While individual results vary based on patient factors, diagnosis, and type of procedure performed, some generalizations about recovery from joint replacement can be made. The majority of joint replacement procedures performed in the United States are done as in-patients. The in-patient stay can range typically from one to four days depending on the institution, patient, and surgeon. The surgery typically takes one to two hours to perform. For patients done in the AM, commonly we get our patients up ambulating that afternoon walking weightbearing as tolerated with a walker or crutches after hip and knee replacement surgery. Exercises are begun the day of surgery and progress for each day the patient is hospitalized. Based on many factors, the patient will continue to ambulate each day and when they meet the goals of being able to ambulate independently with a walker or crutches, getting in and out bed with minimal assist, and being able to get to and from the bathroom, they are ready for discharge. Once discharged, we allow our patients to weight bear as tolerated using their walker or crutches for one to two weeks. At that point, when they feel comfortable, they can advance to a cane in the opposite hand, for hip replacements following some simple precautions and for knee replacements working on range of motion exercises.
The majority of patients who have undergone both a hip and knee replacement will state that the hip replacement was an easier recovery. This has to do in large part to range of motion exercises that are very important for knee replacement patients. We stress early recovery of full functional range of motion which is generally in the range of 0, or full extension, to 115 to 120° of flexion. It is the extremes of motion that require the most diligent rehabilitation.
Patients at one month typically are off their assistive devices, still walking with a slight limp but improving weekly. By two months, over half of the pain that was present preoperatively has resolved and patients continue to improve monthly up to 12 months after surgery.
While there have been a variety of technique changes over the last several years, it is a combination of surgical technique, perioperative anesthetic/analgesia, and managed rehabilitation programs that have led to a more rapid recovery. We recommend that patients do not drive a car if they have had their right lower extremity operated on for approximately four weeks based on reaction time studies for patient safety.
For more information about recovery from joint replacement surgery, contact your orthopedic surgeon or the American Academy of Orthopaedic Surgeons web site.