Joint Replacement Recovery: A Week-by-Week Guide to Healing

Key Takeaways

• Most people go home 1-2 days after surgery with specific movement restrictions
• The first two weeks focus on basic mobility and preventing blood clots
• Physical therapy starts immediately and continues for 3-6 months
• Full recovery typically takes 3-6 months for hip replacement, 4-6 months for knee replacement
• Following your therapy plan closely leads to better outcomes

Getting a new knee or hip joint is a big decision. You’re probably wondering what the recovery will really be like. This guide walks you through each stage of healing, from the day of surgery to getting back to your favorite activities.

Day of Surgery: What Happens

You’ll wake up in the recovery room with your new joint already in place. Here’s what to expect:

Immediate Care:

• Pain medication through an IV
• Compression devices on your legs to prevent blood clots
• A catheter (usually removed within 24 hours)
• Oxygen through a nasal tube

First Steps: Most patients stand and take a few steps the same day as surgery. A physical therapist will help you:

• Get out of bed safely
• Use a walker or crutches
• Practice going to the bathroom

It may seem too soon, but early movement is key to a good recovery. The goal isn’t to walk far—just to get moving.

Week 1: The Hospital and Going Home

Days 1-2 (In the Hospital):

• You’ll work with PT twice daily
• Learn how to navigate stairs safely
• Practice getting in and out of chairs
• Master using assistive devices

Discharge Checklist: Before you go home, you should be able to:

• Walk 150 feet with a walker
• Get in and out of bed independently
• Use the toilet safely
• Climb a few stairs (if you have them at home)

First Week at Home: Your main job is rest, ice, and basic movement. Here’s a typical daily routine:

Morning:

• Take pain medication before it wears off
• Perform ankle pumps and quad sets in bed
• Ice your joint for 20 minutes

Afternoon:

• Short walks around your home (5-10 minutes, several times)
• Practice exercises from PT
• Ice again

Evening:

• Another walking session
• Elevation with ice
• Pain medication before bed

Important Restrictions:

• Don’t twist your knee or hip
• Keep surgical dressing dry for 7-10 days
• Don’t drive (usually 4-6 weeks)
• Avoid bending your hip past 90 degrees (hip replacement)
• Don’t cross your legs (hip replacement)

Weeks 2-4: Building Strength

By the second week, you’ll notice progress. Pain starts decreasing, and movement becomes easier.

What You’ll Notice:

• Less pain medication needed
• Easier to get around your home
• Reduced swelling
• Better sleep
• More independence with daily tasks

Physical Therapy: You’ll likely have PT 2-3 times per week. Sessions include:

• Gentle range of motion exercises
• Light resistance training
• Balance work
• Gait training (walking properly)

Week 2 Goals:

• Walk 10-15 minutes without stopping
• Bend your knee to 90 degrees (knee replacement)
• Perform leg lifts without assistance
• Reduce walker use (transitioning to cane)

Week 4 Goals:

• Walk 20-30 minutes comfortably
• Use a cane or walk unassisted around your home
• Go up and down stairs more easily
• Shower independently

Common Challenges:

• Nighttime pain (can persist for weeks)
• Frustration with slow progress
• Swelling after activity
• Difficulty sleeping

Tips for This Phase:

1. Ice after every PT session and long walks
2. Elevate your leg when resting
3. Stay ahead of pain—don’t skip medication
4. Be patient with yourself

Months 1-3: Steady Progress

The second and third months bring noticeable improvement. Many people feel they’ve “turned a corner” around week 6-8.

Month 2 Milestones:

• Walk without assistive devices indoors
• Drive (with doctor’s approval)
• Return to light activities (grocery shopping, short outings)
• Sleep through most of the night
• Reduced swelling

Month 3 Milestones:

• Walk 30-45 minutes without pain
• Climb stairs normally (alternating feet)
• Stand from a chair without using your arms
• Return to many daily activities
• Discontinue most pain medication

Physical Therapy Focus:

• Strengthening exercises with resistance bands or weights
• Advanced balance training
• Activity-specific movements (squatting, lunging)
• Preparing for return to hobbies

Realistic Expectations: You’ll have good days and bad days. Swelling might increase after busy days. Some morning stiffness is normal. Your new joint may feel “different” but shouldn’t hurt like before surgery.

Months 3-6: Getting Back to Life

This phase is about returning to the activities you love—safely.

