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Susan Marks, a 59-year-old teacher from Wales, had reached the end of her tether.

Seven years earlier, she had been involved in a car crash. The accident caused significant damage to both of her knees, leaving her with acute and ongoing knee pain.

“My pain had got to a level where I was using a stick and finding it difficult to walk the dog,” she told reporters earlier this year.

As X-rays later showed, Susan also had end-stage arthritis in both knee joints. But when she visited her GP to request a knee replacement, there was a problem.

“They said I wouldn’t get on a list because I was too young,” she explains. “They said there was nothing they could do other than give me painkillers.”

In desperation, Susan eventually opted to fly to Lithuania for a private knee replacement. This is one reason why her story made headlines earlier this year: “Woman travels to Lithuania for knee surgery after ‘being told she was too young for NHS op’.” (ITV News)

But her experience also raises some important questions about age and knee replacements. Why would UK doctors say she wasn’t old enough for the operation? And did they have a point?

How young is “too young”?

If you look at the statistics for knee replacements, you’ll see the average patient is around retirement age. The UK’s National Joint Registry (NJR) is one of the best databases in the world for the topic. It says the median age of a patient having a total knee replacement is 70 (though patients having a partial replacement were “typically six years younger.”) Of the 1.8 million people in the dataset, less than 7% are under 55. So, statistically at least, Susan was unusually young when she first requested the operation, in her early 50s.

Why would doctors say you’re “too young” for a knee replacement?

It’s not uncommon to hear doctors say a patient is too young for replacement surgery. Indeed, some surgeons say they won’t perform the operation on people below the age of 60. There are two main reasons for this:

Implant lifespan – Although modern artificial knee joints are very strong, normal daily activities still cause significant wear and tear to the knee over time. Eventually, the implant will wear out. We tend to say the lifespan of an artificial knee will be between 15 and 20 years.

Revision risk – Because artificial knees don’t last forever, the chances of your implant wearing out obviously rise the younger you are. If you’re 50 when you have the operation, you might be looking at a revision knee replacement at 65 or 70. Also, younger people tend to place more daily wear on their knees, reducing the implant’s longevity.

What’s the issue with knee revision?

Knee revision is an effective operation, but it isn’t the same as having a first-time replacement. For a start, it’s a longer and more complicated operation, especially if the old implant is being replaced. Surgery involves removing more bone material to accommodate the new implant. The surgeon may also need to place stems into the bone endings to ensure a secure fix. It takes longer to recover from the operation and, overall, the revision implant typically has a shorter lifespan that the original. (You can find out more about how revision surgery works in this blog: What is revision knee replacement?)

But what if you “can’t manage much longer”? Do you still have to wait?

In her interviews at the time, Susan felt she had reached the end of the road with her injured knees. “I couldn’t have managed much longer,” she explained.

When patients ask us about their suitability for a knee replacement, we explain that it’s reserved for the most severe knee cases. But then the question is: what is severe? Essentially, it means:

• Serious cartilage damage – where injury or osteoarthritis has caused significant wear to the cartilage on bone endings (“bone-on-bone” or “end-stage” arthritis)
• Severe, ongoing pain – the pain feels persistent, or even constant, and is becoming overwhelming; it interferes with daily life and makes it difficult to sleep
• Significant impact on daily activities – the pain or stiffness is making it hard or impossible to do basic movements like walking, climbing steps or descending stairs

If these things describe your own situation – if you feel the pain is making it impossible to cope – then it’s hard to argue that your age should be a barrier to knee replacement until you turn 60. That’s not to say age is irrelevant. It’s a vital consideration, and all patients need to be fully informed about the risks and downsides of early knee replacement.

But, clearly, there’s a balance to be struck between immediate need and long-term wellbeing – particularly as implant technology improves and the lifespan of artificial knees gets longer. The bottom line is that knee replacement is a case-by-case treatment. It needs to be carefully debated by you and your surgeon. If that’s something we can help you with, please get in touch. We’d be very happy to help you weigh up the options and make the right choice for your knee pain.

