Hip and knee replacement recovery at home: what to expect in the first six weeks

The short answer is that most people leave hospital two to three days after a hip or knee replacement, use a walking aid for the first few weeks, and regain strength and flexibility gradually over about 12 months. At Adeney Private Hospital in Kew, you recover at home, with a programme that starts before your operation.

This article explains how that works, what the first six weeks usually involve, and what it costs.

Recovery starts before surgery

Every joint replacement patient at Adeney is invited to our Orthopaedic Preadmission Clinic. It’s a one-hour group session, held on Wednesdays from 11am to 12pm, and you can come in person or join online. Bring a notebook, and a family member or support person if you’d like one there.

Our orthopaedic nurses explain what happens during surgery and during your stay. Our physiotherapists take you through prehab: simple exercises to build strength in the muscles around the joint before your operation. We talk through getting your home ready, and the support you’ll have once you’re back there. We also practice walking with crutches and discuss different aides to assist you post surgery.

Hundreds of Adeney patients have attended the clinic before their surgery, and over 90% have told us they felt better prepared for surgery afterwards.

How long will I be in hospital after a hip or knee replacement?

Most knee and hip replacement patients at Adeney stay on average two to three nights.

You’ll have a private room, and a physiotherapist will usually help you stand and take your first steps within hours of surgery. You go home when your surgeon and care team are satisfied you’re safe on your feet, your pain is managed, and you know your exercises. How long that takes depends on your health, your operation and the support you have at home.

Recovering at home, sooner

Adeney’s joint replacement pathway follows an approach called Enhanced Recovery After Surgery, or ERAS.

The idea is simple. Surgery is hard on the body, so everything around the operation is planned to make it less so. That planning starts well before you come in and carries on after you’re home.

Before surgery. Alongside the preadmission clinic and your prehab exercises, your team checks your general health and helps you get things like blood pressure or blood sugar settled first.

On the day. You won’t fast for longer than you need to. Your anaesthetist plans pain relief that keeps you comfortable without leaving you groggy and nursing staff will talk with you regularly about your pain and give you pain medication.

After surgery. A physiotherapist helps you up and walking within hours. You’re eating and drinking again soon after. Pain is managed with a combination of medicines, with stronger ones used only if you need them.

At home. Your rehabilitation carries on, with an exercise plan and our team checking in.

This is why you’ll spend less time in hospital than you might expect. Australian research supports this: for most people having a straightforward joint replacement, a stay in a rehab ward hasn’t been shown to lead to a better recovery than a supported programme at home.

You only go home when you’re safe and ready. If you live alone without support, or have health conditions that need closer monitoring, tell your surgeon early. They’ll plan the right arrangement with you and involve us in making sure everything is organised.

What support will I have at home?

You’ll leave hospital with an exercise plan from your physiotherapist and written instructions for your medications, wound care and follow-up appointments. Once you’re home:

Our Continuum of Care nursing team calls to check how you’re going.
Your physiotherapy continues at home, following the plan you set with your physiotherapist before you leave hospital. How often you have sessions, and for how long, depends on your operation and how you’re progressing.
Your surgeon or their practice team may also check in by phone or video call after your surgery.
You’ll be given Adeney’s Patient Services number to call if you have any post-surgery questions or concerns.

Getting your home ready

Most people don’t need to modify their home. A few small changes make the first weeks easier:

A stable chair with a firm seat, a firm back and two arms
Loose rugs and electrical cords cleared from where you walk
Secure handrails on stairs, and in the shower if you need them
A shower chair, and a long-handled reacher for picking things up
Meals in the freezer, and someone lined up to drive you

It also helps to have someone with you for the first day or two.

What do the first six weeks look like?

Everyone’s recovery runs at its own pace. As a general guide:

Weeks one and two. You’ll walk with a frame or crutches, do your exercises several times a day, and rest between them. Swelling and tiredness are common. You won’t be driving.

Weeks three to six. Walking gets easier and you’ll go further. Many people move from crutches to a stick, then to nothing. Your exercises change as your strength returns.

