Recovery timeline
Every patient recovers at a different pace, your age, overall health, the procedure performed, and your commitment to physical therapy all shape the curve. These are the general milestones for hip and knee replacement patients.
Day of surgery
Up and walking
Most patients stand and take their first steps with a physical therapist the same day of surgery, using a walker.
Week 1
Home & virtual PT
Home with a walker or crutches. Short, frequent walks. Virtual physical therapy begins this week. Ice, elevation, and medications as prescribed.
Week 2
Outpatient PT begins
In-person outpatient physical therapy begins. Many patients transition from walker to cane this week.
Week 3
Walking & driving
Driving may resume for the left leg around 3 weeks if you are off narcotic pain medication and feel safe. Walking distances continue to increase.
Week 6
First follow-up visit
Your first in-office follow-up with Dr. Debbi, including X-rays. Most patients are walking without a cane indoors by this point and returning to desk work.
Weeks 6–12
Steady progress
Longer walks, stationary bike, swimming, and light resistance training as cleared by your surgeon. Driving usually resumes by this point for the right leg.
3–6 months
Most activities return
Return to golf, doubles tennis, hiking, and most recreational activities as directed. The new joint continues to feel more natural.
6–12 months
Full recovery
Strength, endurance, and comfort continue to improve for up to a full year. Final functional gains often come in this window.
Physical therapy
Physical therapy is the single most important factor in a good outcome. Our team will help coordinate home PT or outpatient PT with a therapist near you.
- Begin exercises the day of surgery as directed by your inpatient therapist.
- Virtual PT begins the first week at home; in-person outpatient PT typically begins around week 2 and continues for 6 to 12 weeks.
- Do your prescribed home exercises every day, short, frequent sessions work better than long ones.
- Walking is one of the best exercises. Start with short distances and build up gradually.
- Avoid high-impact activities (running, jumping) until explicitly cleared.
Managing pain and swelling
Some pain and swelling are expected for several weeks. HSS uses a multimodal approach that combines several non-narcotic medications with narcotic pain medicine used only as needed.
- Ice the joint for 20 minutes at a time, several times a day, especially after PT and walking.
- Elevate the leg above heart level when resting. Swelling is common for up to 3 months.
- Take pain medication before pain becomes severe and before physical therapy sessions.
- Transition off narcotic medication as soon as you comfortably can, most patients are off within 1–2 weeks.
- Stool softeners are important while on narcotic pain medication.
Wound care
- You leave the hospital with a waterproof dressing over the incision. Keep it on until your surgical team tells you to remove it, typically 7 days after surgery.
- You may shower 24 hours after surgery with the waterproof dressing in place. No scrubbing the incision.
- Do not soak in a bath, pool, hot tub, or the ocean until your surgeon clears you (usually 4–6 weeks, after the incision is fully healed).
- Some bruising, mild redness along the edge, and clear drainage in the first few days are normal.
- All sutures used are absorbable, nothing needs to be removed. They dissolve on their own over the first several weeks.
Preventing blood clots
Blood clots (DVT) are one of the risks of joint replacement surgery. You will be given a blood thinner, most commonly aspirin, for a defined period after surgery. Movement is the other key.
- Take your blood thinner exactly as prescribed.
- Do ankle pumps (pointing and flexing your feet) every hour while awake.
- Walk short distances frequently throughout the day.
- Wear compression stockings if prescribed.
Activity and return to life
- Driving: Typically 3 weeks for the left leg, 4–6 weeks for the right leg, and only once you are off narcotic pain medication.
- Work: Desk work at 2–4 weeks. Physical jobs 8–12 weeks or longer.
- Travel: Short trips at 3–4 weeks. Long flights generally after 6 weeks, get up and walk every hour and wear compression stockings.
- Sexual activity: When comfortable, usually after 4–6 weeks.
- Sport: Swimming and stationary bike at 6 weeks. Golf, doubles tennis, hiking, running, and skiing at 3–6 months as cleared.
When to call the office
Call 911 or go to the ER
Sudden shortness of breath, chest pain, or coughing up blood, these can signal a pulmonary embolism and are a medical emergency.
Call the office promptly for any of the following:
- Fever above 101.5°F (38.5°C).
- Increasing redness, warmth, or hardness around the incision.
- Drainage from the incision that is cloudy, yellow, green, or foul-smelling, or any drainage that persists past the first several days.
- Separation or opening of the incision.
- A calf that is newly painful, red, warm, or swollen, possible blood clot.
- Sudden new, severe pain in the operated joint.
- Inability to keep down food or fluids.
- A fall, even if you feel fine afterward.
Follow-up visits
Standard follow-up is at 6 weeks, 3 months, and 1 year, then periodically thereafter. X-rays are taken at most visits. Bring a list of questions, nothing is too small to ask.
Dental work after surgery
Wait at least three months before any elective dental work.
For any dental procedure that can cause bleeding, cleanings, extractions, root canals, you may need a single dose of prophylactic antibiotics. Check with our office before your appointment.