For further reading

Do I need a knee replacement?

Am I too young for a knee replacement?

What are the alternatives to knee replacement?

How long does a knee replacement last?

What can the National Joint Registry tell you about knee replacements?

If you’re facing ACL reconstruction – or have recently had the operation – you probably know that ACL rehab is a bit of a balancing act.

On the one hand, you want to keep your knee active so you can maximise your recovery timeline. But on the other hand, there are dangers in overdoing it – especially in the early stages.

So what does “overdoing it” look like, how would you know if you were putting your ACL under excessive strain, and what does a well-balanced ACL rehab look like? Here’s our take…

What’s actually happening in your knee after ACL surgery?

An ACL reconstruction is a significant operation. The surgeon will remove your torn ligament and create a series of tiny holes in your femur and tibia bones. They will then fashion a graft (usually a piece of your hamstring), stretch it tight across the joint space and secure it to those holes.

The end result is a good, strong substitute ACL. But it will take time, rest and a carefully-controlled programme of physiotherapy to bring it to its full strength. We generally say it takes 6 months for the graft to heal into the bone tunnels and develop a healthy blood supply, and 9 months or more to reach full strength.

Where do patients typically go wrong?

On the whole, people who have ACL reconstructions tend to be young and active. If they make a mistake with their rehab, it’s rarely because they fail to keep up with their physio exercises. It’s usually the opposite: they tend to push too hard and fast in the early stages because they want to rebuild strength as soon as possible.

But this risks irritating the graft just as the tissues are healing and remodelling themselves, generating fresh inflammation that will actually break down the collagen growth you’re trying to encourage. It also runs the risk of loosening that crucial fixation to the bone. If you’re ambitious and sporty, putting your body to the test comes naturally. But for the first three months after ACL surgery, and certainly for the first few weeks, rest and protection are more important than pushing your limits.

A measured ACL recovery will look more like this…

The first 3 months: keep it in-line

Immediately after surgery, you’ll focus on keeping your leg rested and straight (see Bethany’s rehab journey, below). From there, you’ll progress to crutches and gentle mobility exercises – movements like lifting your heel up to your bottom or raising your leg while straight. The key is to keep the movement “in line”, meaning a straight trajectory (rather than from side to side or in rotation). Your early-stage ACL graft won’t tolerate extremes of movement, like twisting, turning and over-bending. You should also avoid exercising with heavy loads, for instance doing lunges with weights.

Months 3 to 6: progression without surprises

Around the three-month mark, most patients are able to progress to some running exercises. But it will be slow and gentle at first. We usually recommend a treadmill, where the going is flat and there are no unexpected bumps to contend with. By six months, you should be able to transition to light outdoor running (again, prioritising flat, predictable surfaces where there’s less risk of tripping). You want to avoid sudden, out-of-the-blue movements and activities. Start small and build up gradually. Your knee should begin to feel a lot stronger; however, even if it feels perfect, keep in mind that it hasn’t yet fully healed. Pushing yourself at this stage might feel like commitment. Biologically, it isn’t.

Months 9 and beyond: reaching full strength

Nine months is generally when we would expect your ACL to be fully healed (though for some patients, it can take longer). Your physiotherapist will give you guidance here, but this is usually the safest point to return to regular sporting activities, high-level training and heavier-loading exercises (like box jumps, pivoting, bounding). A rule of thumb is for your new knee to reach 90% of the strength and functional capacity of the uninjured knee. This is known as a Limb Symmetry Index (LSI) of 90% or greater. This is a good measure of how your new knee will stay secure, stable and injury free.