After six weeks. Most people are back to most everyday tasks, with improvement continuing for months. For knees in particular, strength and flexibility keep coming back over about 12 months.

Your physiotherapist and surgeon will set the pace for you.

When can I drive after a knee or hip replacement?

There’s no single rule in Australia. Many surgeons use around six weeks as a guide. It can be sooner if the operation was on your left leg and you drive an automatic.

You need to be off strong pain medication, able to get in and out of the car comfortably, and able to brake hard in an emergency. Ask your surgeon before you drive, and check with your car insurer.

How long does a knee replacement last?

A long time, for most people. A review of national joint registry data, including Australia’s, estimated that around 82 per cent of total knee replacements were still in place after 25 years. How long yours lasts depends on things like your age, weight and activity, which your surgeon can talk through with you.

What does joint replacement cost at Adeney?

For Medibank and Bupa members with eligible hospital cover, Adeney is zero out-of-pocket. You may know it as “no gap”. That means there’s no additional charge, at the point of care, for:

Surgeon and surgical assistant fees
Anaesthetist fees
Perioperative physician fees
Onsite radiology
Inpatient pathology
Inpatient pharmacy

You may still pay an excess or co-payment, depending on your policy. That’s set by your fund. Prostheses that aren’t on the Government’s Prescribed List, and some medications not on the PBS, can also sit outside the arrangement.

You’ll have all of this in writing before admission. For the full detail, read our Zero out-of-pocket, explained article. Patients with other funds, or without cover, are welcome on standard fee terms with a written estimate.

FAQs

How long does it take to recover from a knee replacement?
Most people manage everyday tasks within about six to twelve weeks. Strength and flexibility continue to recover over about 12 months. Doing your exercises matters.

How long will I be in hospital after a hip replacement?
At Adeney, usually two to three nights. You go home when your care team is satisfied you’re safe and ready.

Does Adeney offer inpatient rehab?
Adeney follows an enhanced recovery pathway, where your rehabilitation starts in hospital within hours of surgery and continues at home with support from our team. If home recovery isn’t right for your situation, your surgeon will plan an alternative with you.

What is enhanced recovery (ERAS)?
Enhanced Recovery After Surgery is a way of planning everything around your operation, from preparation and pain relief to early walking and support at home, so surgery is less taxing on your body.

When can I drive after a knee replacement?
Many surgeons use around six weeks as a guide. You need to be off strong pain medication and able to brake firmly. Your surgeon makes the call.

What is prehab?
Exercises you do before surgery to build strength around the joint. Adeney’s physiotherapists introduce them at the Orthopaedic Preadmission Clinic.

Is joint replacement at Adeney no gap?
For eligible Medibank and Bupa members, there’s no additional charge at the point of care for surgeon, anaesthetist and related in-hospital fees. An excess may apply, and some exceptions exist.

To book a preadmission clinic session, call (03) 7049 5256, Monday to Friday, 8am to 4pm. To find a surgeon, see our orthopaedic specialists.

This article is general information and isn’t a substitute for advice from your own surgeon or GP. All surgery carries risks, and recovery differs from person to person.

References

Healthdirect Australia. Knee replacement. healthdirect.gov.au/knee-replacement
Buhagiar MA, Naylor JM, Harris IA, et al. Effect of inpatient rehabilitation vs a monitored home-based program on mobility in patients with total knee arthroplasty: the HIHO randomized clinical trial. JAMA. 2017;317(10):1037–1046. doi:10.1001/jama.2017.1224
Onggo JR, Onggo JD, de Steiger R, Hau R. The efficacy and safety of inpatient rehabilitation compared with home discharge after hip or knee arthroplasty: a meta-analysis and systematic review. J Arthroplasty. 2019;34(8):1823–1830.
Evans JT, Walker RW, Evans JP, et al. How long does a knee replacement last? A systematic review and meta-analysis of case series and national registry reports with more than 15 years of follow-up. Lancet. 2019;393(10172):655–663.
Adeney post-prehab clinic patient feedback.