A total knee replacement (TKR) is a procedure where the damaged surfaces of the knee joint are resurfaced with an artificial prosthesis, primarily to relieve pain and improve mobility. The seven-week mark post-surgery is a significant checkpoint in the recovery process, representing a transition beyond the initial acute healing phase. This benchmark is a common time to assess progress and adjust the rehabilitation plan. It signifies moving from maximum reliance on pain management and basic movement to aggressively regaining strength and function. This period focuses intensely on increasing the knee’s range of motion and integrating the new joint into daily life.
Physical Healing and Typical Pain Levels
At seven weeks, the surgical incision should be completely closed, dry, and well-healed, often appearing as a pink or purplish line. The skin around the incision begins to soften as the body completes tissue repair. The majority of acute surgical pain should have resolved by this time.
Some degree of swelling (edema) is still common, especially after activity or at the end of the day, and can persist for several months. Pain management typically shifts away from strong prescription medications to a reduced reliance on over-the-counter options, such as NSAIDs or acetaminophen. Discomfort at this stage is frequently muscle soreness or fatigue related to intensive physical therapy and strengthening exercises. This rehabilitation discomfort is different from the deep, throbbing pain experienced immediately following the operation.
Expected Range of Motion Goals
The primary metric of success in early recovery is the knee’s range of motion (ROM), measured by physical therapists using a goniometer. At seven weeks, the immediate goal is to achieve full knee extension, meaning the leg can straighten completely to zero degrees. Attaining full extension is necessary for achieving a normal walking pattern.
For knee flexion (the ability to bend the knee), patients should aim for a range between 110 and 120 degrees by this stage. This level of flexion is considered functional, allowing for activities like sitting comfortably and navigating stairs. Flexion of 100 to 110 degrees is the minimum required for basic daily activities. Obstacles to achieving these goals often include dense scar tissue and persistent joint stiffness.
Functional Milestones and Daily Activities
By the seventh week, patients are mastering practical activities that signify a major return to independence. Most individuals have transitioned away from walkers or crutches and are walking independently, possibly using a cane only for longer distances. The focus shifts to normalizing the gait pattern, moving beyond the cautious steps of early recovery.
Driving is a milestone often achieved around this time, provided the patient is off narcotic pain medication and has sufficient reaction time and strength. Stair climbing should progress from the initial “step-up with the good leg” method to a more natural, alternating foot-over-foot pattern. Patients are also generally able to manage light household chores and find a more comfortable sleeping position, which improves overall rest.
Transitioning to Long-Term Rehabilitation
Rehabilitation structure frequently changes around the 7-to-9-week mark, moving out of the intensive, supervised phase. While some patients continue formal physical therapy, the emphasis often shifts to an independent, home-based exercise program. This maintenance phase requires commitment to self-directed exercises to continue building strength and endurance.
Patients typically receive clearance to return to low-impact recreational activities that place minimal stress on the new joint. Swimming, water aerobics, and stationary cycling are recommended for continued strengthening and improving mobility. Stiffness and minor discomfort can persist for up to a year, even though significant gains are made now. Full recovery, including the maximum return of strength and stability, generally occurs around the 6-to-12-month mark.