Red flags: how your knee tells you to stop

The good thing about our bodies is that they’re generally very good at signalling their limits – and when we might have overreached them. As you work on your post-operation rehab, these are some common red flags to be conscious of:

• Sharp or lingering pain – mild muscle soreness that fades with rest is a normal part of post-exercise recovery. Sharp stabbing pain – or a throbbing ache that lingers – is a warning to stop the activity and rest before you do serious damage.
• Significant swelling (effusion) – Major swelling around your knee (as opposed to some mild tightness after exercise) is a sign that the tissues are irritated and the knee is acting to protect itself with cushioning fluid. This creates a hostile environment for the graft.
• Lingering Stiffness: Excess fluid buildup doesn’t just cause discomfort; it can also physically limit your range of motion, making the joint feel stiff and tight. You want to be encouraging smooth overall movement in your knee, not recurrent stiffness.
• Instability – Overdoing a workout can fatigue the nearby muscles, such as the quadriceps and hamstrings, that provide crucial support to your joint as it heals. This can potentially put extra strain on the new ligament, causing it to feel wobbly or unsteady.

 

Bethany’s rehab journey

After fully rupturing her ACL during a football match, 20-year-old striker and sports coach Bethany Norman had ACL reconstruction surgery with Chris Bailey Orthopaedics. Here, she explains what the first 3 months of rehab were like.

“For the first few days [after surgery] it’s quite difficult to move. It wasn’t so much painful as very weak around the knee. To begin with you have to keep your leg straight, without bending, and lie completely flat when you sleep. You have to throw a dressing gown cord round your foot and raise it with your hands when you want to lift the leg. After that I was on to crutches for about two weeks.

“You have regular physio, and they give you mobility exercises to start off with. They’re not very intense; it’s just things like lifting your heel up to your bottom, or raising your leg straight up, holding it there and then putting it back down again.

“After that you go on to things like strengthening and cardio exercises and eventually squats and lunges. Ten weeks after the operation, the physio did a test to see if I could walk without a limp (I could). He also had me do a leg press to see whether my recovering leg could bear 70% of the weight that my other leg could bear. At that point it could only do about 20%! But by the 12-week mark I had made it to 70%.”

Read the full story of Bethany’s ACL injury and recovery

All about ACLs – more articles to read on our website

What is ACL reconstruction?

Why “prehab” is vital for ACL surgery

Will my ACL be the same after reconstruction surgery?

Patient case study: Beth Farmer’s ACL reconstruction story

What’s causing the surge in Premier League ACL injuries?

Windswept knee deformity is a problem with the alignment of the knees. It’s a rare condition nowadays, but one we do see from time to time in our clinics.

So what exactly does “windswept” refer to, what causes it and – most importantly – how would you treat it? Here’s a brief guide to an unusual but challenging condition.

Understanding knee alignment

Windswept deformity is what we call a malalignment issue. Think of your knees as the midpoint in an imaginary line running down each leg. This line (doctors call it the “long axis of the leg”) starts in the centre of your hip and runs down to your ankle. In an ideal world, the axis would fall in the middle of your knee joint. In reality, most people’s alignment isn’t quite so perfect. Most of us have knees that point either outwards or inwards:

Varus alignment – is the medical term for knees that angle outwards, arching the legs (“bowlegged”)

Valgus alignment – is when the knees point inwards, towards each other (“knock knees”)

You can find out more about the implications of varus and valgus knees in this article: I’m a bit knock kneed / bow-legged: is that a problem?

What are “windswept knees”?

While most people’s alignment tilts either inwards or outwards on both knees, windswept deformity (WSD) is different. With WSD, one knee is in valgus misalignment while the other is varus. This gives the condition its very visual name. The legs appear to lean in the same direction, like an object that has been blown by a strong gust of wind.

What causes windswept knees?

The potential reasons are quite varied. In children, windswept deformity is usually linked to bone disorders like rickets (now rare in developed countries), growth issues or rare genetic conditions such as Blount’s disease (tibia vara). In adults, it’s more likely to be an acquired condition. Common causes in adults include:

Past surgery – if you’ve had an osteotomy or an operation to remove your lateral meniscus

Injury – if you’ve badly damaged your knee, for instance by fracturing the outer side of your tibial plateau (the upper surface of your shinbone)

Inflammatory disease – if you suffer from an inflammatory joint condition like inflammatory arthritides or rheumatoid arthritis

Degenerative arthritis – if you develop “wear-and-tear” arthritis: windswept deformity is 20 times more common in people who suffer from osteoarthritis

Are windswept knees a problem?

