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Joint replacement recovery starts the moment you wake up from surgery, and the first week sets the tone for everything that follows. After more than twenty years performing hip and knee replacements, here is what I tell my patients: the first seven days are uncomfortable, but they are also when you make some of your fastest progress. Most of my patients stand and take a few steps the same day. In this guide I walk you through what is normal, what helps, and the warning signs that mean you should call us right away.
What does joint replacement recovery look like in the first week?
The first week of joint replacement recovery is about three things: controlling pain, getting up and moving, and protecting the new joint. Most patients go home the same day or after one night, and walking begins within hours.
In my practice, I want patients out of bed and taking supported steps before they leave us. That early movement is not pushing too hard. It lowers the risk of blood clots and helps swelling drain.
You will feel tired. Anesthesia, blood loss, and the work of healing all add up. Short naps are fine. Long stretches in one position are not, because stiffness sets in fast.
How much pain is normal after joint replacement?
Real but manageable pain is normal in the first week, and it should ease a little each day. I tell patients to expect discomfort, not agony. We plan ahead so you are never chasing the pain.
Today we use what is called multimodal pain control. That means several gentle tools working together (acetaminophen, anti-inflammatory medicine when it is safe for you, a nerve block placed during surgery, ice, and elevation) so we lean on strong narcotics as little as possible.
What helps control pain in the first week?
Staying ahead of the pain is the single most useful habit in early joint replacement recovery. Take your medicine on the schedule we give you, not only when pain spikes.
Ice the joint several times a day for about 20 minutes. Keep the leg elevated above heart level when you rest. Move a little every hour while you are awake. These simple steps do real work.
When will I walk after joint replacement surgery?
Most patients walk within hours of surgery, often before they go home. A physical therapist helps you stand, transfer, and take your first steps safely with a walker or crutches.
For the first few days you will lean on that walker or those crutches. Most people move off them within a few days to a few weeks, depending on the joint and how steady they feel. Knee patients focus early on bending and straightening. Hip patients focus on safe positions to protect the new joint.
You may hear a clicking or clunking sound when you move, especially after a knee replacement. That noise comes from the metal and plastic surfaces of the implant and usually fades over the weeks ahead.
Is swelling and bruising normal after a joint replacement?
Yes. Swelling, bruising, warmth, and some numbness around the incision are all expected in the first week. Swelling can come and go for up to a year, and it is usually worst in the evening or after activity.
The fix is simple and it works: elevate the limb, ice the joint, and avoid sitting or standing in one spot for too long. If a compression stocking was prescribed, wear it as directed.
Swelling on its own is normal. Swelling paired with calf pain, marked redness, or new warmth deep in the leg is different, and I cover those warning signs next.
What warning signs should I watch for during joint replacement recovery?
Call your surgeon right away for chest pain, shortness of breath, a fever above 101 degrees Fahrenheit, calf pain or swelling, or spreading redness, drainage, or a bad odor at the incision. These can point to a blood clot or an infection, the two complications I most want to catch early.
Warning signs of a blood clot or infection
A blood clot in the leg may show up as new calf or thigh pain, tenderness, redness, or swelling. If a clot travels to the lung, it can cause sudden shortness of breath or chest pain that worsens with a deep breath. This is an emergency: call 911.
Infection warning signs include a persistent fever, shaking chills, increasing redness or tenderness at the incision, and new drainage. These are uncommon, but they are exactly why we stay in close contact during the first weeks. When something feels off, call us early rather than waiting.
The 7 essentials that support joint replacement recovery at home
Once you are home, your daily habits drive how smoothly the first week goes. Here is the short list I give every patient.
- Take pain medicine on schedule, not only when pain peaks.
- Move every hour you are awake; short, frequent walks beat long, tiring ones.
- Ice and elevate to keep swelling down.
- Keep the incision clean and dry until we clear you to shower or bathe.
- Do your prescribed exercises daily; effort here drives your results.
- Stay hydrated and eat protein to give your body what it needs to heal.
- Watch for warning signs and call early, not late.
By the end of the first week, most of my patients are walking farther, sleeping a bit better, and starting to trust the new joint. Full joint replacement recovery takes months, but the hardest, fastest-changing stretch is behind you.
Joint replacement recovery in Franklin and Middle Tennessee
I am Dr. Cory Calendine, a board-certified, fellowship-trained orthopaedic surgeon, and I perform more than 700 hip and knee replacements each year at the Bone and Joint Institute of Tennessee. That volume matters in the first week, because we have refined every step of recovery for the patients we serve across Franklin, Nashville, Columbia, and the surrounding communities.
Many of my patients are candidates for anterior-approach hip replacement, subvastus knee replacement, and robotic-assisted joint replacement using the Mako® system, techniques chosen to protect muscle and support a faster, steadier recovery. (Disclosure: I serve as a paid consultant to Stryker, the maker of the Mako robotic platform.)
If you are preparing for surgery, or recovering now and have questions, our team is here. Call us at (615) 791-2630 or request an appointment with Dr. Calendine. We are located at the Bone and Joint Institute of Tennessee, 3000 Edward Curd Lane, Franklin, TN 37067.
Medical disclaimer: This article is for general educational purposes only and does not replace personalised medical advice. Every patient and every joint replacement recovery is different. Always follow the specific instructions of your orthopaedic surgeon and care team, and contact them directly with questions about your own recovery. If you think you are having a medical emergency, call 911.
Watch: when does the pain stop during joint replacement recovery?
One of the most common questions I hear during joint replacement recovery is when the pain finally eases. In this short video, I walk through what to expect with knee replacement recovery and the timeline most patients can plan on.
