Best Sitting Position After Knee Replacement

After undergoing knee replacement surgery, seemingly simple activities like sitting can become surprisingly challenging. Finding comfortable, safe sitting positions is crucial not only for your daily comfort but also for protecting your new joint and promoting optimal healing. For patients in the UK recovering from knee replacement surgery, understanding how to sit properly can make a significant difference in your recovery experience.

Knee replacement (arthroplasty) is one of the most commonly performed orthopaedic procedures in the UK, providing relief for thousands of patients suffering from severe arthritis or knee injuries. While much attention is given to walking and exercise during recovery, proper sitting techniques are equally important yet often overlooked.

This guide examines the best sitting positions after knee replacement surgery, including how to sit safely, what positions to avoid, and how to manage different seating situations you'll encounter during recovery.

Before exploring specific positions, it's important to understand why sitting correctly is so crucial after knee replacement surgery:

• Protects your new joint: Proper positioning reduces stress on your new prosthesis and the surrounding tissues
• Promotes healing: Correct alignment helps healing tissues recover in the optimal position
• Prevents complications: Proper sitting helps avoid potential issues like excessive swelling or blood clots
• Maintains range of motion: The right sitting techniques help preserve the mobility gains from your physiotherapy
• Reduces pain: Correct positioning minimises unnecessary strain and discomfort

Ms. Caroline Williams, Specialist Orthopaedic Physiotherapist at University Hospitals Bristol, explains: "Many patients focus exclusively on their walking technique but overlook sitting positions. However, considering how much time we spend seated, proper sitting technique is essential for recovery and long-term function of the new joint."

The optimal sitting position after knee replacement prioritises both comfort and joint protection:

Chair Selection

The ideal chair for knee replacement recovery should have:

• Proper height: Your hips should be level with or slightly higher than your knees when seated
• Firm support: Avoid soft, low sofas or chairs that you "sink" into
• Armrests: These provide support when sitting down and standing up
• Supportive back: Good back support helps maintain proper posture
• Sufficient depth: The chair should support your thighs without pressing against the back of your knee

Body Positioning

Once you've selected an appropriate chair, focus on:

• Equal weight distribution: Sit with weight evenly distributed across both hips
• Proper knee alignment: Your operated knee should be extended forward slightly rather than bent acutely
• Foot placement: Both feet should rest flat on the floor (or on a small footstool if needed)
• Back positioning: Maintain contact between your lower back and the chair
• Regular movement: Change positions slightly every 30-45 minutes

Knowing how to sit down and stand up safely is just as important as maintaining the right position once seated.

How to Sit Down Safely

Follow these steps when sitting:

1. Position yourself with the back of your legs touching the chair
2. Extend your operated leg slightly forward
3. Reach back for the armrests with both hands
4. Lower yourself slowly, controlling your descent with your arms and non-operated leg
5. Once seated, adjust your position to ensure proper alignment
6. If needed, use your hands to gently lift your operated leg into position

How to Stand Up Safely

When it's time to stand:

1. Move forward to the edge of the chair
2. Extend your operated leg slightly forward
3. Position your non-operated foot slightly underneath you
4. Place both hands on the armrests
5. Push through your hands and non-operated leg to rise to standing
6. Gain your balance before reaching for any walking aid

Different sitting situations present unique challenges after knee replacement. Here's how to manage common scenarios:

Dining Chairs

Dining chairs are often problematic as they're typically lower and lack armrests:

• Solution: Add a firm cushion to increase the height
• Consider a temporary chair with armrests at the dining table
• Sit at the corner of the table so you can extend your leg without obstructing others
• Use a chair that allows you to keep your knee at or close to a 90-degree angle

Car Seats

Getting in and out of cars can be particularly challenging:

• Technique for entering: Sit sideways on the seat first with both legs outside, then pivot and bring your legs in one at a time
• Recline the seat back slightly for more room
• Push the seat all the way back to maximise leg room
• Consider a plastic bag on the seat to help you pivot more easily
• Use a cushion if needed to raise the seating height

Lounge Seating and Sofas

Standard sofas are often too low and soft for proper knee positioning:

• Temporary solutions: Use a firm cushion or two to increase the height
• Sit at the end of the sofa where you can extend your leg if needed
• Consider a temporary recliner rental during early recovery
• Use a footstool to support your leg if it feels more comfortable elevated

Toilet Seats

Standard toilets are typically too low for comfortable use after knee replacement:

• Recommended equipment: Raised toilet seat (available through the NHS or for purchase)
• Consider toilet frames with armrests for additional support
• Keep a small stool nearby to support your operated leg if needed
• Ensure bathroom rugs are secured to prevent slipping

Knowing what not to do is equally important for protecting your new knee:

Avoid These Sitting Positions

• Cross-legged sitting: Places excessive stress on your new joint
• Sitting with your knee bent under you: Can damage the prosthesis and surrounding tissues
• Low seats without support: Makes standing difficult and places strain on the joint
• Sitting with legs elevated above heart level: May feel comfortable but can increase swelling
• Sitting for prolonged periods: Can lead to stiffness and increased pain

Problematic Sitting Habits

• Slouching: Compromises spine alignment and increases knee strain
• Leaning to one side: Creates uneven pressure on your hips and knees
• Tucking feet under the chair: Forces your knee into excessive flexion
• Sitting with legs crossed at ankles: Can restrict circulation (particularly problematic after surgery)
• Using a footstool that's too high: May place excessive bend in your knee

Your sitting needs and abilities will evolve throughout your recovery process:

Weeks 1-2

• Focus on proper technique over duration
• Use the highest, firmest chairs available
• Prioritise chairs with armrests
• You may need assistance to sit and stand initially
• Consider rental equipment for home use during this period

Weeks 3-6

• Gradually increase sitting duration as comfort allows
• Begin using more typical chairs with good technique
• Continue using cushions to modify standard seating as needed
• Practice techniques for managing challenging seating environments

Beyond 6 Weeks

• Most patients can begin using normal seating with good technique
• Public seating becomes more manageable
• Car travel becomes more comfortable
• Continue avoiding very low, soft seating when possible

Several assistive devices can make sitting more comfortable and safer during recovery:

• Chair risers: Elevate existing chairs to a more appropriate height
• Firm cushions: Provide additional height and support
• Recliner chairs: Allow comfortable extended sitting with leg support
• Grab bars: Provide support when sitting and standing in bathrooms
• Leg lifters: Help you position your operated leg when sitting
• Wedge cushions: Create a sloped seating surface that reduces knee flexion

Finding the best sitting position after knee replacement requires attention to detail and often some modifications to your usual habits and environment. While it may seem challenging initially, developing proper sitting techniques is an investment in your recovery and the long-term success of your knee replacement.

Remember that your needs will evolve throughout the recovery process, and what works best in the early weeks may change as your healing progresses. Be patient with yourself and willing to adapt your approach as needed.

Our healthcare provider marketplace can connect you with specialist physiotherapists and occupational therapists who can provide personalised guidance on optimal sitting positions and techniques specific to your home and work environment. With the right approach to sitting and other aspects of your recovery, you can look forward to enjoying the full benefits of your knee replacement.