Hip and Knee Surgery

Yes. Some nerve pain is normal after knee replacement, especially in the early weeks. During surgery, small skin nerves get cut, stretched or irritated. This can cause burning sensations, tingling, pins and needles, numbness or shooting pains around the knee or down the leg. These symptoms most often occur outside your incision. They can appear anywhere around your knee or lower leg.

These sensations usually improve over weeks to months as healing happens. Mild numbness around the scar is common. It may last a long time but is rarely troublesome.

Contact your care team if:

• The pain is severe, worsening or not improving
• You notice new weakness, significant swelling or changes in skin colour
• The pain interferes with sleep or rehabilitation
• You have concerns that feel “not right” for you

Your care team can assess whether the pain is part of normal healing or whether additional treatment or advice is needed.

Some pain or soreness is common when you increase activity after hip or knee replacement. Your muscles, soft tissues and joints are still healing. They can get irritated as they adjust to more demands.

This type of pain usually:

• Feels like muscle ache or stiffness
• Improves with rest, ice and pain relief
• Settles within a day or two

Reduce your activity a bit, then increase it more slowly.

Contact your care team if:

• Pain is severe, persistent or worsening
• Pain does not settle with rest
• You notice increasing swelling, redness or warmth
• You cannot continue exercises or daily activities

A gradual, steady increase in activity is key to a safe recovery.

The operated leg often feels warmer than the other after hip or knee replacement surgery. Healing increases blood flow to the area. This can last up to 12 months. Seek medical advice right away if warmth comes with:

• Increasing redness, swelling, or drainage from the wound
• Worsening pain
• Fever or chills
• Sudden calf pain or swelling

These symptoms could indicate an infection or a blood clot and need urgent assessment.

Yes. Weakness or a sense that the leg may “give way” is common after hip or knee replacement. It often comes from muscle weakness, swelling and less confidence in the joint during healing.

Strength and control improve gradually with physiotherapy and regular exercises. This often takes several weeks to months.

Contact your care team if:

• The leg gives way often or suddenly
• Weakness worsens instead of improving
• You have new numbness, severe pain or loss of control

Using walking aids as advised and continuing your exercises will help improve stability and confidence as you recover.

Swelling in the leg, ankle and foot is very common after hip or knee replacement surgery. Gravity pulls fluid down the leg. This happens more when you are on your feet more.

Swelling can last weeks to months. It often improves with:

• Elevating the leg when resting
• Regular movement and exercises
• Ice (as advised)
• Anti-inflammatory medications
• Compression stockings (if prescribed)

Seek urgent medical advice if:

• Swelling is sudden, painful or much worse
• One leg swells much more than the other, especially in the calf
• You develop calf pain, redness or warmth
• You have shortness of breath or chest pain

These symptoms could indicate a blood clot and need prompt assessment.

You can usually shower immediately after surgery, as your dressing is waterproof. But avoid baths, pools, hot tubs and the ocean until the wound fully heals.

This is typically around four to six weeks after surgery, but timing can vary depending on how your incision is healing. Always follow the advice of your surgeon or care team, as going into water too early can increase the risk of infection. If you are unsure, check with your health-care provider before bathing or swimming.

You can apply cream or ointment once the incision is fully healed (skin closed, dry, no scabs, oozing, or signs of infection), usually around three to four weeks after surgery.

Once healed:

• Use a simple, non-perfumed moisturizer, bio-oil, or a silicone-based scar product (if recommended)
• Gently massage the area to help soften the scar
• Avoid applying creams directly over any open areas

If your surgery is in summer or you will face high sun soon after, apply sunscreen to the healed scar. Do not apply creams opr ointments to unhealed wounds. If unsure, ask your surgeon or health-care team before scar care.

Trouble sleeping is common after hip or knee replacement due to pain, swelling or stiffness. Safe strategies include:

1. Pain management:
   • Take prescribed pain medications as directed (including before bed, if advised)
   • Use over-the-counter pain relief (acetaminophen, NSAIDs) or prescription anti-inflammatories (if recommended)
2. Comfort measures:
   • Use pillows to support your leg, placing them under your leg, between your legs, or behind your back
   • Apply ice or cold packs earlier in the evening if swelling is contributing to discomfort
3. Sleep habits:
   • Stick to a regular sleep schedule
   • Keep the room cool and dark
   • Avoid screens or heavy meals before bed
4. Sleep aids:
   • Avoid taking benzodiazepines while also taking narcotic pain medication
   • Consider non-addictive sleep medications, such as melatonin

Important: Do not start new medications or supplements without asking your care team. Contact them if pain is severe or if sleep issues affect recovery.

Yes. Taper gradually and follow your surgeon’s instructions. Over-the-counter medications can replace stronger prescription painkillers. Never stop abruptly without asking your care team.

Using a walking aid after hip or knee replacement is strongly recommended, especially in the first few weeks, to protect your joint, prevent falls and support safe walking.