Misalignment in the knees isn’t necessarily a problem. As we’ve seen, some degree of malalignment in adulthood is very common. The key is whether it progresses – ie gets worse over time – and / or starts to cause symptoms. What are the potential symptoms of windswept knee deformity? The main ones are:

Instability – as the centre of balance in your legs shifts, you become more prone to falling

General discomfort – the imbalance puts more pressure on the outer-side muscles and bones in one joint, and the inner parts of your other knee, causing persistent pain through the hips, knees and ankles

Pain – the pressure points can begin to cause cartilage wear and acute pain in certain parts of the knee joints.

How do you diagnose windswept knees?

Interestingly, it’s quite common for loved ones to notice the condition before the patient does. That’s partly because acquired windswept deformity is insidious; like osteoarthritis, it tends to creep up on you over time. In the early stages, many people imagine it’s just part of the ageing process. In clinic, we can usually identify WSD with a physical examination. After that, we would normally want to order some imaging so that we can take a more detailed look at the overall alignment of your legs.

What are the treatments for windswept knees?

If windswept deformity is beginning to cause problems, we always start with conservative treatments. That usually means:

Physiotherapy – to help you build up strength in the supportive muscles around your knees and to improve the mobility of your joints

Bracing – If the deformity is still correctable – meaning we can manually straighten your legs to a degree – we may try to correct the deformity with a brace (though the braces can be quite bulky and tricky to get used to).

But if conservative approaches don’t work, we can look to corrective surgery instead. The two main operations here are:

Osteotomy

This is a procedure that’s designed to relieve painful pressure on a specific section of the knee joint. We remove a small wedge of bone near the joint in order to gently alter the alignment of the leg and shift your body weight away from the damaged compartment and onto healthier cartilage.

Total knee replacement

Knee replacement is an operation for joints that are suffering from serious, ongoing pain or stability problems. With WSD, the goal is to completely realign and restabilise your legs, and this normally involves both knees at the same time, with a specialised implant design to straighten each limb alignment and properly redistribute the mechanical forces going through your legs. Though knee replacement for windswept deformity is complex, studies have shown it can be highly effective when the surgeon carefully tailors the soft tissue balancing and alignment angles for each distinct knee.

Noticed a worrying shift in your knee alignment, or concerned about a loved one’s changing balance? We’re here to help. Whether you have questions about corrective surgery, want to discuss a specific joint concern or just need some expert reassurance, you can call or email us to book an appointment and get help with the next steps. We’ll be delighted to help you find the support you need.

Recently, researchers in Denmark carried out a survey for International Patient Safety Day. They contacted nearly 1,000 people who were waiting for surgery and asked for their feelings about it.

The results were revealing: just over half (51%) had “moderate or high levels” of fear about their upcoming operations.

Fear of surgery, then, is really quite common, not least when it comes to a major operation like a knee replacement. If you’re waiting for a replacement yourself, or considering one, you might be feeling anxious about the procedure itself, or the potential risks and complications, or how long it will take to recover.

All these concerns are completely understandable – but how much should they actually worry you? Here are five things that we think it’s helpful to know about knee replacements, to help you feel more reassured.

1) Feeling scared is actually normal (and healthy)

As the Danish study shows, pre-surgery nerves are really the norm rather than the exception. If you’re feeling some degree of worry before surgery, that’s quite natural. In fact, it can actually be helpful. Although knee replacement is very safe (see point 3), it’s still a big operation that takes time and effort to recover from and that works best when patients prepare well and know what to expect afterwards. Being alert to these things can help you approach the operation in the right way, with realistic expectations. For more on just this topic, see this recent article: 7 tips from one of our knee replacement patients.

