The principle, in one paragraph.
A joint replacement is a bearing. Metal runs on plastic, the plastic slowly sheds microscopic particles, and the body's reaction to those particles is what eventually loosens an implant. Anything that loads that bearing harder or more often uses it up faster. That is the whole of the activity advice, and everything below follows from it.
What it does not mean is that you should be careful with the joint. Being inactive after a joint replacement is its own harm, and it is the more common mistake. The aim is to be as active as you like in ways that do not repeatedly pound the bearing.
Reasonable, with no particular caveat.
- Walking, including hills and long distances.
- Swimming and water exercise, once the wound is fully healed.
- Cycling, road or stationary. One of the best options for both joints.
- Golf. Most people are back between eight and twelve weeks.
- Bowls, croquet, gardening.
- Gym work including weights, with technique guidance for the first few months.
- Dancing, yoga and Pilates, with sensible limits on deep flexion positions after a hip replacement.
Reasonable with judgement.
- Doubles tennis, yes. Singles is a different proposition because of the sprinting and the direction changes.
- Skiing, if you skied before. Groomed runs, controlled turns, not the first season. It is the fall that carries the risk, not the skiing.
- Hiking, yes, with poles on steep descents. Downhill loads a knee replacement considerably more than uphill does.
- Surfing and paddleboarding, generally fine, with the caveat that getting to your feet quickly is harder after a knee replacement than people expect.
- Horse riding, discussed individually. Mounting and dismounting are the problem rather than the riding.
Generally advised against.
- Running and jogging as a regular activity. Occasional running for a bus is not the issue; a training programme is.
- Contact and collision sport.
- Jumping sports, including competitive netball and basketball.
- Squash, for the same reason as singles tennis, more so.
None of these is forbidden, and you are an adult. What you are being told is what the trade is: repeated impact buys you activity now at some cost to how long the implant lasts, and that cost matters more the younger you are. See am I too young for a knee replacement for how that arithmetic works.
Hips come back faster than knees.
Worth saying plainly, because people compare notes with friends and worry. A hip replacement generally returns to activity sooner, with fewer restrictions and less rehabilitation, and most people stop noticing it entirely. A knee takes longer, asks more of you, and remains more aware of itself, particularly on stairs and kneeling.
The one caution specific to the hip is deep flexion combined with rotation, which is the position you reach getting into a low car or sitting on the floor and twisting. After an anterior approach this is much less of a concern than after a posterior one, and it is a caution rather than a prohibition.
Roughly when.
- 0 to 6 weeks. Walking, prescribed exercises, stationary cycling once the knee will turn the pedal.
- 6 to 12 weeks. Swimming once the wound is sealed and cleared, outdoor cycling, gym work, golf chipping and putting.
- 3 to 6 months. Full golf, doubles tennis, hiking, most gym programmes.
- 6 to 12 months. Skiing and anything requiring confident single-leg control. By twelve months the result is largely settled.
These are typical rather than prescribed, and your own reviews at six weeks, three months and twelve months are where the specifics get decided.
Ask about your activity, not activity in general.
Generic advice is more restrictive than individual advice, because it has to cover everybody. If a particular thing matters to you, name it in the consultation. The answer about your sport, on your joint, at your age is usually more permissive than the answer about sport in general, and it is the only one worth having.
Common questions.
Can I run after a joint replacement?
It is generally advised against. Not because the joint will fail on the day, but because impact accelerates wear of the polyethylene bearing, and bearing wear is what determines how long the implant lasts. The advice is firmer after a knee replacement than after a hip.
When can I play golf again?
Most people are back on the course between eight and twelve weeks, often starting with putting and chipping and building up. A hip usually comes back sooner than a knee. Use a buggy for the first few rounds.
Can I ski after a knee replacement?
Yes, if you skied before. Groomed runs, controlled turns, and not the first season after surgery. It is the falls rather than the skiing that carry the risk, so conditions and terrain choice matter more than the activity itself.
Can I kneel after a knee replacement?
Kneeling is not harmful to the implant. It is uncomfortable for many people and some never find it comfortable again, which is worth knowing before surgery rather than discovering afterwards. A cushion or a kneeling pad helps.
Will sport wear my joint replacement out faster?
Impact and high volume will, over decades. Low-impact activity does not meaningfully, and the health cost of not exercising is a real cost too. The sensible position is to be active in ways that do not repeatedly load the bearing.
When can I swim?
Once the wound is fully healed and your surgeon has confirmed it, usually around four to six weeks. Do not get into a pool, spa or the ocean with a wound that has not sealed.
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.