What to Expect at Discharge
Most patients are discharged from hospital 1–3 days after joint replacement surgery and even sooner after keyhole procedures. At discharge, you should receive:
- A written summary of your procedure and any specific precautions
- Medication to take home — usually pain relief, blood thinners (for lower limb surgery) and possibly antibiotics
- Wound care instructions and a date for wound check or stitch removal
- Basic mobility aids — crutches, a frame, or other equipment appropriate to your procedure
- A physiotherapy exercise sheet with your initial home programme
- A follow-up outpatient appointment date
If you haven't received clear instructions on any of these before you leave, ask before you go.
Preparing Your Home Before You Leave Hospital
Ideally, your home should be prepared before your admission date. Key considerations:
- Sleeping arrangements: Ground-floor sleeping is preferable for the first week after lower limb surgery. Ensure your bed is at a suitable height — not too low.
- Toilet height: A raised toilet seat is strongly recommended after hip or knee replacement to maintain safe joint angles
- Trip hazards: Remove loose rugs, cables and clutter from all walkways
- Handrails: Ensure stair handrails are secure — a physiotherapist can advise on stair technique
- Everyday essentials within reach: Arrange your kitchen, bathroom and bedroom so you don't need to reach high or bend low unnecessarily
- A chair with arms: Essential for safe standing up and sitting down in the early post-op period
Managing Pain in the First Two Weeks
Post-operative pain is normal and expected — but should be manageable with the medication you've been given. Take your medication as prescribed rather than waiting until pain becomes severe. Poorly controlled pain leads to reduced mobility, worse swelling and slower recovery.
In addition to medication, the following strategies help:
- Ice packs applied for 15–20 minutes, several times per day, reduce swelling and provide pain relief (always with a cloth barrier — never directly on skin)
- Elevation of the operated limb reduces swelling — particularly important in the first 1–2 weeks
- Gentle prescribed exercises maintain circulation and reduce protective muscle spasm
- Positioning — your physiotherapist will advise on optimal resting positions for your specific procedure
Movement and Activity in Week One
The single most important thing in week one is: move regularly, but gently. Aim to get up and walk for short periods (5–10 minutes) several times throughout the day. Prolonged sitting or lying in one position increases swelling, raises DVT risk and makes the next movement more painful.
This does not mean overdoing it. Fatigue after surgery is real — your body is healing, which is metabolically demanding. Rest between activities, but do not stay still for hours at a stretch.
Red Flags: When to Seek Help
- Calf pain, redness, swelling or warmth — possible DVT, seek urgent medical review
- Sudden increased pain, particularly in the chest or breathing difficulty — possible pulmonary embolism, call 999
- Wound signs of infection: increasing redness, swelling, warmth, discharge, smell, or fever above 38°C — contact your surgical team
- Wound opening or dehiscence — contact your surgical team
- Dislocation signs after hip replacement: sudden severe pain, leg appearing shorter or rotated — seek emergency care
- New neurological symptoms — pins and needles, numbness or weakness not present before surgery
Your Physiotherapy Plan in the First Two Weeks
Most hospital physiotherapy departments provide a single session of advice before discharge — but this is rarely enough. Structured, ongoing physiotherapy from the first week at home makes a measurable difference to outcomes.
A home visit physiotherapist will:
- Review your discharge exercises and ensure you're performing them correctly and safely
- Assess your movement quality and pain levels and adjust the programme accordingly
- Address any specific challenges in your home environment
- Teach you safe techniques for stairs, transfers and daily tasks relevant to your specific surgery
- Monitor your wound and swelling and flag any concerns
- Provide the reassurance and guidance that reduces anxiety and keeps you progressing
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