2) Your surgery team is highly experienced (and prepared)

Knee replacement is one of the oldest and most commonly-performed surgeries in the UK. About 116,000 people had the operation in 2024/2025. We’ve performed nearly 3,000 knee replacements here at Chris Bailey Orthopaedics alone. What this means is that surgeons have been able to develop techniques and aftercare programmes that make joint replacement very safe and successful. We work in centres where these operations are performed day in and day out. The whole team, from the nurses to the physios, is focused on looking after people with different requirements, pain thresholds and fitness levels. You’re in very good hands!

3) Worried about complications? The risks are very low

As with any operation, it’s important to be aware of the risks associated with replacement surgery. There are certain complications – such as blood clots or infections – that every patient needs to be aware of so they can be alert to them afterwards. But it’s also important to put these risks in context. Less than 1% of patients get an infection after surgery. The likelihood of a serious complication after a replacement is less than 5%. As the National Joint Registry explains, “the overall risk involved in joint replacement is very low.”

4) Patient satisfaction is high: focus on your long-term goals

Ask the average knee replacement patient how they felt about their surgery afterwards and, statistically, you’ll find they are likely to be very positive. Of the patients who had the operation in 2024/25, NHS England reports that nearly nine in 10 (89.6%) felt their situation had improved afterwards (more than 70% described it as “much better”). While recovery from a joint replacement can be tough-going in the early days, the key thing is to focus on the long-term goal. After years of pain and immobility, most patients find the outcome is worth the undertaking.

5) Pre-surgery anxiety can be managed

No good consultant, of course, would ever want to dismiss a patient’s worries. But if the operation is making you seriously anxious, the most important thing to do is tell your surgical team about it. Write down your concerns and tell them what’s on your mind. They’ll be very happy to provide reassurance – and specific tailored support, such as anti-anxiety medication, if you need it. We’d also recommend looking into stress-relieving techniques before your operation. Many patients find that breathing exercises and self-calming techniques can be very helpful. The Royal College of Anaesthetists and the British Society of Clinical and Academic Hypnosis have created some relaxation recordings aimed at helping patients to relax before surgery. It’s worth checking them out if you’re interested in exploring this further.

Worried about your upcoming surgery? You don’t have to go through it on your own. If you have questions, want to discuss specific concerns or just need some expert reassurance, we’re here to help. Call or email us to explain your concerns and schedule a consultation. We’ll be delighted to help.

In a recent blog, we posed the (slightly rhetorical) question: Could just two hours of exercise a week transform knee pain?

The answer, according to a major new study of patients with persistent joint pain, was an emphatic yes. The researchers found that people who stuck with an expert-led gym programme for 12 weeks experienced a 35% improvement in pain, on average. That’s a very impressive result.

But classic cardio work wasn’t the sole focus of the Joint Pain Programme, which involved 40,000 people and is now being touted for a wider rollout across the NHS. It also encouraged patients to work on their “mobility, stability and strength” – three things that are critical for giving painful knees the best chance of improvement.

And if there’s one muscle that provides all three of those things, it’s the quadriceps. In this article, we’ll examine why the “quads” are so closely linked to knee-joint health – and break down five simple, low-impact quad exercises that are often recommended to patients with long-term knee pain.

What are the quadricep muscles?

The quads are at the front of your thigh, covering an area from just below the hip to just above your knee. There are actually five muscles in the set, not four: the rectus femoris, vastus intermedius, tensor of the vastus intermedius, vastus lateralis and vastus medialis. But, together, they provide some very important functions:

• enable you to straighten your leg (AKA “knee extension”)
• help you maintain balance
• help you to flex your hips
• absorb shock when your heel strikes the ground during movement
• keep your kneecap stable and properly aligned with your leg

How does quad strengthening help your knees?

The key thing about strong quads is that they offload pressure from the knees. Your knees have to bear a lot of impact when you move – the equivalent of 2-3 times your bodyweight when walking on the flat and up to 6 times on stairs. If your quads are weak, more of that force travels through your knee joint. This can degrade the smooth cartilage covering on bone endings more quickly, leading to pain and, eventually, osteoarthritis. You can think of strong quads as a bit like good scaffolding – they provide a support structure that relieves the stress factors on a painful joint.

