Recovering from Joint Replacement at Home

Twenty years ago, people stayed in the hospital for a week after a hip or knee replacement, then went to a rehabilitation facility for another week or two. Now, many patients go home within a day or two of surgery.

This isn't because we're cutting corners. It's because we've learned that most people actually recover better at home, with home health support, than in institutional settings. You get more personalized attention, lower infection risk, better sleep, and you're learning to function in your actual environment.

But it does mean you need to know what you're doing. Here's the practical guide.

Before Surgery: Get Ready

The better prepared you are before surgery, the easier recovery will be.

Set up your recovery space. A chair that's easy to get in and out of, with armrests. A raised toilet seat and grab bars in the bathroom (or at minimum, know you'll need these and arrange to get them installed quickly after you're home). Ice packs. A reacher/grabber so you don't have to bend down.

Do any exercises your surgeon recommends. Strengthening your legs before surgery gives you a head start on recovery.

Line up help. You're going to need someone around for at least the first week, maybe longer. Meals prepared or ordered. Grocery shopping handled. Someone to drive you to follow-up appointments.

Understand your medications. You'll come home with prescriptions - probably pain medication, blood thinners, possibly antibiotics. Know what you're taking and why before you have surgery.

The First Week: Survival Mode

The first few days at home are the hardest. Pain is at its worst, you're adjusting to medications, and everything feels difficult.

Pain management is the priority. Take your pain medication as prescribed, not just when you "really need it." Staying ahead of the pain is much easier than catching up once it's severe. As days pass, you'll gradually need less.

Icing and elevation help. Use ice packs on your surgical site (with a cloth between the ice and your skin) several times a day. Keep your leg elevated when you're sitting or lying down.

Home health starts quickly - usually within a day or two of coming home. A nurse will check your incision, review your medications, monitor for complications, and make sure you know the warning signs to watch for. A physical therapist will start gentle exercises and make sure you can move safely.

For the first week, your job is mostly to rest between PT sessions, do your prescribed exercises, manage your pain, and not fall.

Weeks 2-4: Building Momentum

As you get past that first week, things start feeling more manageable. Pain decreases, you need less medication, and you're able to do more.

Physical therapy intensity increases. You'll work on walking farther, building strength, maybe starting stair training if you have stairs at home. You might transition from a walker to a cane.

The home health nurse visits less frequently but continues monitoring your incision and overall progress. Most surgical incisions are fully healed by 2-3 weeks.

You can start doing more daily activities, but don't overdo it. The biggest mistake at this stage is doing too much because you're feeling better, then having a setback.

Specific Precautions

Hip and knee replacements have different recovery considerations.

After hip replacement (especially with a posterior approach), you'll have movement restrictions for 6-12 weeks:

Don't bend your hip past 90 degrees - so no low chairs, no picking things up off the floor without your reacher, no putting on shoes and socks the normal way.

Don't cross your legs or turn your operated leg inward.

These precautions exist because your hip can dislocate if you push it too far before it heals. Your surgeon will tell you exactly what your restrictions are and when they lift.

After knee replacement, the focus is on bending and straightening:

Your goal is eventually getting your knee to bend at least 120 degrees and straighten completely. This is what physical therapy focuses on heavily.

Expect significant swelling - it's normal and can last for months. Keep icing and elevating.

Warning Signs

Contact your doctor or home health agency immediately if you notice:

Fever over 101 degrees - could indicate infection.

Increased redness, warmth, or drainage from your incision - also possible infection signs.

Calf pain, especially if one calf is more swollen than the other - could be a blood clot.

Chest pain or sudden difficulty breathing - could also be a blood clot that traveled to your lungs.

Sudden increase in pain that's not explained by increased activity.

These things can happen even when you're doing everything right. Don't ignore warning signs.

Timeline for Returning to Normal

Everyone recovers at their own pace, but here's a general timeline:

2-3 weeks: Walking short distances with a walker, basic self-care mostly independent.

4-6 weeks: Walking with a cane or independently, able to do most daily activities. Most people are done with home health by this point.

6-8 weeks: Usually cleared to drive (once off narcotic pain medication and able to react normally).

3 months: Most daily activities feel comfortable. Many people return to low-impact exercise.

6-12 months: Considered fully recovered. Many people forget they even had the surgery.

The Role of Home Health

Home health nursing and physical therapy bridge the gap between hospital and full independence.

The nurse watches for complications in those critical early weeks when problems are most likely to develop. The PT gets you moving safely and confidently in your own environment.

Typically, you'll have nursing visits a few times in the first week or two, then tapering off. PT might continue for 4-6 weeks, with visits becoming less frequent as you improve.

By the time home health discharges you, you should be safe to continue your recovery independently, with a clear exercise program to follow and knowledge of when to call your surgeon with concerns.

The Bottom Line

Recovering from joint replacement at home is the norm now, and for good reason - most people do better at home than in facilities.

Take it seriously, do your exercises, follow your precautions, watch for warning signs, and give yourself time. In a few months, you'll have a new joint that could last 20+ years.