Your post-surgical capabilities depend on your pre-surgical fitness level, your rehab, and which sports or activities you intend to resume.

Total knee replacement (TKR) is one of the most popular procedures in orthopedic and sports medicine, enabling millions of people to resume an active life. For many patients, it can seem like a miracle.

One of our patients, an 84-year-old guy named Ashton, was a gentleman farmer who routinely lifted bales of hay and when necessary, could hoist a calf. He had the cardiovascular system of a much younger man. We performed a TKR on his left knee and he was able to rejoin his wife in doubles tennis. Ashton told everyone that his doctors had given him a new lease on life.

While Ashton represented one end of the age spectrum, we are also seeing more patients in their 20s and 30s. Some have had been in car accidents, or damaged their knees on a basketball court or baseball field. Rather than limp around until they couldn’t stand it any more, these young people opted for surgery so they wouldn’t miss a decade or more of the activities they love.

In the past, total knee replacement patients tended to be those who had exhausted all conservative treatment options, and were in constant pain. These days, we treat many patients before they reach that point.

Because TKRs have returned so many patients to an active lifestyle, knee replacement surgeries rate near the top when patients are asked to describe their degree of satisfaction with their surgery.

Initial Rehab; Eventual Recovery

Damage to the cartilage in the lateral, medial, or patellofemoral knee may be a result of osteoarthritis, which can be triggered by injury or age-related degeneration. About 95% of knee replacements are performed to treat osteoarthritis. With total knee replacement, we remove all or part of the knee and replace it with an artificial joint made of metal and plastic. This joint acts as a hinge, allowing flexion, extension and rotation.

Immediately after surgery, your rehab program will be supervised by your doctor and physical therapist. They will prescribe exercises to help strengthen and remobilize.

As a reference, the American Association of Orthopaedic Surgeons publishes the following exercise guide for patients who’ve had a total knee replacement.

Once you’ve completed your rehab program, certain low-impact activities are encouraged for knee replacement patients. After the initial phase when you are restricted to certain exercises, you may start down the road towards a return to full activity. If you feel you are ready for a more vigorous workout, ask your doctor for a personalized evaluation.

Sports Generally Considered Safe for New Knees

Here are some moderate activities to choose from. If you experience pain or swelling after engaging in a workout, take a day off and let the knee rest before you return to action.

The following are good choices, starting about 12 weeks after surgery:

  • knee-replacement-recoverygolf
  • rowing
  • walking
  • yoga
  • dancing
  • doubles tennis
  • swimming
  • weight-lifting
  • aerobics or calisthenics
  • bowling
  • elliptical machines
  • cycling

Other exercises are discouraged without your doctor’s express approval, including:

  • jogging or running
  • contact sports such as football or baseball
  • competitive squash or racquetball
  • anything that involves jumping, such as basketball or water-skiing

In general, post-surgical knee patients should try to avoid twisting motions or any sudden wrenching or impact on the leg. If you are biking, avoid the hills, at least for the first few weeks. You’ll need to guard against infection and may be advised to take an antibiotic before any dental work or minor surgery.

Because of the metal components in your knee, it may also take a little longer to get through airport security— a small price to pay when you consider how much faster you’ll move through the world with your new knee.