Artificial total knee arthroplasty is a highly effective procedure, but if the success of the surgery is based on the surgical technique without effective rehabilitation, the surgery will not be as effective as it should be. For total knee arthroplasty, functional exercise is as important as the surgery, as it relates to the future function and mobility of the knee. Under the guidance of the surgeon, functional exercises should be started as early as possible and should be based on active activities, supplemented by passive activities. Knee extension exercises are as important as flexion, if not more important. It is normal to feel pain during the early activities, so you should not be afraid to move for fear of pain and lose the best practice activity period (within one week after surgery), which will affect the functional rehabilitation of the knee joint after surgery. The postoperative rehabilitation (exercise) guidance for total knee replacement includes: muscle training, gait correction, psychological adaptation and whole body training. (1) Early exercise (0-7 days postoperative) Knee in slightly flexed functional position, ice pack for 24 hours, oral analgesic drugs, 6 hours postoperative functional muscle exercise as follows: ① quadriceps static contraction training: patient lying down, lower limb straight, the affected limb do quadriceps static contraction to maintain 5 seconds and then relax, ten sets a day; ② knee extension and elevation exercises: lower limb straight, as for quadriceps exercises. Raise the leg a dozen centimeters above the bed, maintain it for 5-10 seconds, slowly lower it, repeat this action until the thigh feels fatigue, three times a day; ③ ankle extension and flexion exercises: patients lying flat on the bed, muscle relaxation, keep the knee joint straight, ankle joint to do a uniform rate of plantarflexion and dorsiflexion as a group, maintain 8-10 groups per minute, do 3-5 minutes each time, three times a day; ④ postoperative day 2 -The starting angle was 0 degrees, and the ending angle was 20 degrees, with one flexion and extension in one minute at a slow speed, twice a day for 30 minutes. The angle gradually increased, and the speed also gradually increased, and the angle was between 90-120 degrees on the seventh day, and the ice bag was applied for 1 hour after each exercise; ⑤ The drainage tube was removed on the second and third postoperative days, and the third day the crutches were partially weight-bearing to walk on the ground. (2) Mid-term exercise (8-14 days after surgery) Gradually increase the weight-bearing of the affected knee, but still crutches should be partially weight-bearing, increase seated flexion exercises: sit on a chair, put a towel under the new joint, straighten the leg as much as possible, maintain the action, insist on 5 seconds, then flex the knee as much as possible, maintain the action, insist on 5 seconds again, repeat continuously. (3) Late exercise (15-21 days after surgery) Focus on gradually restoring the weight-bearing ability of the affected limb, starting walking and gait training, and strengthening the patient’s balance. Further strengthen the muscle strength enhancement training of the quadriceps and N cord muscles, using isotonic, isometric and isometric muscle strength training methods. The early stage of stair training mainly relied on crutches and the lower limb of the healthy side to support the stairs. The affected limb gradually transitioned from non-weight-bearing to partial weight-bearing. When training, the healthy side goes up first and the affected side goes down first; after the patient gets used to it, the dependence on crutches is gradually reduced and eventually the patient can walk independently without crutches. (4) Home exercise precautions ① continue to do knee flexion, extension and muscle rehabilitation exercises after returning home; ② keep the wound clean and dry, four weeks after surgery, you can take a shower, there will be numbness on the outside of the incision after surgery, this is normal; ③ tooth extraction, colds or other diseases, you must tell the physician to replace the artificial knee, so that antibiotics can be given to prevent infection; ④ in general, after surgery, the affected limb should not be fully weight-bearing for six weeks, after three months, no crutches. (5) After six months, you can swim, play golf and other mild sports, but avoid jumping, squatting, running, tennis, basketball and other strenuous sports; (6) Please follow the doctor’s instructions and return to the clinic for regular checkups if you have any of the following conditions, such as redness, swelling, pain or abnormal pus discharge. (5) Walking Exercise Precautions Proper walking is the best way to help the knee joint recover, and you need to walk with a walker or crutches at first. The first step is to feel comfortable and maintain balance while standing upright, then move the walker or crutches forward a small distance, straighten the knee on the operated side and move it forward, firstly follow the foot to the ground, move the body forward, then flatten the foot and finally release the toes from the ground. The walking frequency, pace distance and speed should be even. When muscle strength and endurance are increased, you can gradually extend the walking time. (6) Notes on going up and down stairs Going up and down stairs requires strength and coordination, and is the best exercise to enhance the strength and endurance of the limbs. (7) General requirements for rehabilitation (exercise) The rehabilitation after total knee replacement should vary from person to person due to the patient’s physical condition, medical condition, psychological quality, subjective requirements, and surgical procedure. In addition, since patients who receive total knee replacement have a history of long-term pain, deformity and dysfunction of the knee joint, functional exercise should be performed gradually and not too quickly to avoid undue injury.