Key points:

• Most patients start with a walker, crutches or cane
• Choice of device depends on strength, balance and your physiotherapist’s advice
• Use an aid even if confident, as it cuts fall risk and helps your joint heal properly

Your physiotherapist will guide you in gradually reducing use. Weather, slippery conditions or surroundings may mean you need an aid for safety even if you no longer need one in your home.

Tip: It’s better to use an assistive device when needed than risk instability or injury.

Sedentary or desk-based work:

• Often around six to eight weeks after surgery, if pain is controlled and you can sit comfortably and move regularly
• Some people return sooner with modified hours

Active or physically demanding work:

• Often eight to 12 weeks or more, depending on job demands
• Allows time for strength, balance, and endurance to improve

Follow your surgeon’s advice and consider a gradual return or modified duties.

Most patients notice steady improvement in the first six to eight weeks, but full recovery can take up to 12 months. Pain, swelling and stiffness gradually improve, and strength and endurance continue to increase over time.

Remember that you have a new joint, made of different materials than the original. For this reason, some replaced joints never feel completely “normal” but can still provide excellent function with minimal pain regardless.

After knee replacement, kneeling or deep squatting may feel uncomfortable. It is usually safe once cleared by your surgeon and physiotherapist

For hip replacement, avoid bending the hip more than 90° in the first six to 12 weeks.

Always follow your surgeon’s advice for safe positions. Positions may vary by hip replacement approach. Check with your surgeon and physiotherapist.

Low-impact (walking, swimming, cycling): Often safe a few weeks after surgery, once your surgeon clears you.

High-impact (running, jumping, contact sports): May need three to six months or more, based on recovery and implant.

Build up gradually to prevent injury.

Mild clicking or popping is common and usually harmless. It comes from plastic and metal parts rubbing in the new joint.

Seek advice if it is accompanied by:

• Sudden pain
• Locking or catching of the joint
• Swelling or redness
• Instability

Yes, we strongly recommend an ice machine after a knee replacement. Cold therapy can significantly reduce pain, swelling, and bruising, making your recovery faster and more comfortable.

Benefits:

• Consistent, even cooling over the knee
• Longer, safer use than ice packs
• More convenient than bags or gel packs that melt
• Helps control inflammation, especially in the first few days
• Can improve sleep and mobility

Application time:

• Ice packs: 15 to 20 minutes per session, several times a day
• Ice machines: allow longer, controlled cooling, sometimes for hours at a time, in the first 48 to 72 hours
• Longer, consistent cooling is generally safe and may be more effective than short ice pack sessions

Tips for safe use:

• Use a protective cover or cloth between the skin and the machine
• Follow your surgeon’s or physiotherapist’s instructions
• Stop if your skin becomes red, numb or uncomfortable

Left hip or knee (automatic car):

• Often two to four weeks after surgery if you are comfortable, can bend and straighten your leg, and can react safely

Right hip or knee:

• Typically six weeks or more, as the right leg operates the pedals

Important considerations:

• Stop strong pain medications that dull alertness
• Have full leg control for emergencies
• Always check with your surgeon before resuming driving

Tip: Start with short, low-risk drives and gradually increase distance.

Yes, once you are comfortable sitting and moving your knee, but long trips require care:

Guidelines:

• Take breaks every 45 to 60 minutes to stand, stretch, and walk
• Elevate and move your leg during stops to reduce swelling
• Stay hydrated
• Follow your blood-thinning medication instructions
• Wear compression stockings (if advised)

Timing:

• Short trips: often safe within the first few weeks
• Longer trips: ideally four to six weeks, depending on recovery

Tip: Start with shorter drives to ensure tolerance before long trips.

Most modern implants do not trigger airport or security metal detectors, although some older implants may. Even if it triggers the metal detector, this is a common occurrence that airport staff are familiar with. You do not require a letter or certificate. Simply advise airport personnel about your replaced joint(s) if asked.

In most cases, routine dental work or minor procedures do not require antibiotics after a hip or knee replacement.

Key points:

• Antibiotics before procedures are only recommended in specific situations, usually if there is a high infection risk or your surgeon advises
• The need depends on medical history, type of implant and the procedure
• If recommended, antibiotics are taken just before the procedure, not continuously

Important:

• Always check with your orthopaedic surgeon or dentist
• Do not start antibiotics on your own

Modern hip and knee replacements typically last 15 to 20 years or more, depending on activity level, weight and overall health. However, complications such as infection, loosening or dislocation can still happen at any time.

Most patients do not need revision surgery in the first 10 to 15 years. Revisions may be needed if the joint wears out, loosens, or develops an infection.

Typically:

• First post-operative visit: two to six weeks after surgery
• Subsequent visits: around three months and/or one year
• After the first year, many patients have follow-up yearly or every few years, depending on their surgeon’s protocol