Does the science back this up?

Yes. There are some good studies that support the link between stronger quads and healthier knees. One randomised clinical trial with osteoarthritis patients, for example, found that targeted quad exercises led to a significant reduction in knee pain intensity. Another study involving a 12-week quad-strengthening programme showed patients’ shock-absorbing capacity increase by 36% and a significant improvement in pain and function.

5 quad exercises

With those things in mind, here are five common routines that knee specialists often recommend for quad strengthening. A quick note before you plunge into them, though: it’s essential to consult your doctor or physiotherapist before trying any new exercise programme. If you’re experiencing chronic joint issues or osteoarthritis symptoms, always ask a specialist first so they can tailor them to your own knees. A second rule of thumb: if any exercise causes sharp or worsening pain, don’t persist with it!

Quad exercise with towel

Sit down on the floor or your bed with your back straight and legs stretched out in front of you. Place a rolled-up towel under one knee. Gently bring your toes and foot of that leg towards you, while pushing the back of your knee downwards and letting your heel rise from the floor as you do so. Keep this position for five seconds, then relax. Repeat 10 times.

Straight-leg raise (lying)

This is a straightforward exercise that’s often recommended to patients who are recovering from knee replacement surgery. Lying on your back, move one leg up into a bent position. Then simply raise your other leg, keeping it straight as you do so. Raise it to about 25cm (10”) if it feels comfortable, hold for five seconds, then gently lower it again. Repeat five times.

Long arc quad exercise (sitting)

This exercise is very similar to the last one, but you’ll be seated rather than lying back. Take a straight-backed chair and sit down with both feet flat on the floor. Slowly raise one of your legs upwards until it’s straight (if you can move it comfortably that far). Hold this position for 3-5 seconds, then relax. Repeat 10 times.

Quad strength with squats

Squats are simple exercises that help to strengthen your hamstrings and glutes as well as your quads. To give yourself the best support, get a kitchen chair and stand behind it, holding on to the top of the chair. Then gently squat downwards, feeling the weight go into your heels. You could hold this pose for 5-10 seconds before returning to your starting position.

Quad stretch from kneeling

Just slightly more advanced, this exercise starts in a kneeling position. Make sure you’re on a comfortable surface, like a yoga mat, with your back straight. Now move one leg out in front of you, until it forms a right angle. Next, tuck in your bottom so you can feel your kneeling leg being gently stretched. If you’re able to, you can improve the stretch by holding on to the ankle behind you and pulling it slowly towards your bottom.

And 5 more articles on exercise and knee pain…

If you’re interested in finding out more about targeted exercise and how it can improve knee health and reduce long-term pain, you may find these other blogs helpful…

Why is exercise good for arthritis knee pain?

Can exercising more often increase your risk of knee arthritis?

3 common exercises for knee replacement patients

Winter Primer: 5 simple tips for cold-weather exercise

ESCAPE-pain review: a course to help you manage knee pain

Last month, a patient sent us a very helpful letter. Having recently undergone a knee replacement with Mr Bailey, she had been reflecting on the challenges of recovering from knee surgery when you live by yourself. She wanted to share some of her thoughts and tips with patients who will be going through the same thing.

From cooking meals to getting around the house, recovering from a big operation presents some logistical issues if you don’t have a partner or housemate alongside to help. Particularly when it comes to a procedure like total knee replacement, where you’ll be immobile and uncomfortable for the first few days after surgery.

But it’s not just about physical help around the home. The psychological side is important too (more on that below!).

So if – like an estimated 8.6 million people in the UK – you currently live alone, how can you best prepare yourself for recovery after knee surgery? Here are our patient’s top tips…

1) Go easy on yourself

Knee replacement patients tend to fall into two categories. Some people want to get going ASAP (like Rod Stewart!). Others prefer to take it slowly. If you’re more like the first type, it’s important to be realistic about the mental and physical impact that surgery will have on your body and what you can achieve in the early days. “Don’t push yourself,” advises our patient. Rather than trying to stuff your downtime with tasks, aim for incremental achievements. “Only do one major thing per day – for example, renewing your road tax – and little else.”

