Background: Total knee arthroplasty (TKA) is the preferred surgical remedy for osteoarthritis with severe degeneration of knee. But the functional recovery deficits related to muscle strength remains a rehabilitation challenge in most of the patients. The inclusion of negative muscle work (eccentric contraction) over concentric work has recently received rehabilitative attention. Objective: The aim of this study was to investigate the effect of combined eccentric-concentric program over the routine concentric program in alleviating pain, improving muscle strength and range of motion of knee joint after TKA. Methods: A prospective experimental design including 30 subjects following TKA was conducted. This study was conducted in Alva’s Health Center, Moodubidire, Dakshina Kannada, Karnataka, India. Thirty subjects who underwent unilateral TKA were randomly allocated in a 1:1 ratio into E-C (Eccentric-concentric) group and C group (concentric) during the routine early rehabilitation program post TKA. Outcomes measured for comparison included Numeric pain rating scale, circumferential measurement of thigh, active knee flexion – extension ROM and quadriceps muscle strength. Independent t test was used to analyse measurements taken at baseline and follow up at 6 weeks. Results: Follow up assessment at 6 weeks demonstrated a significant improvement in knee extension ROM and quadriceps muscle strength. No significant improvement was observed in pain, thigh girth and flexion ROM. Conclusion: These findings suggest that individuals undergoing TKA would benefit from the rehabilitation program that includes eccentric exercise in improving quadriceps strength and knee extension without lag.