Total Knee Replacement- The Importance of Exercise Pre and Post Operation – Matthew Osborn AEP

Osteoarthritis is a common disorder of the joints, where cartilage of the joints breaks down and can lead to pain and disability. Due to the joint losing its ability to move smoothly and the lack of cartilage to absorb shock, the mobility and strength of our joints are impacted.  Osteoarthritis, specifically in the knee, can lead to progressive declines in strength and impacts our ability to perform function tasks (e.g. walking, climbing upstairs, weight bearing) .  Without effective treatment, the condition can progress to the point where surgical interventions are needed. The most common surgery for this is a total knee replacement and whilst this is effective for pain relief in the short term, this typically results in reduced leg strength and function in the long term.

With this said, there is increasing evidence that shows that preparing for total knee replacement surgery through a structured exercise program may improve strength and function. If this is effective, exercise training can improve a patient’s recovery and quality of life post-operation. A study completed by al (2011) looked at the impacts of exercise training on people with end-stage osteoarthritis.  This study found that through a 4-8-week rehabilitation program, knee extension and flexion strength had improved along with the ability to perform functional tasks.  With these findings, resistance training has the potential to accelerate the rehabilitation process of total knee replacement.

If you are currently experiencing severe knee osteoarthritis and are looking for surgical management, starting an exercise program is a great way to prepare for this.  This program should include the following;

  • Activation and strengthening exercises – It is important that prior to surgery, the quadricep muscle group is effectively activated and strengthened. With improved strength, this provides more support for the joint, which can assist with pain relief. Simple exercises that achieve this can be sit to stands, knee extensions against a pillow or completing step ups.
  • Mobility Exercises- Simple exercises such as knee extensions, leg curls, leg swings are effective ways of promoting blood flow and fluid in the joint. With increased blood flow, this improves range of motion which can reduce pain and stiffness in the joint.
  • Stability exercises – With a reduction in quadricep and hamstring strength, this leads to an increased risk of falls in older populations. To counteract this, completing balance exercises and improving the joints proprioception (the body’s awareness in space) is the best way for falls prevention.



Swank,A., et al. 2011. Prehabilitation Before Total Knee Arthroplasty Increases Strength and Function in Older Adults With Severe Osteoarthritis.Journal of Strength and