A different way to do a knee replacement — and a different recovery because of it.
Most of what makes the first weeks after a knee replacement hard is not the incision. It is swelling, inflammation, and pain that is allowed to build before anyone treats it — and it is patients doing far more than they should.
The Quiet Knee Protocol changes three things at once: how the operation is performed, how pain is managed, and how much you are allowed to do afterward. All three matter. Changing only one of them does not produce the same result.
The name is literal. The goal is a knee that does not shout at you.
What it has done for my patients
The remaining 15% of patients use more than 10 pills.
Nationally, more than 40,000 people a year become addicted to opioids following total joint surgery. That statistic is the reason this protocol exists at all.
Pain and stiffness at six weeks
The clearest way I can describe the difference is to tell you what my own patients used to look like at their six-week visit, and what they look like now.
Using the standard approach — mechanical alignment, formal therapy starting two days after surgery, narcotics as the backbone of pain control — a typical patient at six weeks had roughly a 50% chance of pain during the day and a nearly 100% chance of pain at night.
Using the Quiet Knee Protocol, daytime pain at six weeks is now rare, and about 30% of patients report pain at night.
Patient dissatisfaction follows the same pattern. The figure quoted for decades has been that 15–20% of patients are dissatisfied after a standard total knee replacement. More recent evidence suggests the real contemporary number is closer to 10% (why the estimates differ).
My dissatisfaction rate using this protocol is around 3% — well below either benchmark.
These are my own results, in my own patients. They are not a guarantee, and no surgeon can promise you an outcome. But they are the reason I changed how I do this operation.
Where it comes from
The Quiet Knee Protocol was developed by Dr. Andrew Wickline, M.D., in upstate New York. He performs over 700 total knee replacements a year and has the lowest complication rate in the state of New York. He built the protocol specifically to reduce how many opioids his patients needed.
You can read about his work at andrewwicklinemd.com. I adopted the protocol because the results were better than what I was getting, and I have used it since.
The three parts
The protocol is not a pain plan. It is three things working together, and the third one is the part patients underestimate.
The surgical technique
I use Kinematic Alignment rather than Mechanical Alignment, and a Subvastus Approach to open the knee. Both are designed to do less damage on the way in — which means less to recover from.
The medication protocol
Several medications that control pain and inflammation without narcotics, started before the pain does. Some patients add narcotics on top; the large majority use fewer than 10 pills in the 90 days after surgery.
The activity restrictions — your part
This is the most important part of the protocol, and it is the only part I cannot do for you. The first two weeks are strictly limited, and there are step-count limits every week for six weeks. Patients who exceed them have more pain, more swelling, and more stiffness.
Formal therapy does not start until two weeks after surgery — the knee needs time to quiet down first.
Before your surgery: what to buy
Three things are worth having at home before your surgery date, not after. All three work on the same problem — swelling — and all three work better if you start them early.
- A compression garment. Pick one of two options. Which one ›
- Protein. Start two weeks before surgery. Why ›
- Diosmin & hesperidin. An over-the-counter supplement. Start two months before. Details ›
Downloads
Print them, keep them where you can see them, and bring them to your appointments.
Disponible en español. Both guides are available in English and Spanish.
After Your Total Knee Replacement
Step limits week by week, both range-of-motion exercises with photos, and when to call. PDF · 5 pages
Protein Supplementation for Surgery Recovery
Why protein matters, how much to take, and which products to buy. Start this two weeks before surgery. PDF · 2 pages
Compression Garments
Two options for swelling control — the Reparel sleeve and the EdemaWear stockinet. Buy one before surgery. Includes sizing charts and the TRIA20 discount code. PDF · 3 pages
Diosmin & Hesperidin
An over-the-counter supplement that reduces swelling. Start two months before surgery. PDF · 2 pages
Important. These pages explain the protocol in general terms. They are not a prescription and are not medical advice. Your own plan is determined by Dr. Olsen based on your health history, and only the written instructions you receive from this office apply to you. Never start, stop, or change a medication based on what you read here.
Considering knee replacement?
Dr. Olsen will talk through whether the Quiet Knee Protocol is right for you.
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