Preparing for Knee Replacement: Prehab, Home Setup and Your First Week

Most of the attention around knee replacement goes to surgery and recovery, but the weeks before surgery are an opportunity too. Building some strength, learning your exercises in advance, and setting up your home can make the first days back easier and less stressful. This guide covers what prehab can realistically do, how to prepare your home, and what to plan for the first week.

What prehab can (and cannot) do

“Prehab” is exercise and education before surgery. Research on prehab for total knee replacement is encouraging but modest:

• A 2022 meta-analysis found that prehab improved knee function before surgery and up to about three months after it, compared with surgery alone — with low to very low certainty, and no clear difference at 6 to 12 months.
• A 2023 meta-analysis of orthopedic prehab found moderate-certainty evidence for better function about six weeks after knee replacement.

In plain terms: prehab may help you start recovery from a stronger, better-prepared place, especially in the early weeks. It does not replace rehab after surgery, and every surgeon’s protocol comes first.

Prehab exercises people commonly practice

These are common examples, not a prescription. Ask your surgeon before starting, and skip anything that increases knee pain.

• Quad sets and straight leg raises
• Heel slides to keep the knee bending
• Sit-to-stands from a firm chair
• Glute bridges and side-lying hip lifts
• Standing balance at the counter
• Walking or stationary cycling at a comfortable level

Learning these before surgery has a second benefit: when you come home sore and tired, the exercises already feel familiar.

Setting up your home

1. Plan a first-floor setup if stairs are hard. A bed or recliner on the main level can make the first days easier.
2. Clear the paths. Remove loose rugs and cords between the bed, bathroom and kitchen.
3. Raise low seats. A firm chair with armrests and, if needed, a raised toilet seat make standing up easier.
4. Prepare the bathroom. A shower chair and grab bars help; ask your team before using a tub.
5. Put essentials within reach. Phone, chargers, medications, water and ice packs near where you will rest.
6. Practice with your walker. If you will use one, learn to walk, turn and sit with it before surgery.

Our free knee replacement home prep checklist covers each room in more detail.

Planning the first week home

• Arrange a helper for the first days, especially for meals and bathing
• Know your surgeon’s rules for weight bearing, swelling care and driving
• Schedule physical therapy to start soon after you come home
• Know the warning signs to call your surgeon: fever, increasing redness or drainage, calf pain or swelling, or chest pain or shortness of breath (call 911)

Prehab and rehab at home

In-home physical therapy can start before surgery and continue after it with the same Doctor of Physical Therapy, practicing on your own stairs, bed, chair and car. PTN Fitness serves homes across Northern Virginia and Washington DC. Learn more about in-home PT after knee replacement and the Knee Replacement Recovery Program.

Common questions

This article is for educational purposes only and is not a substitute for an individual medical evaluation. Follow the advice of your physician and care team.