When considering joint replacement surgery, one of the first questions patients ask is: “How long will recovery take?”
The answer isn’t one-size-fits-all. Hip and Knee replacements follow distinctly different recovery paths, and understanding these differences can help you prepare mentally, physically, and practically for what lies ahead.
If you’re weighing your options or planning surgery, knowing what to expect week by week makes the journey less intimidating and more manageable.
Why Hip Replacements Typically Recover Faster
Hip replacement surgery is often described as more straightforward than knee replacement, and that difference shows up in recovery timelines.
The hip is a simple ball-and-socket joint. Surgeons can access it with minimal disruption to surrounding muscles, especially when using the Direct Anterior Approach (DAA). This approach works between muscle planes rather than cutting through them, which means:
- Less muscle trauma
- Less post-operative pain
- Faster return to walking
- Minimal soft-tissue healing required
Because the hip joint is naturally stable and doesn’t require extensive rehabilitation to regain range of motion, most patients feel confident walking within days.
Why Knee Replacements Take Longer
The knee is a complex, weight-bearing joint that allows flexion, extension, and rotation. It depends heavily on soft tissues, ligaments, tendons, and muscles to maintain stability and function.
Knee replacement surgery involves:
- Removing damaged cartilage and bone
- Balancing ligaments and soft tissues
- Ensuring proper alignment and stability
- Regaining range of motion through intensive therapy
Because of this complexity, recovery requires more time, effort, and rehabilitation. The first few weeks are often described as more painful and demanding than hip replacement.
Week-by-Week Comparison: What to Expect
Week 1–2: Early Days
Hip Replacement:
- Walking with support on the same day or next morning
- Minimal pain compared to pre-surgery arthritis
- Most patients use a walker for 1–2 weeks
- Ability to navigate stairs with assistance
Knee Replacement:
- Walking with support on the same day
- More swelling, stiffness, and discomfort
- Walker or crutches for 2–3 weeks
- Focus on regaining extension and reducing swelling
Week 3–6: Building Confidence
Hip Replacement:
- Independent walking indoors
- Driving (typically after 4–5 weeks)
- Outdoor walks and light activities
- Return to desk work
- Most patients are off the walker by week 6
Knee Replacement:
- Continued physical therapy (6–8 weeks total)
- Gradual improvement in flexion and extension
- Stiffness after prolonged sitting is common
- Walker may still be needed outside the home
6 Weeks–3 Months: Returning to Routine
Hip Replacement:
- Most patients feel 85% recovered by 6 weeks
- Comfortable with travel, longer walks, indoor cycling
- Muscle strength continues building
- Full recovery by 2–3 months for most activities
Knee Replacement:
- Noticeable improvement in pain and function
- Able to resume most daily activities
- Range of motion continues improving
- Still building strength and endurance
3–12 Months: Long-Term Recovery
Hip Replacement:
- Near-complete recovery by 3 months
- Full strength and endurance by 6 months
- Implant lifespan: 20–30+ years with modern techniques
Knee Replacement:
- Full recovery can take 6 months to 1 year
- Some patients take up to 2 years to feel “normal”
- Knee may remain slightly larger than the other side
- Range of motion may not fully match pre-arthritis levels
Why the Difference? It’s About Anatomy
The hip joint relies primarily on muscle strength for stability. Once the implant is in place, the hip functions almost immediately.
The knee joint depends on soft-tissue balance—ligaments, tendons, and capsule must all heal and adapt to the new implant. This takes time and deliberate rehabilitation.
Additionally:
- Hip surgery involves less bone and tissue removal
- The knee requires precise ligament tensioning
- Knee rehabilitation demands more active participation
- Swelling and stiffness are more pronounced in knees
Physical Therapy: Different Intensity, Different Duration
Hip Replacement:
- Therapy focuses on safe walking, strength, and avoiding dislocation
- Many patients require minimal formal PT (some surgeons prescribe none)
- Home exercises emphasize muscle activation and endurance
Knee Replacement:
- Intensive PT for 6–8 weeks is standard
- Focus on regaining flexion (bending) and extension (straightening)
- Exercises target stiffness reduction and quadriceps strength
- Commitment to therapy directly impacts outcomes
Which Surgery Should Come First?
If you need both a hip and knee replaced, hip replacement typically comes first.
Why?
- Hip recovery is faster (6 weeks vs. 6 months)
- Chronic hip pain can cause “referred pain” in the knee
- A painful hip interferes with knee replacement rehabilitation
- Replacing the hip first may reduce knee pain enough to delay or avoid knee surgery
The Bottom Line: Set Realistic Expectations
Hip replacement offers a faster, more predictable recovery. Most patients feel significantly better within 6 weeks and fully recover by 3 months.
Knee replacement requires patience and commitment. Recovery takes longer, therapy is more intensive, and full function may take 6 months to a year.
Neither timeline is “better” ; they simply reflect the anatomical and functional differences between these two critical joints. What matters most is choosing the right surgery at the right time and committing to the recovery process.
Schedule a consultation with Dr. Hulse to discuss whether hip or knee replacement is right for you and what you can expect every step of the way.