After hip or knee surgery

Recovery and rehabilitation

Recovery after hip or knee surgery is a gradual process. Early movement, appropriate exercise, pain control and steady progression all play a part in rebuilding strength, mobility and confidence.

Overview

What does rehabilitation involve?

Rehabilitation helps you regain movement, strength and independence after surgery while allowing the tissues around the joint time to recover.

NICE recommends that rehabilitation after primary hip or knee replacement begins on the day of surgery if possible, and no later than 24 hours afterwards. Early rehabilitation includes mobilisation, advice about daily activities and a home exercise programme.

For many people, recovery then becomes increasingly self-directed. You continue the exercises and activity advised by the physiotherapy team and gradually build your walking, strength and everyday function.

Recovery is not identical for everyone. Age, general health, preoperative fitness, the operation performed and the complexity of the reconstruction can all influence progress.

Use your own recovery plan rather than somebody else's timetable.

The guidance on this page is general. Follow any weight-bearing restrictions, movement precautions, wound instructions and exercise programme given specifically to you.

The foundations of recovery

What helps you move forward

Recovery is more than exercise alone. Pain control, movement, strength, rest and confidence all work together.

Movement

Start moving safely

Nurses and physiotherapists help you begin standing and walking after surgery. Early movement supports circulation and helps restore independence.

Exercise

Follow your rehabilitation exercises

Exercises are used to restore movement, strengthen muscles and improve control around the operated joint. Perform the programme you have been given.

Pain

Keep pain manageable

Appropriate pain relief can make it easier to walk, sleep and complete exercises. Take prescribed medicines as directed and discuss inadequate pain control with your clinical team.

Swelling

Expect some swelling

Swelling and bruising are common after joint replacement and can persist for a period of time. Follow the advice provided about rest, elevation or cold therapy.

Pacing

Build activity gradually

Increase walking and daily activity steadily rather than trying to do too much at once. Recovery often has better and more difficult days.

Independence

Return to normal tasks

Everyday activities are reintroduced as mobility and confidence improve. Occupational therapy advice can help with practical tasks where needed.

Recovery pathway

How rehabilitation usually progresses

01

Early mobilisation

Rehabilitation starts in hospital with getting out of bed, standing, walking with appropriate support and learning the initial exercises.

02

Safe discharge

Before going home, the team will make sure you can mobilise safely enough for your circumstances and understand your medicines, exercises and practical precautions.

03

Building strength and function

At home, walking and exercises are progressed gradually. The focus shifts from simply getting around safely towards strength, endurance and normal daily activity.

04

Returning to normal life

Driving, work, hobbies and exercise return at different stages depending on your operation, recovery and the advice of the surgical team.

Hip and knee recovery

Different joints, different priorities

Many principles are shared, but hip and knee rehabilitation place emphasis on slightly different aspects of movement and recovery.

Hip replacement

Rebuilding walking and hip strength

Hip replacement rehabilitation focuses on safe walking, rebuilding muscle strength and gradually increasing everyday activity. NHS guidance notes that full recovery commonly takes several months.

  • Use walking aids for as long as advised
  • Follow any specific hip movement precautions
  • Build walking distance gradually
  • Complete the exercises prescribed by your physiotherapy team
  • Ask before returning to higher-impact or demanding activity
Knee replacement

Restoring movement and muscle control

Knee rehabilitation places particular emphasis on regaining bending and straightening, improving thigh muscle strength and rebuilding a confident walking pattern. Recovery can take several months or longer.

  • Work on the exercises provided for knee movement
  • Build thigh strength gradually
  • Use walking aids until you can mobilise safely
  • Expect swelling to fluctuate as activity increases
  • Continue exercises consistently rather than only when the knee feels easy
When to seek medical advice

Know the difference between expected recovery and a potential complication

Pain, tiredness, bruising and swelling can all occur during normal recovery. However, some symptoms need prompt assessment because they may indicate infection, a blood clot or another complication.

  • Increasing redness, heat, swelling or discharge from the wound
  • Fever or feeling significantly unwell
  • Increasing rather than improving pain without an obvious explanation
  • New calf pain, swelling, warmth or tenderness
  • A sudden change in the joint after a fall or injury
Seek urgent emergency assessment for sudden breathlessness, chest pain, coughing up blood or collapse.

These can be symptoms of a pulmonary embolism and require immediate medical attention. Use 999 or emergency services where appropriate.

Measuring progress

Recovery is about function, not just the calendar

Improvement often continues for months after joint replacement. It is usually more helpful to look at what you can do than to compare your progress with a fixed date.

Mobility

Walking further and more confidently

Progress may include needing less support, walking more comfortably and managing stairs or everyday journeys with greater confidence.

Function

Doing more for yourself

Dressing, preparing meals, household activity, work and hobbies gradually become easier as movement and stamina improve.

Strength

Rebuilding over time

Muscle strength and endurance take time to return. Consistent rehabilitation generally matters more than trying to accelerate recovery too quickly.

Frequently asked questions

Questions about recovery and rehabilitation

How long does recovery after joint replacement take?

Recovery varies between patients. NHS guidance says hip replacement recovery may take several months, while knee replacement can also take several months or longer. Your operation, health and rehabilitation all influence the timescale.

Do I need physiotherapy after surgery?

Rehabilitation starts in hospital. NICE recommends advice on mobilisation, daily activities and a home exercise programme. Many patients continue with self-directed rehabilitation, while supervised physiotherapy may be appropriate when additional support is needed.

How much should I walk?

Walking should be increased gradually according to comfort, safety and the advice of your physiotherapy or surgical team. More is not always better if a sudden increase causes excessive pain or swelling.

When can I drive again?

Driving depends on the operation, which side was treated, medicines, movement, strength and your ability to control the vehicle safely. Follow the advice of your surgeon and insurer rather than relying on a single general timescale.

When can I return to work?

This depends on your operation, recovery and the physical demands of your job. Desk-based work and heavy manual work usually require different recovery periods, so discuss your circumstances with the clinical team.

Questions during recovery?

Use your own rehabilitation plan as your guide

If you are unsure about activity, exercises, wound healing or your progress after surgery, contact the clinical team rather than changing your recovery programme based on general advice.