Making the decision to undergo hip or knee replacement surgery is a big deal. While you may be looking forward to the idea of being pain-free and moving around more easily, it’s important to have a realistic outlook of the process.
Knowing what steps to take before the procedure—and what to expect after—can help ease any fears you may have about surgery and can help set you up for a successful recovery.
From operating room to recovery room
A typical hip or knee replacement surgery usually takes a few hours. Once the procedure is complete, you’ll be moved to a recovery room where you’ll be monitored while you wake up from the anesthesia.
“You can expect to be in the recovery room for a couple of hours, until the hospital staff determines you’re stable enough to move to a regular hospital floor,” says Ugo Ihekweazu, MD, an orthopedic surgeon at the Texas Orthopedic Hospital in Houston.
What to expect during your hospital stay
After the anesthesia wears off and you’re settled into your regular hospital room, you’ll likely feel tired. You may also start to feel pain, in which case the nurses will give you pain medication and ice for any swelling you’re experiencing at the surgery site.
Despite the discomfort you may experience, a big emphasis is often placed on moving around as soon as you’re able to tolerate it. “In some cases, that means getting up and walking even a few hours after surgery,” says Dr. Ihekweazu.
You’ll likely meet with a physical therapist who can show you how to properly use a walker, crutches or other assistive devices you may use to help you get around.
“Physical therapy is probably the most important thing that patients are doing at the hospital after the procedure,” says Ihekweazu.
Your post-surgery hospital stay could range from one night to a few days, depending on the procedure. “Recovery from hip and knee replacement surgery has improved considerably even over the last five to 10 years,” says Ihekweazu. “Historically patients would stay in a hospital for a week, maybe two. Now people have gone from staying in the hospital two to three days to an overnight stay. That’s the standard of care over the last couple of years.”
Shorter hospital stays are due in large part to improvements in surgical and anesthetic techniques, explains Ihekweazu. “Surgeons are using more minimally-invasive techniques so there’s less muscle damage, and patients are able to get up and walk pretty quickly after hip or knee surgery.”
Discharge day
The day after surgery, depending on how you’re feeling, your doctor may start talking about whether you’re ready to go home. But everybody is different—some people may feel eager to get home; others may not feel up to it right away.
“No one will rush you out of the hospital before you’re ready,” says Ihekweazu. “The key thing is safety. We want patients to go home when they’re safe to do so.”
Before you’re cleared for discharge, your doctor may want to confirm your ability to successfully do certain tasks on your own, including:
- Getting in and out of bed
- Walking with the use of a walker or crutches, and climbing a few stairs
- Eating, drinking and using the bathroom
- Moving your joint, especially bending and straightening the knee after a knee replacement
- Performing any recommended home exercises
- Managing pain with the prescribed treatment plan
Once you’re ready, and you’ve been approved for discharge, you’ll likely meet with a member of the hospital staff (often called a discharge planner) to go over any instructions you need to follow while recovering at home, including:
- How to properly clean and care for your surgical wound
- How to spot the warning signs of possible complications
- How to care for your new knee or hip
Creating an optimal post-surgery home environment
Setting yourself up for success once you get home from the hospital requires putting in some legwork before your procedure. A specialist at the hospital can also help you prepare for a successful transition back home.
One of the main components is making modifications around your home to ensure safety. An occupational therapist may even come to do a home evaluation. The Arthritis Foundation recommends:
- Eliminating clutter to make getting around easier and to reduce the risk of falls
- Elevating low furniture—like seats, beds and even toilets—to make getting up easier
- Installing a seat in the shower as well as grab bars
- Moving frequently-used items—like pots, pans and plates—to places where you can easily access them
- Strategizing ways to eliminate unnecessary trips up and down stairs—for example, if your bedroom is upstairs, creating a space for sleeping on the main floor
While assistive devices are also helpful after surgery, you may need to wait until after your procedure to see exactly what you’ll need. That said, having certain items on hand right away can be useful, such as:
- Ice packs, to help soothe pain and inflammation at the surgical site
- Comfortable, loose clothing that’s easy to get on and off and move around in
- Reachers and grabbers to help you get items stored up high and down low
- A walker basket, to help you move things around more easily
- A chair on wheels, to make it easier to get around when you’re not up for walking
- Compression stockings or TED hose to help reduce the risk for blood clots
You may also want to take time before surgery to enlist friends and family. “Any time you have a big operation, there’s going to be a phase of uncertainty where you’ve got to rely on other people,” says Ihekweazu. “If you're fortunate to have a big network of family and friends, I would activate them. I would ask them to come visit you in the hospital and at home and to go on those long walks with you after surgery that help with your rehab.”
Ihekweazu adds that building that support system can play a big role in supporting your emotional health, as well.
Moving for a successful recovery
If you’ve had a hip replacement, the best thing you can do once you’re home is get up and walk, do stretching exercises and make sure you’re moving every day, says Ihekweazu. “For most hip patients, there’s not really any expectation to do outpatient physical therapy,” he notes.
The scenario is somewhat different if you’ve had a knee replacement. “Most surgeons would want their total knee replacement patients to be in some sort of outpatient physical therapy program as soon as they leave the hospital,” says Ihekweazu.
The reasoning? According to Ihekweazu, surgeons may be concerned that certain patients don’t sufficiently move their knees after surgery, creating the potential for stiffness that could persist for several months. Taking part in physical therapy can help you regain range of motion, strength and balance.
Remember that it’s not uncommon to need help getting around at first. “Most patients after hip and knee surgeries go home with a walker and use it for about two to four weeks after the procedure,” says Ihekweazu. That can vary depending on how active you were prior to the surgery. “The more active you were beforehand, the quicker you’ll be able to get around without the walker.” When you no longer need a walker, you may still benefit from using a cane for another few weeks to a month.
Just don’t push it. “The most important thing is to be safe,” adds Ihekweazu. “Don’t try to rush yourself off of a cane or walker.”
Regaining a sense of normalcy
As the weeks go by during your recovery, you may start to wonder when you’ll get back to your old life. According to Ihekweazu, it typically takes six to eight weeks post-surgery for most patients to feel pain-free, while it’s not uncommon to take up to three to six months overall to start feeling normal again. Every patient is different, of course, and recovery times vary depending on your circumstances.
Check in with your doctor about any questions you may have, such as:
- When can I resume normal activities?
- When can I drive again?
- When can I return to work?
- When can I travel again?
“Have a conversation with your doctor,” says Ihekweazu, “and go from there.”
