HIPS OR KNEES: WHICH IS A FASTER RECOVERY?
The surgical procedure for a total hip replacement is slightly shorter surgery than a total knee surgery because the hip joint is a simpler joint. The knee joint has to rotate and flex, absorbing loads from off-center to keep us upright, and it has to move the body from side-to-side. A surgeon has a more complicated job to ensure everything is balanced and stable when replacing a knee joint. Because of this, after a knee replacement, there is more tissue healing for the body to complete compared to a hip replacement.
Therefore, expected full recovery times for replacement hips tend to be shorter than for replacement knees.
Generally speaking, a complete recovery for a knee replacement is 3-12 months and for a hip replacement is 2-6 months. Complete recovery is achieved when the surgical wounds and soft tissue are thoroughly healed, when you feel well enough to return to your activities, and when your joint’s functions and range of motion are considerably improved. In both cases the body may continue recovering for up to 2 years, although this may not be particularly noticeable to the individual.
THE JOINT REPLACEMENT JOURNEY AND TIMELINE
You may know someone who had hip or knee replacement surgery and went home the same day. In the past, hip and knee replacement surgery required a hospital stay lasting several nights. With advances in procedural techniques, anesthesia medications, pain management and rehabilitation, many people can now have a joint replacement surgery without spending a night in the hospital.
The facilities where you will be able to go home on the same day after surgery include stand-alone ambulatory surgery centers (ASC) and outpatient surgery centers affiliated with a hospital. An example of an ASC is Sequoia Surgical Pavilion in Walnut Creek, California. Both knee and hip replacements for privately insured and Medicare patients may be done in an ASC or outpatient surgery center when the patient is healthy enough to have surgery in such a setting and has the appropriate home setting and support. If you have a separate medical issue, and are expected to need care for longer, then your joint replacement surgery would likely take place in the hospital setting. Your orthopedic surgeon can help you decide if you are a candidate for outpatient hip or knee replacement surgery.
HOW LONG DOES A JOINT REPLACEMENT SURGERY TAKE?
Whether having joint replacement surgery in an ASC or as a patient in a hospital, the length of the procedure itself is the same, about 1.5 hours for a hip and 2 hours for a knee. However, the total time spent in the healthcare facility is shorter when comparing surgery in an ASC vs. in a hospital.
WHEN CAN I GO HOME AFTER JOINT REPLACEMENT SURGERY?
If you are admitted to hospital, you will likely spend one or two nights in the hospital. If you are having surgery in an ASC, you will stay less than 24 hours. After surgery is complete, you would spend some time in a post-anesthesia-care-unit (PACU). This is a ‘recovery room’ area that allows you to recover and start practicing standing and walking. The typical recovery room stay ranges from about 1 to 1-1/2 hours. Patients are permitted to go home as soon as discharge criteria are met. These criteria usually require that you:
Have stable vital signs such as blood pressure and heart rate
Are safe walking with crutches or a walker
Feel good enough to eat and drink without nausea
Have no dizziness or drowsiness
Can got to the bathroom
Have pain well controlled.
WHEN CAN I WALK AFTER JOINT REPLACEMENT SURGERY?
Most surgeons and hospitals today emphasize getting you out of bed quickly. Most people are walking with the assistance of a walker on the day after surgery and using a cane or nothing at all by two to four weeks. Early ambulation (walking) has been shown to reduce the risk of a post-operative blood clot and is an important part of recovery. Progression to using a cane or nothing at all typically occurs within the first month or two after surgery. Despite the rapid progression to moving without assistance, it is typically not recommended to return to sporting activities until the third month after surgery, and even then, high impact activities are to be avoided altogether.
WHEN CAN I DRIVE AFTER TOTAL JOINT SURGERY?
Most surgeons allow patients to drive once they stop taking pain relievers and the patient can operate the vehicle normally and without pain, usually at around 2 to 4 weeks. You should not drive while on narcotic pain medications and should discuss returning to driving with your operating surgeon.
WHEN CAN I GO BACK TO WORK AFTER JOINT REPLACEMENT?
Returning to work is highly dependent on your general health, activity level and demands of your job. Most patients can return to a job within six weeks following surgery, depending on the demands of the position. If you do have a more demanding job that requires lifting, walking, or travel, you may need up to three months for full recovery.
HOW LONG DOES IT TAKE TO COMPLETELY RECOVER FROM A JOINT REPLACEMENT?
HIP:
Two to six months
The majority of people who undergo total hip replacement are able to participate in a lot of their daily activities by six weeks. By three months, most people have regained much of the endurance and strength lost before or around surgery and can participate in daily activities without restriction.
KNEE: Three to twelve months
For a knee replacement, it can take up to three months for you to return to most activities, and likely six months to one year to fully recover maximal strength and endurance. This depends on your condition before surgery, additional medical problems, and your commitment!
HOW TO SPEED UP RECOVERY FROM A KNEE OR HIP REPLACEMENT
It might be odd to think this, but recovery from joint replacement surgery actually begins before surgery. To improve the likelihood of a quick and smooth recovery from knee and hip replacement surgeries, follow these guidelines prior to surgery:
BEFORE SURGERY:
PREPARE YOURSELF
The physical preparations you make may affect both the outcomes of the surgery and your recovery time.
Health: Get in better physical shape if needed
Smoking: If you smoke, cut down or quit altogether several weeks in advance of surgery. Smoking affects blood flow and could delay healing
Diet: Eat a well-balanced, healthy diet. If you are overweight, your physician may recommend a weight loss program before surgery.
PREPARE YOUR HOME
Take steps before going home that will help make your recovery easier and faster. Planning ahead is the key to minimizing stress and optimizing your outcome.
Get Help: Upon returning home, arrange for someone to assist you for 1-2 weeks after hospital discharge
Meal Preparation: Stock up on pre-made meals or ready-made food prior to your surgery
Safety: Remove throw rugs and other items from the floor that could cause you to slip. Chairs and couches should be at knee level or higher for ease of sitting and standing
Assistive equipment:
A long-handled sponge for bathing
A grabbing device to eliminate unnecessary bending or reaching
Disabled Parking Permit: You may apply for a temporary disabled parking permit from the DMV to use for several weeks after surgery.
GO TO JOINT CLASS
Joint classes are classes that help patients prepare for joint replacement surgery. In a joint class the clinical staff teach participants what to expect before, during and after surgery, and how to plan for their part in a successful surgical outcome.
Once surgery is completed, follow your surgeon’s directions and protocols. These have been designed to keep you comfortable and optimize your recovery. Post-surgical activities may include the following:
AFTER SURGERY:
Use all equipment as directed – ice machines, braces, compression devices
Commit to your Physical Therapy visits and prescribed home exercise routines
Stick to your prescribed medication schedule
Attend follow-up appointments. A typical follow-up schedule for a total hip or knee replacement is:
Two to three-week follow-up for a wound check
Six-week follow-up to evaluate your recovery with new x-rays
Three month appointment after Physical Therapy is completed
One-year. This is often considered the point of full recovery for a joint replacement
5 and 10 years.
HOW LONG WILL MY NEW JOINT LAST?
According to the American Association of Hip and Knee Surgeons:
“A total joint replacement lasts 15-20 years. A more accurate way to think about longevity is via the annual failure rates. Most current data suggests that both hip and knee replacements have an annual failure rate between 0.5-1.0%. This means that if you have your total joint replaced today, you have a 90-95% chance that your joint will last 10 years, and an 80-85% that it will last 20 years. With improvements in technology, these numbers may improve.”
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