In the six weeks before a knee replacement, finish any medical and dental appointments your surgeon asks for, start a short prehab program to strengthen the thigh and keep the knee moving, set up your home with a firm chair, a raised toilet seat and clear walkways, arrange help and rides for several weeks, and book outpatient physical therapy so it can start when your surgeon says. Orthopaedic surgeons’ patient guidance from the AAOS covers the same ground. Doing it in stages, week by week, keeps the last few days before surgery calm.
Last reviewed By the Monon Therapy Collective editorial team
- Start
- About six weeks before your surgery date
- Chair to have ready
- Stable, firm seat, 18 to 20 inches high, with arms (AAOS)
- Driving afterwards
- Often about 4 to 6 weeks, per your surgeon (AAOS)
- Daily activities
- Most resume within about 3 to 6 weeks (AAOS)
Why does the six weeks before a knee replacement matter so much?
Because the first two to three weeks after surgery are the hardest time to organize anything. Pain, swelling, a walker and limited driving all make errands, appointments and furniture moving difficult, so whatever you set up beforehand is what you live with during early recovery.
Six weeks is enough time to clear medical and dental requirements without rushing, to complete several weeks of prehab, and to arrange help with less stress. It also gives you time to ask the surgeon’s office the practical questions most people only think of in the hospital: which protocol will guide rehab, how long you will use a walker, and when therapy should begin.
Which medical and dental checks usually come before a knee replacement?
Your surgeon may ask for a complete physical examination with your primary care doctor several weeks before the operation, and blood and urine tests and an electrocardiogram are often needed to plan the surgery, according to the AAOS. The AAOS also advises finishing major dental work, such as extractions and periodontal treatment, before surgery, and a urological evaluation for anyone with recent or frequent urinary infections.
These steps aim to reduce the risk of infection in the new joint and to make sure your heart, lungs and blood are ready for anesthesia. Give your surgeon a complete list of medicines and supplements; they will tell you which to stop and which to keep taking. Book these appointments in the first week of your countdown, since results sometimes lead to a second visit.
If you smoke, ask your doctor about stopping before the operation: the AAOS notes that smokers have higher rates of poor wound healing and infection after surgery, and that fractures take longer to heal. People with diabetes should ask how their blood sugar targets around surgery are managed, and anyone with a skin problem such as a cut, rash or sore near the knee should tell the surgeon’s office, because broken skin near the incision can delay the date.
What prehab exercises help before a knee replacement?
Exercises that strengthen the quadriceps, keep the knee straightening and bending as fully as it can, and build general fitness and balance. People who arrive at surgery with stronger thighs and better motion often find the early rehab steps easier, though prehab cannot remove the pain of the arthritic joint.
Typical choices include quad sets, straight leg raises, terminal knee extensions, sit-to-stands from a chair, gentle cycling and single-leg balance beside a counter. A few sessions with a physical therapist also let you practise walker use and stairs before you need them. The prehab before joint replacement guide sets out a full program.
How should I set up the house for the first weeks after a new knee?
Make the main floor work without stairs where possible, remove loose rugs and cords, add bathroom support and set up a firm, stable chair with arms. The AAOS suggests a chair with a seat height of 18 to 20 inches, safety bars or a secure handrail in the shower or bath, and a toilet seat riser with arms if your toilet is low.
- A firm chair with arms, 18 to 20 inches high, in the room you will spend the day in
- Clear walkways wide enough for a walker, with rugs and cords removed
- Night lights from the bedroom to the bathroom
- Grab bars or a secure handrail in the shower or bath, and a shower chair if needed
- A toilet seat riser with arms for a low toilet
- Everyday items moved to between waist and shoulder height
- Ice packs or a cold therapy device ready in the freezer
Who should I line up to help, and for how long?
Plan for help with meals, shopping, laundry, pets and driving for at least the first few weeks. The AAOS notes that most people resume driving around 4 to 6 weeks after surgery and most normal daily activities within about 3 to 6 weeks, so rides to physical therapy are the gap most people underestimate.
If you live alone, ask the hospital’s social worker or discharge planner about arrangements before the operation, as the AAOS suggests. Cook and freeze meals, set up online grocery delivery, and make a rota of family or friends for rides. The answer on when you can drive after a knee replacement explains what decides that date.
When should I book outpatient physical therapy for after the operation?
Book it before surgery, so the first appointment fits the start date in your surgeon’s instructions and you are not searching for a therapist while sore and swollen. Ask the surgeon’s office for a written referral and the rehab protocol to take to the first visit.
Most people have outpatient therapy for several weeks to a few months; the answer on how many physical therapy sessions after a knee replacement gives typical ranges and the total knee replacement rehab page shows the phases. To be matched with an independent therapist in the network, complete the physical therapy questionnaire and choose after surgery. The garage at Carmel City Center is a short walk from the suites, worth knowing while you are on a walker, and the therapist’s office checks your coverage before the first visit; see cost and insurance.
Your six-week knee replacement countdown
A sample timeline. Your surgeon’s instructions come first wherever they differ.
Week 6: medical appointments
Book the pre-operative physical, any tests, and dental work. Give your surgeon a full list of medicines and supplements.
Week 5: start prehab
Begin quad and knee motion exercises, ideally with a physical therapist who can also teach walker use and stairs.
Week 4: arrange help
Set up a rota for meals, shopping, pets and rides for at least the first few weeks; ask about a discharge planner if you live alone.
Week 3: equipment
Get or borrow a firm chair with arms, a toilet seat riser, a shower chair and grab bars. Confirm what the hospital will supply, such as a walker.
Week 2: set up the house
Clear walkways, remove rugs and cords, add night lights, move daily items to waist height and set up a main-floor resting area.
Week 1: book rehab and pack
Confirm your first outpatient physical therapy visit and the protocol, cook and freeze meals, and pack loose clothing and supportive shoes.
After surgery, call your surgeon or 911 if
- Calf pain, tenderness or swelling in either leg (possible blood clot)
- Sudden chest pain or shortness of breath (call 911)
- Fever, chills, or increasing redness, warmth or drainage at the incision
- New or rapidly worsening pain or swelling in the knee
If you think it is an emergency, call 911.
