What are typical postoperative rehabilitation milestones after total knee arthroplasty?

• A. Early range of motion to 0–90 degrees by day 3–7; ambulation with assistive devices within 1–3 days; discharge by days 2–5; return to normal activities by 6 weeks to 3 months.
• B. Range of motion to 180 degrees by day 1; full activity within 24 hours.
• C. No ROM for 6 weeks; bed rest.
• D. Discharge the day of surgery with full activity.

Answer: (A)

Postoperative rehabilitation after total knee arthroplasty centers on restoring knee motion, enabling safe walking, and returning to function within a realistic timeline. A typical progression aims for knee flexion from near 0 degrees (full extension) to about 90 degrees within the first week, usually by day 3 to 7, so moving the knee early helps prevent stiffness and supports daily activities. Ambulation with assistive devices is expected within the first couple of days, often by days 1–3, to promote gait training, improve circulation, and reduce complications. Hospital discharge commonly occurs by days 2–5 with outpatient or home-based rehabilitation continuing afterward. Return to normal activities is generally targeted around 6 weeks to 3 months, reflecting tissue healing, quadriceps strengthening, and adaptation to a new knee.

These milestones are consistent with current practice because pushing for ROM too aggressively (such as 180 degrees on day 1) is rarely feasible due to pain, swelling, and muscle inhibition. Conversely, withholding ROM for weeks or discharging the patient with full activity on the day of surgery do not align with typical recovery patterns and can lead to stiffness or unsafe progress.