Recovery is the part you control.
The operation sets the ceiling on your result. What happens over the following twelve weeks determines how close you get to it. That is true of both joints and it is emphatically true of the knee, where the difference between a good result and a disappointing one is more often rehabilitation than surgery.
This page is the overview. The detailed, joint-specific version is in recovering from a hip replacement and recovering from a knee replacement, and what happens after the first year is in life after a hip replacement and life after a knee replacement.
The two joints are not the same, and advice does not transfer.
People arrive expecting hip recovery to resemble knee recovery, usually because a relative had the other one. The difference is large enough that advice about one is actively misleading about the other.
- A hip asks little of you afterwards. You walk on the day of surgery, there are usually no formal precautions after an anterior approach, and most of the recovery is walking a little and often. A short course of physiotherapy is typical.
- A knee asks a great deal. Full extension in the first fortnight, then supervised physiotherapy two or three times a week through weeks two to six, which is the window that decides the outcome. Twelve to eighteen sessions is typical.
Hip replacement, week by week.
- Weeks 0 to 2. Walk little and often. Full weight bearing. After an anterior approach there are usually no formal precautions. Wound reviewed at about two weeks.
- Weeks 2 to 6. Wean off aids as your gait normalises, in the order two crutches, one, none. Most people are walking unaided somewhere in this window.
- Weeks 6 to 12. Strength, balance and endurance. Cycling and hydrotherapy.
- 3 to 12 months. Stamina, and the last of the limp.
Knee replacement, week by week.
- Weeks 0 to 2. Full extension is the priority. Ice, elevation, quadriceps sets, heel slides. Swelling peaks in this period.
- Weeks 2 to 6. Progressive flexion and gait retraining. This is the window that decides the outcome, and consistency matters more than intensity.
- Weeks 6 to 12. Strength and endurance. Flexion continuing to improve.
- 3 to 12 months. Swelling and warmth settle slowly. Improvement continues well past six months.
Milestone reviews.
You are reviewed at about two weeks for the wound, then at six weeks, three months and twelve months. Those reviews are included in the surgeon's fee rather than billed separately, and they are the point at which a problem gets caught while it is still easy to fix.
The six-week review is the one that matters most after a knee replacement, because it is the last comfortable moment to act on stiffness. If flexion has stalled below 90 degrees at that point, a manipulation under anaesthetic works well; a few months later it works considerably less well.
Pain, sleep and swelling.
Expect the operated joint to be sore, expect it to disturb your sleep, and expect both to improve week on week rather than day on day. Most people are off strong analgesia within two to three weeks and using nothing regular by six.
Swelling lasts longer than anyone expects: six to twelve weeks after a hip, three months or more after a knee, worse at the end of the day and better in the morning. Warmth over a knee replacement for several months is normal and is not, on its own, infection.
Sleep is the thing patients find hardest and mention least. It is not a sign that something is wrong, and it settles.
Driving, work and travel.
Driving. Hip: when you can perform an emergency stop without hesitation and you are off strong pain medication, usually two to six weeks. Knee: usually four to six weeks, same test. Check your insurer's position rather than assuming.
Work. Desk work at two to six weeks, often part time first. Standing, ladders or heavy lifting is closer to three months. Certificates come from the rooms; if your claim is through WorkCover or CTP, they handle that directly.
Travel. Short domestic flights from about six weeks. Long haul is generally deferred to around three months because of clot risk, and should be discussed rather than assumed.
When to call the rooms.
Call (07) 5493 8038 if you develop a fever, a wound that is discharging or reddening, calf pain or swelling, new shortness of breath, a sudden loss of movement that had been improving, or pain that is escalating rather than settling after the first fortnight. In an emergency call 000.
None of those is a nuisance call. Suspected infection in particular is far easier to treat early than late.
Working with your physiotherapist.
Choose a practice you can reach easily, because attendance is the variable that matters, and book it before your surgery date rather than after. Written, procedure-specific protocols are provided and your physiotherapist can request them directly through the referrer page.
Common questions.
How long does recovery take after a joint replacement?
Most people are walking unaided between two and six weeks and back to ordinary life by about three months. A hip is usually further along than a knee at every point. Improvement continues past twelve months in the knee, particularly in swelling and the last of the stiffness.
How much physiotherapy will I need?
After a knee replacement, two or three supervised sessions a week for the first six weeks, plus daily work at home. After a hip replacement, usually a short course rather than a programme, because most of a hip recovery is walking.
When can I drive?
After a hip replacement, when you can perform an emergency stop without hesitation and are off strong pain medication, usually two to six weeks. After a knee replacement, usually four to six weeks and on the same test. Check your insurer's position.
When can I go back to work?
Desk work at two to six weeks, often part time first. Work involving standing all day, ladders or heavy lifting is more like three months. Certificates are issued by the rooms.
Is swelling normal?
Yes, and it lasts longer than people expect. Six to twelve weeks after a hip, and up to three months or more after a knee, worse at the end of the day. Warmth over the knee for months is also normal and is not infection on its own.
When should I call the rooms?
Fever, a wound that is discharging or reddening, calf pain or swelling, new shortness of breath, sudden loss of movement that had been improving, or pain that is escalating rather than settling. In an emergency call 000.
This page provides general information about a medical condition and a surgical procedure. It is not individual medical advice and does not replace consultation with a qualified practitioner. Outcomes vary between individuals and all surgery carries risk. A referral is needed for a consultation with Professor Daevyd Rodda; without one, you can start with the practice nurse practitioner, who can provide it.