Post-TKR physiotherapy begins on the day of or the day after surgery. In hospital, this involves: assisted standing and walking with a frame (typically Day 1), ankle pumps and deep breathing exercises to prevent DVT and chest complications, and instruction on safe bed transfers and bathroom use. The critical range-of-motion goal for week one is 0° extension (fully straight) and 90° of flexion.

At Curis 360, our physiotherapists begin home visit TKR rehabilitation from the day of discharge — which in many Bengaluru hospitals is Day 3–5 post-surgery. This seamless transition from hospital to home physiotherapy is critical: the first 2 weeks are when scar tissue formation is most active, and aggressive but appropriate early mobilisation prevents the permanent stiffness that results from scar tissue contraction.

Ice application for 15–20 minutes every 2 hours is prescribed throughout the first 2 weeks to control swelling and pain. The knee should be elevated above heart level when resting. The physiotherapist will also assess the home environment for trip hazards and recommend grab rails or commode adaptations as needed.

The primary goal from weeks 2–6 is achieving 0–120° of knee range of motion and independent walking without a walking frame. Our physiotherapists use progressive range-of-motion techniques — heel slides, prone hangs for extension, and stationary cycling (which can typically begin at week 3 once 90° flexion is achieved). Manual scar tissue mobilisation begins at approximately day 14 to prevent adherence of the skin and subcutaneous tissue to the surgical capsule.

Stair training is a high-priority goal for most of our Bengaluru patients, whose homes invariably have stairs. We use the principle 'up with the good, down with the bad': lead with the operated leg going up (the stronger leg lifts the body weight), lead with the operated leg going down (the stronger leg controls the descent). This is practised first with a railing on both sides, then one side, then no railing.

Quadriceps strengthening is the central focus of this phase. Post-TKR patients typically experience significant quad atrophy. Straight leg raises, terminal knee extensions, and mini-squats against the wall progressively rebuild the strength needed for safe, independent walking and stair use.

By 6–8 weeks, most patients can walk without an assistive device on flat surfaces, perform kitchen activities, and manage light household tasks. The physiotherapy focus shifts to achieving full range of motion (targeting 130°+ flexion for floor-sitting, which is a practical necessity in many Indian households), improving walking speed and endurance, and reintroducing activities like driving and market visits.

Common problem areas at 6–8 weeks that require targeted physiotherapy include: persistent extension lag (the knee does not fully straighten, causing a limp), kneeling difficulty (relevant for prayer positions), and swelling that returns after activity. Each of these has a specific physiotherapy solution — our team at Curis 360 has extensive experience managing post-TKR complications without requiring a return to hospital.

Multiple clinical studies show that home-based physiotherapy after TKR produces equivalent or better outcomes compared to clinic-based physiotherapy for most patients, with significantly higher patient satisfaction. The primary advantage is that rehabilitation occurs in the patient's actual functional environment — their home stairs, bathroom, kitchen, and bedroom — rather than in a generic clinic setting.

For Bengaluru's large elderly population, particularly in South Bengaluru neighbourhoods such as Jayanagar, Banashankari, Koramangala, and Vasanthapura, travel to a clinic in the first 4–6 weeks post-surgery is both difficult and risky. Curis 360's home visit TKR programme eliminates this barrier entirely. Our physiotherapists bring portable TENS machines, resistance bands, and goniometers to each session. Home visits are available 7 days a week, from 7 AM to 7 PM.