What to Expect One Year After Total Knee Replacement

Most likely you have found this article because your knee replacement from a year ago isn’t what you expected.  Or maybe you’re just planning ahead and making sure that your expectations for your TKR are realistic.

What to Expect One Year After Total Knee Replacement

Either way, knee replacements usually provide my patients with incredible pain relief and return to activities they could never have done without the surgery.  However, you may still have unrealistic expectations for where your knee should be vs. where it most likely will be in a year.

Let’s go over what I see in my practice when it comes to knee replacements 1 year later.  I am fortunate enough to see numerous patients years after their knee surgery for reasons other than their knee.  Because of this I have a good idea of what people truly experience 1 year after total knee replacement.

One year after total knee replacement, you can expect to have zero or minimal pain and discomfort in your new knee.  Your knee range of motion should be full and you should be independent walking both inside and outside of your home.  Most patients note that they feel 95-100% back to full knee use 1 year after knee replacement.  At one year, most knee replacements feel natural and normal in their body and all swelling is gone in the knee.

How Long Does It Take For a Total Knee Replacement to Feel Normal?

This ‘normal’ timeframe will vary from person to person however in general most say their knee replacement feels normal around 6 months after surgery.  For some this timeframe can be longer lasting up to 12 months post-op depending on age, health status and activity level.

It depends upon what someone defines as normal in their own mind.  For some, the word normal would indicate no pain, no limitations at all.  Others may define normal as being mobile and independent with some pain, stiffness or minor aches still present.  Usually those dealing with longer term knee pain issues would define normal as still have some issues if they are minor.

One common theme amongst my knee replacement patients is that the new knee joint still feels different from the other knee for up to a year or so.  When asked to clarify, the answer is usually that it just feels a little strange or not natural in the leg for about a year or so until the body adapts it as its own.

Why Does My Knee Hurt 1 Year After Surgery?

Regarding pain in the new knee a year after surgery, this needs to be broken down into different levels of pain.   For the purposes of this discussion, let’s define these as 3 levels of pain:  Minimal, moderate and severe.

Pain After Total Knee Replacement

Minimal Knee Pain 1 Year After Knee Replacement 

For those having minimal knee pain 1 year of after knee replacement, I would suggest this is well within normal expectations.  Would we like the knee to be pain free one year after surgery?  Absolutely.  Our bodies don’t always work in that way unfortunately and some minor aches and pains can and should be expected even a year after replacement.

Moderate Knee Pain 1 Year After Knee Replacement

If you are having moderate knee pain a year after surgery, in the 3-6/10 range on the pain scale, there can be many reasons.  First, its possible that you did not fully complete your physical therapy regimen and regain full range of motion.  Without full range of motion, I would expect you to have moderate pain with basic walking, stairs and physical activities.  

Another possible explanation is that your surrounding tissues of the knee (ie. tendons/ligaments/muscles) were so damaged pre-surgery that they still have lingering issues.  If this was the case, you will still have some discomfort after surgery, hopefully just not as much as you did beforehand.

This is something that you can certainly check back with your surgeon about however they likely will tell you that it is normal.  

Severe Knee Pain 1 Year After Knee Replacement

If you are truly having severe knee pain 1 year after knee replacement then you certainly need to get reevaluated by your surgeon.  Hopefully you have already done this but if not, don’t waste any further time wondering.

By severe pain we are talking anywhere over 6-7/10 with regularity.  This is not normal and should not be ignored as it is a sign that something is not right with your knee.

There are a range of possible reasons for your pain from infection to a knee replacement that did not take or damage to your replacement.  In any case, immediate evaluation needs to be done to determine why your pain is so high.

I rarely if ever see this in my knee replacement clients as a majority either have complications early in the process or none at all.  Problems after 1 year usually occur due to a fall or injury to the knee which causes a clear issue at the joint.

Returning to Activities After Knee Replacement

By the time you have reached one year after your knee replacement, you should be able to return to all activities that you reasonably can perform.  Such activities can include but aren’t limited to biking, swimming, walking, hiking, tennis, pickleball, golf, yoga, exercising, dancing, boating and bowling.  

Activities that you should not expect to return to even a year after knee replacement include any high impact or jumping sports.  Included in this list are running, volleyball, basketball, football, rugby and soccer.

You will no longer have any TKR weight lifting restrictions at this stage either. If you have questions on which activities you can or cannot perform after knee replacement please consult with your surgeon and physical therapist.

Daily Living Activities One Year After Knee Replacement

At this stage of your recovery all of your normal ADLs or activities of daily living should be performed in your most normal manner.  Everything from showering and sleeping to going up and down stairs and cleaning up around the house should feel normal.

Dusting, vacuuming, laundry and general housework should be pain free and feel normal at the one year mark.  There’s a chance you can still have some fatigue after doing these activities and need to rests in between but likely not.

Prolonged bending activities such as gardening, yard work and cleaning on all fours can and probably will continue to be a problem at this stage.  Can you perform them?  Yes.  Will they be comfortable and activities that you can do without pain?  Probably not. 

Realistic Expectations After Knee Replacement

Don’t forget, you had your knee replaced.  This is not the same as getting a fresh new original knee, the one you were born with.  Nature’s version of a knee with real cartilage and pristine bone is much better than the man made version you now have.

If you’re having some issues with your new knee one year out of surgery, maybe its time to lower your expectations.  Can’t kneel for more than 5 minutes?  That’s normal.  Having a little stiffness when you get up from a chair?  That’s life.

Understand that your new knee might not be 100% perfect.  Is it way better than the old, broken down knee you used to have?  I thought so.

Final Thoughts on What to Expect One Year After Total Knee Replacement

  • Should Have Minimal to No Pain in Your New Knee After One Year
  • Return to General Activities and Housework Should Feel Normal 
  • Return to Most Non-Impact Activities and Sports is Realistic at 1 Year
  • Return to Impact or Jumping Activities Should Not Be Expected at 1 Year
  • Adjusting Your Expectations After Knee Replacement Should Be Considered
About Jeffrey Roth MPT

Owner and operator of Roth Therapy Services in Pittsburgh, PA focusing on in home rehabilitation physical therapy services.


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