Discharge Instructions After Hip & Knee Replacement

The surgery is behind you and you're home — and if you're like most patients, this is when the questions really start. The first few days after a hip or knee replacement are when people feel the most uncertain about what's normal. This guide is here to change that: to help you feel prepared, informed, and confident as you settle in at home. It's general education to set expectations — your surgeon's specific instructions always come first.

The first 24–72 hours at home

Most patients go home the same day or after a short stay, with a care partner to help for the first several days. Plan to lean on family or a friend early on — for meals, getting around, and staying on top of your medications. Two things surprise people most in this window: fatigue and the timing of discomfort.

Feeling wiped out is normal — your body is healing and the anesthesia and medications take a toll. And here's an important one to anticipate: it's common to feel more discomfort on day 2 or 3, not less. During surgery the tissues around the joint are numbed with a long-acting anesthetic; as it wears off, the soreness catches up. That's expected, not a setback.

Walking and activity

Early movement is one of the most important parts of a modern recovery. You'll be up and walking — with a walker for support — soon after surgery, and gentle, frequent walking from there is genuinely good for you: it builds strength, restores your stride, and helps prevent blood clots.

• Progress gradually — most patients move from a walker, to a cane, to no aids as balance and strength return.
• Short and frequent beats long and occasional — a few minutes several times a day, building up over time.
• Move without overdoing it — let comfort be your guide; if something hurts too much, ease off.
• Avoiding falls is the top priority — a fall in the early weeks can damage the new joint. Take stairs carefully and use your walker or cane until you're steady.

For the bigger arc of what each phase looks like, see the hip recovery timeline and knee recovery timeline. Remember that most patients keep improving for up to a year, so the early weeks are just the beginning.

Swelling and bruising

Swelling is a normal, expected part of healing — and it can travel down the leg into the ankle, foot, and toes. Bruising around the area is normal too. Swelling often eases over the first weeks but can linger for a few months; it improves steadily over time. Two simple tools make the biggest difference:

• Ice the joint regularly (never directly on the skin — use a cloth barrier).
• Elevate the leg above the level of your heart, with a pillow under the ankle — not under the knee. Propping the knee can leave it stiff and make it harder to fully straighten, which matters especially after a knee replacement.

For a deeper look at why a joint swells and how to manage it, see our guide to swelling after joint replacement. One distinction worth knowing: general, gradual swelling that improves with elevation is expected — but new, severe, one-sided calf pain and swelling is different and worth a prompt call.

Incision care

Incision care is mostly common sense, and the specifics depend on how your surgeon closed and dressed it — so the most important rule is to follow the instructions you were given. The general principles:

Some numbness around the incision is common and usually fades with time. If you notice increasing redness, warmth, or drainage, that's a reason to call the office (see below).

Medications

We'll keep this general on purpose — follow your own prescriptions and your surgeon's instructions, which are tailored to you. The modern approach to recovery rests on a few ideas:

• A non-opioid foundation — scheduled medications such as acetaminophen and an anti-inflammatory (as your surgeon directs), combined with ice and elevation, do most of the work of keeping you comfortable.
• Stronger pain medication is for breakthrough pain — used sparingly and weaned off as soon as your pain allows, because opioids have real downsides (constipation, grogginess, tolerance).
• Blood-clot prevention — you'll take a blood thinner for a period of time, alongside walking and ankle pumps, to lower clot risk.
• Expect constipation — it's common after surgery (less movement, pain medication, anesthesia). Hydration, fiber, a stool softener, and moving around all help.

Sleep, energy, and recovery

Two things catch patients off guard here: how tired you feel and how disrupted sleep can be in the first weeks. Both are normal. Your energy will fluctuate — a productive day is often followed by a tired one — because healing itself is hard work.

For sleep, many patients are more comfortable on their back with a pillow under the ankle, or on their side with a pillow between the legs. Keeping up with your comfort routine (medication timing, ice, elevation) before bed helps. Above all, be patient with the rhythm of it:

When to call your surgeon

Most of what happens in early recovery is normal. A few things, though, deserve a prompt call to the office — or, for the most serious, emergency care. Your surgeon's specific instructions always supersede this general guidance.

When in doubt, call — that's exactly what the office is there for. It is always better to ask than to wonder.

What patients commonly tell me

The first week tends to produce a very consistent set of reactions:

Every one of these is normal, and every one is easier to handle once you know it's coming. That's the whole purpose of this guide.

Recovery starts well before discharge, too — a confident first week begins with good preparation. If you're still in the planning stage, see how to prepare for joint replacement surgery, and — if you're still deciding whether it's time — the signs you may need a hip replacement or a knee replacement. The bottom line for these first days: most of what feels alarming is a normal part of healing, progress comes in small steps, and we're only a phone call away.