Recovering from a knee or hip replacement at home

After a knee or hip replacement, most of the recovery happens at home, and most of it is work: walking, daily exercises, and a house set up so the new joint is protected. The surgeon’s instructions come first, because they’re written for that person and that surgery. This note covers the common ground, from the National Library of Medicine’s discharge guidance for both surgeries, and the signs that mean call.^1,2

The short answer

• Use the walker or crutches as long as the surgeon or therapist says. After a knee replacement, that can be up to 3 months.^1,2
• Do the physical therapy exercises every day, and get up and move after about 45 minutes of sitting.^1,2
• Set up the house: no tripping hazards, grab rails in the bathroom, a firm chair with a back, and as little climbing of stairs as possible.^1,2
• Take blood thinners exactly as prescribed, and wear compression stockings if they were ordered.¹
• Call the surgeon for calf pain or swelling, chest pain, shortness of breath, a fever above 101°F, or redness, swelling or drainage at the incision.^1,2

Walking and exercise

• Use a walker or crutches as directed: up to 3 months after a knee replacement, and after a hip replacement until the surgeon says it’s fine to stop.^1,2
• Take short walks often, in nonskid shoes. Skip high heels and slippers.¹
• After a knee replacement, don’t twist or pivot with the walker, and don’t kneel or climb ladders.¹
• After a hip replacement, don’t put full weight on the new hip until the surgeon says it’s OK.²
• Do the physical therapy exercises at home every day, and get up and move after sitting for 45 minutes.^1,2
• After a knee replacement, ice the knee for 30 minutes before and after activity to help with swelling.¹
• Don’t carry anything heavier than 5 to 10 pounds. A pouch on the walker helps.¹

Protecting a new hip

A new hip can dislocate, especially in the first few months.² Avoid low chairs and soft sofas, and follow the movement precautions the surgeon gives.² Call the surgeon if the hip feels like it has slipped out of position, or if it’s hard to bend.²

Setting up the house

• Clear tripping hazards, like loose rugs and cords.¹
• Put grab rails next to the toilet and in the tub or shower, with a slip-proof mat.^1,2
• Keep a firm chair with a back in the rooms used most.^1,2
• Set up a bedroom on the first floor if possible, so there are no stairs to climb.^1,2
• Keep the bed low enough that the feet reach the floor when sitting on it.¹

Preventing falls at home goes room by room.

The incision

Keep the dressing clean and dry, and change it only if the surgeon says to. After a knee replacement, showering may be fine 5 to 6 days after surgery if the surgeon approves. Don’t scrub the incision, and don’t soak in a bath, hot tub or pool. Stitches or staples usually come out 10 to 14 days after surgery.¹ Wound care at home covers the signs of infection.

Preventing blood clots

After a knee replacement, people may wear compression stockings for about 6 weeks and take blood thinners for 2 to 4 weeks.¹ Take them exactly as prescribed, and never double a dose.¹ The short, frequent walks help too.

The signs of a clot in the leg are calf pain, or a leg that’s swollen, red and warmer than the other. Chest pain or shortness of breath can mean a clot has reached the lungs.² Call the surgeon for any of these, and call 911 if chest pain or shortness of breath comes on suddenly or is severe.

When to call the surgeon

• Calf pain or swelling, or one leg swollen, red and warmer than the other^1,2
• Chest pain or shortness of breath, and 911 if it’s sudden or severe^1,2
• A fever above 101°F (38.3°C)^1,2
• Bleeding that won’t stop¹
• Redness, swelling, more pain or drainage at the incision^1,2
• A foot or toes that look darker than normal or feel cool¹
• After a hip replacement, a feeling that the hip slipped out of position²

What home health adds

For people who qualify for home health, Medicare covers physical and occupational therapy at home, and skilled nursing for things like caring for a surgical wound and injections.³ Right after surgery, when leaving home takes a lot of effort, therapy at home fits. Once getting out is easier, therapy usually moves to an outpatient clinic. The science of physical therapy at home explains what the research shows.