the car.
  • When riding in a car:
    • On your first ride, stop and stand up after about 45 minutes. Take pain medications before your first ride home.
    • Break up long car rides. Stop, get out, and walk around every 45 - 60 minutes.
    • Ask your doctor or nurse when you can drive. You may need to wait up to 4 weeks after surgery.
  • When getting out of the car:
    • Turn your body as someone helps you lift your legs out the car.
    • Scoot and lean forward.
    • Standing on both legs, use your crutches or walker to help stand up.

Do NOT drive until your doctor says it is okay.

When You Are Walking

  • Use your crutches or walker until your doctor tells you it is okay to stop using them -- often up to 4 - 6 weeks after surgery. Use a cane only when you have been told it is okay.
  • Put only the amount of weight on your knee that your doctor or physical therapist told you was okay. When standing, stretch your knees as straight as possible.
  • Take small steps when you are turning. Try not to pivot on the leg that was operated on. Your toes should be pointing straight ahead.
  • Wear shoes with nonskid soles. Go slowly when you are walking on wet surfaces or uneven ground. Avoid flip-flops, as they can be slippery, and you may fall.

Activities You Cannot Do Even After You Flly Recover from Surgery

You should not do downhill skiing or play contact sports, such as football and soccer. In general, avoid sports that require jerking, twisting, pulling, and running. You should be able to do lower-impact activities, such as hiking, gardening, swimming, playing tennis, and golfing.

Other rules you will always need to follow include:

  • Take small steps when you are turning. Try not to pivot on the leg that was operated on. Your toes should be pointing straight ahead.
  • Do not jerk the leg that was operated on.
  • Do not lift or carry more than 20 pounds. This will place too much stress on your new knee. This includes grocery bags laundry, garbage bags, and tool boxes. Unfortunately, this also includes many pets.

Alternate Names

Knee arthroplasty - precautions; Knee replacement - precautions

Update Date: 8/12/2011

Updated by: C. Benjamin Ma, MD, Assistant Professor, Chief, Sports Medicine and Shoulder Service, UCSF Department of Orthopaedic Surgery, and Linda J. Vorvick, MD, Medical Director, MEDEX Northwest Division of Physician Assistant Studies, University of Washington, School of Medicine. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.

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