If you or a loved one are considering hip or knee replacement surgery, then you are probably wondering about the timeline for surgery and recovery. In this post, we will review the timeline for joint replacement to help seniors and their families have a more realistic expectation of what to expect.
Before Surgery
Non-Surgical Treatments
Before resorting to surgery, doctors will generally try less invasive therapies. These might include physical therapy, oral medications, ointments rubbed into the sore joint, weight loss, or joint injections. Cortisone shots can last up to 6 months. Some people may take supplements such as glucosamine and chondroitin. These appear to work very well for some people, but not others.
Surgery, whether hip or knee replacement, is generally recommended only when the joint has degraded or been damaged to the point where other therapies fail. Traditionally, doctors recommend surgery when the patient can no longer tolerate the pain. Simply not being able to engage in athletic activities is generally not a criteria, but the pain and mobility issues have to affect everyday life.
Scheduling Surgery
Once the decision to go ahead with surgery has been made, your doctor will go through the kind of implant or implants they recommend and detail the risks of surgery. There are a variety of replacement joint implants available, and the right one depends on factors such as your age and your size. Generally, the waiting time at this point will depend on the scheduling of the surgical center of hospital. Knee and hip replacement surgery is generally not considered urgent.
In some cases, your doctor may recommend doing both knees or both hips at the same time. Doing a hip and a knee at the same time, however, is seldom recommended. Generally, the surgeon will want to do the hip first, although this may change if the knee is causing you more problems. The reason for this is that hip replacement is a much simpler surgery with a shorter recovery time, and that it is much easier to recover from hip surgery with a painful knee than the reverse.
You can do both knees at the same time, but while it can shorten recovery, it can also increase risk. In fact, double knee replacement is only recommended for younger people who are fit and have no other health problems. For most seniors, staged knee replacement is better, with the worse knee being replaced first. With hips, however, it is more common to do both at the same time because the surgery is much simpler and the recovery time is shorter.
For more information on knee replacement, check out our infographic: Preparing for Knee Replacement.
Preparing for Knee Replacement
Day of Surgery
When it comes time for the surgery, you will need to fast for at least 8 hours prior to the operation. Your doctor will instruct you to arrive early to your procedure. Hip replacement surgery takes between 1 and 2 hours. It can also be done as an outpatient procedure for individuals who are in good health. Knee replacement surgery generally takes up to 2 hours but does take a bit longer than hip replacement. For most seniors, a 1- to 4-day hospital stay is likely following surgery. You will not be discharged until you can sit up in bed and walk some.
After Surgery
After Hip Replacement
After hip replacement surgery, you will be put in a program of physical therapy. For 6 to 8 weeks, you will be receive outpatient therapy, and you will have to do exercises on your own for about 3 months. You will need some pain medication, which will be tapered off as you recover. You will need a walker, crutches, or other medical equipment and you won't be able to drive for 3 to 6 weeks.
Until you are fully recovered, you should avoid flexing your hip past 90 degrees, crossing your operated leg over your other leg, and walking pigeon-toed. Depending on how well you recover, these restrictions could last anywhere from 60 days to 6 months. You should continue to avoid activities with a high fall risk, such as skiing or roller-blading, and high-impact sports, such as running or soccer. Being limited in your mobility requires patience so you can heal properly.
After Knee Replacement
As with hip surgery, you will do a program of physical therapy. You will also not be able to navigate stairs for several weeks. You may also want to stock up on useful medical equipment to help you around the house.
It can take up to a year to fully recover from knee replacement surgery. Your leg may be put in a continuous passive motion (CPM) machine, which will continue to exercise your knee and keep it from stiffening up. Generally this is only while in the hospital, but some people get one to take home. You will have to wear a support stocking on the knee for a period of time. You will need to use a cane for the first few weeks, but should be able to return to everyday activities including driving by week 6.
During recovery, you should also be sure to get up every hour or so while sitting. If you absolutely have to sit for a long time, elevate the leg. Do not lift weights for at least 12 weeks after surgery. As with hip surgery, avoid activities with a high fall risk or ones which are hard on your legs.
Generally, most people fully recover from joint replacement surgery after about 6 months and can return to most of their prior activities, although you should always talk to your surgeon about specifics. During the recovery period, many seniors may benefit from home care services to help them perform tasks of daily living. At Caring, we offer a Hip & Knee Replacement Specialty Program that provides tailored training and services to help seniors who've undergone joint replacement. Reach out to your local Caring office to learn more.