Month 4-5:

• Resume most normal activities
• Begin low-impact exercise (swimming, cycling, walking)
• Increased energy and stamina
• Joint feels more “natural”
• PT may decrease to once weekly or end

Month 6:

• Return to recreational activities (golf, gardening, dancing)
• Walk without noticeable limp
• Minimal to no pain
• Full range of motion (or close to it)
• Independence in all daily activities

Activities to Approach Gradually:

• Golfing: Start with putting, then short game, finally full swings
• Gardening: Use knee pads, avoid kneeling for long periods
• Travel: Take breaks to walk and stretch
• Sports: Low-impact only (check with your doctor)

Activities to Avoid Long-Term:

• High-impact sports (running, basketball, jumping)
• Heavy lifting (over 50 pounds)
• Activities with twisting motions

Physical Therapy: Your Secret Weapon

People who stick with their PT program have better outcomes. Here’s why it matters:

Benefits of Consistent PT:

• 30% faster return to activities
• Better range of motion
• Reduced risk of complications
• Stronger supporting muscles
• Improved balance and stability

What Makes PT Successful:

1. Attendance: Don’t skip sessions
2. Home Exercises: Do them daily, not just when you feel like it
3. Communication: Tell your therapist what’s hard or hurts
4. Progression: Gradually increase difficulty as you improve

Red Flags to Report:

• Exercises that cause sharp pain (not just discomfort)
• Increased swelling that doesn’t go down
• Weakness that gets worse
• Difficulty with movements you could do before

Tips for Faster, Safer Recovery

Before Surgery Preparation:

• Lose excess weight if possible
• Strengthen muscles through “prehab” exercises
• Arrange home setup (grab bars, raised toilet seat)
• Stock up on easy-to-prepare meals

During Recovery:

1. Ice religiously: 20 minutes on, 40 minutes off
2. Elevate: Keep leg above heart level when resting
3. Move regularly: Short, frequent walks beat long, infrequent ones
4. Stay hydrated: Helps reduce swelling and constipation
5. Eat protein: Supports tissue healing (aim for 75-100g daily)
6. Sleep quality: Use pillows for positioning, take pain meds before bed
7. Prevent infection: Keep incision clean and dry, watch for redness

Mental Health Matters: Recovery can be emotionally challenging. It’s normal to feel:

• Frustrated with limitations
• Worried about setbacks
• Impatient with slow progress
• Tired or overwhelmed

Support strategies:

• Connect with others who’ve had the surgery
• Set small, achievable weekly goals
• Celebrate milestones
• Ask for help when needed

When to Call Your Doctor

Most discomfort during recovery is normal. But some symptoms need immediate attention:

Call Immediately If You Experience:

• Sudden, severe pain that medication doesn’t help
• Fever over 101°F
• Increasing redness, warmth, or drainage from incision
• Calf pain, tenderness, or swelling in one leg
• Chest pain or difficulty breathing
• Inability to move your leg

Call Within 24 Hours For:

• Pain that steadily worsens instead of improving
• Persistent nausea or inability to eat
• Incision that opens or looks infected
• Confusion or extreme drowsiness
• Fall or direct impact to your new joint

Full Recovery Timeline

Everyone heals differently, but here’s what most people can expect:

Knee Replacement:

• 6 weeks: Resume most daily activities
• 3 months: Return to easy recreational activities
• 6 months: Full recovery for most people
• 1 year: Maximum improvement achieved

Hip Replacement:

• 6 weeks: Resume most daily activities
• 3 months: Full recovery for many people
• 6 months: Maximum improvement for most
• 1 year: Joint feels completely natural

Factors That Affect Recovery Speed:

• Age (younger patients often heal faster)
• Overall health and fitness before surgery
• Commitment to PT and home exercises
• Surgical approach used
• Complications or setbacks
• Support system at home

Looking Ahead

Joint replacement surgery can give you years—even decades—of pain-free movement. The recovery takes patience, but most people say it’s worth the effort.

Your new joint can last 15-20 years or more with proper care. Focus on:

• Maintaining healthy weight
• Staying active with low-impact exercise
• Following up with your surgeon as recommended
• Protecting your joint during activities

Remember: recovery isn’t a straight line. You’ll have great weeks and frustrating weeks. Trust the process, stick with your therapy, and give your body the time it needs to heal properly.

Frequently Asked Questions

How long will I need pain medication?

Most people need prescription pain medication for 2-4 weeks, then transition to over-the-counter options. By 6-8 weeks, many people need only occasional pain relief. Always follow your doctor’s tapering instructions.

When can I drive after joint replacement?

Typically 4-6 weeks for most people, but only after you’re off narcotic pain medication and can perform an emergency stop without hesitation. Right leg surgeries may require a longer wait. Get your doctor’s approval first.

Is it normal to feel depressed during recovery?

Yes, temporary depression or anxiety affects about 40% of joint replacement patients. The combination of pain, limited mobility, and dependence on others can be emotionally draining. Reach out to your doctor if feelings persist beyond a few weeks.

How much swelling is normal?

Some swelling is expected for 3-6 months. It’s usually worse at the end of the day and improves with elevation and ice. Sudden, severe swelling in one leg needs immediate medical attention.

Can I kneel after knee replacement?

Many people can kneel after full recovery, though it may feel uncomfortable. Start with a thick cushion and avoid prolonged kneeling. Some people never feel comfortable kneeling again—this doesn’t mean your surgery failed.

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Last medically reviewed: March 2025

Medical Disclaimer: This information is for educational purposes only and should not replace professional medical advice. Every patient’s recovery is unique. Always follow the specific instructions provided by your surgeon and medical team.