What to Expect in the First Two Weeks After Total Knee or Hip Replacement Surgery
Choosing to have a total knee or hip replacement is a big decision and a hopeful one. It means you’re ready to reduce chronic pain and get back to doing the things you love. But like any major surgery, recovery doesn’t happen all at once. It begins with small, purposeful steps, especially in those crucial first two weeks.
Here’s what to expect during the early part of your journey.
Surgery Day: A Big First Step
Most people are surprised to learn that many joint replacement patients are discharged home on the same day as their surgery. This depends on your overall health and how quickly you can get moving afterward.
Here’s what typically happens right after surgery:
Pain Management: You'll receive medications to keep pain manageable, enough to let you move comfortably but not completely pain-free (and that’s okay).
Mobility Begins Early: You’ll be encouraged to stand and take a few steps (with help) within a few hours of surgery. If your home has stairs, you’ll likely practice them before being discharged.
Preventing Complications: To reduce the risks of blood clots or pneumonia, you might be given blood thinners and asked to do breathing exercises and simple movements.
Prepare: Before surgery, make your space fall-proof by removing throw rugs, clearing walkways, and keeping essentials within easy reach to avoid unnecessary bending or reaching.
Week 1: Transition and Adjustment
Once you’re home, the real work begins. The first week can feel tough, but you’re not alone and each day will get a little easier.
Pain and Swelling Management
Swelling is normal. Ice, elevate, and take your medications on schedule, don’t wait until pain builds up.
Getting Around
You’ll continue walking short distances daily using a walker or crutches. Movement is key to recovery and helps prevent complications.
Wound Care
Your surgical incision will most likely be covered with a dressing, which your care team will advise you on how and when to change.
Watch for signs of infection: increased redness, warmth, drainage, or fever. If you have any concerns, please don’t hesitate to give your surgical team a call.
Movement and Safety
The nursing or therapy team will review any specific movement restrictions you may have after surgery. Most of the time, total hip replacements have a bit more restrictions than total knee replacements. But, each doctor and each protocol may be different depending on the type of surgery.
Physical Therapy
Exercises will focus on improving range of motion, reducing stiffness, and beginning to rebuild strength.
Compliance is key. Follow your Physical Therapist’s instructions on how frequently to perform your exercises.
Nourish Your Body
Hydration and nutrition matter. You may not feel like eating much, so aim for small, protein-rich meals and plenty of fluids to help your body heal.
Week 2: Building Strength and Confidence
By now, you might be noticing progress: fewer aches, more confidence, and better movement.
Growing Independence
You’ll likely be walking more and, depending on your balance, may begin transitioning from a walker to a cane (with your therapist’s approval).
Reduced Pain
Pain typically starts to decrease, though some discomfort during activity or therapy is normal.
You may reduce your use of stronger medications and rely more on over-the-counter pain relief.
Physical Therapy Progression
Exercises will gradually become more challenging. Focus will be on improving range of motion, especially after a knee replacement.
Emotional and Mental Well-being
It’s completely normal to feel tired, frustrated, or a bit down. Don’t hesitate to lean on friends, family, or a counselor for support.
When to Call Your Doctor
Contact your surgical team immediately if you experience:
Signs of infection (fever, increasing redness or drainage)
Chest pain or difficulty breathing
Sudden, severe pain or swelling in the leg
A popping sensation or inability to move the joint normally
Final Thoughts
The first two weeks set the stage for everything that follows. While you won’t be back to normal just yet, each day brings real, meaningful progress.
Stay consistent, be patient with yourself, and trust the process. You’re doing the work, and your body is healing. And that’s something to be proud of.
Tip: Discuss setting realistic goals with your physical therapist. Everyone’s path is a little different but we’re here to help you every step of the way.
About the Author:
Laura Johnson is a physical therapist at our Appleton North and Touchmark clinics. She specializes in helping people recover from total joint replacements and assisting those with Parkinson’s in improving their independence and well-being through LSVT BIG programming.