2) Commit to your rehab

On the other hand, you don’t want to ditch activity completely in those first few days. The exercises that your physio will give you after surgery are designed to keep you flexible, prevent your knee from stiffening, and strengthen the muscles that support your joint: all things that will improve your recovery. So, it’s important to persist. “Do all the exercises even if they hurt,” says our patient. “In another four weeks, they will hurt less!”

3) Plan your support network

Human contact is more than just having an extra pair of hands around the house (although that’s also good advice for your first week at home). It can actually impact your pain levels, physical outcomes and speed of recovery too. “Arrange in advance for visitors to come to cheer you up,” our patient advises. “And make sure they are the sort of people who will make you a cup of tea and tell you gossip and news, otherwise you will get lonely.”

4) Line up comforting distractions

Talking of psychology, “distraction” is an important recovery tool too. In fact, distraction therapy is an established branch of modern pain management – see for example how Great Ormond Street Hospital uses it with young patients who face surgery. This can be as simple as lining up a set of books, films or audio shows you love. “Watch comforting TV and listen to comforting radio,” says our patient. If you’re looking for inspiration, she recommends “Secret Garden, The Assembly, Kitchen Cabinet and Gardeners’ Question Time”!

5) Stock up on easy meals and treats

Getting “kitchen-ready” is one of our top pieces of advice for pre-surgery preparation. Like many people, our patient found cooking was the last thing she wanted to do during week one. “Don’t worry about meals,” she says. “[Ready meals] are good. Factor in treats for yourself – strawberries, chocolate, hummus, ice cream. You may not feel like eating at all… but DO eat, otherwise you will faint!”

6) Keep things in perspective

“Be positive” sounds glib, but there’s strong scientific evidence to suggest that the attitude we carry into surgery makes a significant difference to our outcomes after it. One study found that going into major surgery with an optimistic mindset physically changed the recovery experience, with optimistic patients reporting significantly lower pain levels and fewer symptoms weeks after the procedure. “Keep telling yourself you are the lucky one, and that things will get better, however grim they are at the start,” says our patient.

7) Give yourself permission to rest

The final tip is like the first: be gentle with yourself. Knee replacement is often described as a marathon not a sprint. It can be tough at times. It’s hard not to compare yourself with friends who’ve been through the same operation. You might feel guilty about not getting back on your feet as quickly as you hoped. Don’t be too hard on yourself, says our patient. Rather, see this as an opportunity to slow down. “Allow yourself to rest. If you’re someone used to doing everything at 100mph, just realise you can’t and give in for once.” Having seen many thousands of patients go through the process, we think that’s solid advice.

More about preparing for a knee replacement

Considering a knee replacement and how you can improve your recovery? You’ll find lots of practical resources on our website to help you plan the journey ahead. Here are some articles you might find helpful:

Preparing for surgery

• How should I prepare for a knee replacement? A general guide on what to expect and how to get your body ready for surgery.
• Knee surgery checklist: 12 things to do before your operation – A checklist of things to organise around your home and life before surgery day
• Preparing for major surgery – Lifestyle and medical advice to ensure you’re in the best shape for your operation.

Knee replacement timeline and recovery

• How long does it take to recover from a total knee replacement? – A timeline of what to expect during the weeks and months following your operation
• How to improve your total knee replacement recovery time – Actionable tips and strategies to help you heal faster and more efficiently
• 3 common exercises for knee replacement patients – A breakdown of the essential physiotherapy movements you will likely need to do during recovery.

Life after your operation

• How to get better sleep after a knee replacement – Practical tips for finding a comfortable position and getting a good night’s rest post-surgery.
• How to manage stiffness after a knee replacement – Reassuring advice on understanding and relieving the common problem of joint stiffness.
• How to use ice treatment after knee surgery – Best practices for safely and effectively using ice therapy to manage pain and swelling.