Day by day, then week by week, after a knee or hip replacement. Most people delay surgery for years because nobody told them honestly what the recovery involves — so here it is, including the parts that are genuinely hard.
Written and medically reviewed by Dr. Tarun Baghla, MBBS, MS (Orthopaedics)
Surgery takes 60–90 minutes, usually under spinal anaesthesia so you are comfortable but not fully asleep. Within a few hours a physiotherapist has you sitting, and most patients stand and take a few steps with a walker the same evening. It sounds alarming. It is deliberate — early movement is what prevents clots and stiffness.
Pain is controlled with a combination of medicines rather than one strong drug. You will walk further each day, learn to manage stairs, and start bending exercises. Most people are managing 90° of bend before discharge. Expect swelling and bruising — both are normal and both look worse than they are.
This is the stretch nobody warns you about. You are home, the novelty has gone, sleep is broken, and the exercises hurt. Walking indoors with a walker, icing several times a day, elevating the leg. Stitches or clips come out around day 12–14. Most people need help at home during this period — arrange it in advance.
Walker to a stick, then often to nothing indoors. Bending typically reaches 100–110°. Sleeping improves. You can usually return to desk work around week 4–6, and drive once you can perform an emergency stop without pain — commonly week 4–6 for a right knee, sooner for a left in an automatic.
Walking without support, stairs comfortably, most household activity. Bending 110–120° or more. Swelling after a long day is still normal and can continue for months — it is not a sign that something is wrong.
Strength keeps improving for a full year. Occasional aching in cold weather, some numbness in a patch of skin beside the scar (usually permanent, and harmless), and clicking sounds from the implant that mean nothing. Walking, swimming, cycling and gentle gym work are all encouraged.
Most patients who have had both say the hip was the simpler recovery. It hurts less early on and regains function faster — but it comes with movement restrictions the knee does not.
Walking with a walker on the day of surgery or the next morning, usually with full weight through the leg. Hip pain often improves immediately — the arthritic pain that kept you awake is simply gone, replaced by surgical soreness that behaves predictably.
You will be taught the hip precautions and they are not optional in the first six weeks: no crossing the legs, no bending the hip past 90°, no low chairs or low toilets, no twisting on a planted foot. These protect against dislocation while the tissues heal.
Walker to a stick around week 2–3, often nothing indoors by week 4–6. Stitches out around day 12–14. Desk work from week 3–4, driving usually week 4–6. A raised toilet seat and a high chair make this period considerably easier.
Most restrictions lift around six weeks once the soft tissues have healed. Walking distance builds steadily. Many patients describe forgetting which hip was operated on.
Unrestricted walking, swimming, cycling, travel. Running and contact sport are discouraged permanently — not because the hip will fail tomorrow, but because impact wears the bearing surface faster and you want this implant to last decades.
| When can I… | Knee replacement | Hip replacement |
|---|---|---|
| Stand and take a few steps | Same day | Same day or next morning |
| Go home | 2–4 days | 2–4 days |
| Walk without a walker | 3–6 weeks | 2–4 weeks |
| Climb stairs normally | 4–8 weeks | 3–6 weeks |
| Drive | 4–6 weeks | 4–6 weeks |
| Return to desk work | 4–6 weeks | 3–4 weeks |
| Return to physical work | 3–4 months | 3–4 months |
| Fly short haul | 3–4 weeks | 3–4 weeks |
| Attend a wedding and sit through it | 6–8 weeks | 4–6 weeks |
| Kneel or squat | Discouraged long term | Limited; avoid deep squatting |
| Sit cross-legged | Sometimes, after 3 months | Discouraged permanently |
| Feel it is “my own knee/hip” again | 6–12 months | 3–6 months |
Knowing these in advance is what stops people panicking when they happen — because almost all of them are normal.
Broken sleep, swelling, exercises that hurt, and a feeling that you have made a terrible mistake. Almost every patient has this week. It passes.
Finding a comfortable position is genuinely difficult early on. A pillow under or between the knees helps. It settles by around six weeks.
Ankle and knee swelling after a long day can persist for three to six months. Elevation and ice still help at month four. It is not a complication.
Small skin nerves are unavoidably cut. A patch beside the scar stays numb, often permanently. It causes no problem beyond the odd sensation.
Metal and polyethylene make sounds that cartilage did not. Painless clicking is normal and does not mean anything is loose.
Good weeks and bad weeks. A bad day after a good one does not mean you have damaged anything — usually it means you did more the day before.
Recovery goes measurably better for people who prepare. Most of this costs nothing.
Someone with you for the first two weeks, particularly at night. This matters more than any equipment.
Raised toilet seat, a firm high chair with arms, loose rugs removed, a night light, everyday items moved to waist height.
Four weeks of quadriceps exercises before surgery measurably speeds recovery afterwards. Ask for the protocol at your pre-op visit.
Insurance pre-authorisation, approved amount in writing, and leave from work arranged before admission rather than during it.
Know who will supervise your rehabilitation at home and book them before surgery, not after discharge.
Nobody should agree to surgery without knowing what the year afterwards looks like. Bring your X-rays and ask every question on your list — including whether you need it at all yet.
