Joint replacement

Joint replacement, also known as arthroplasty, is a surgical procedure that involves replacing damaged or diseased bone or cartilage with metal or plastic components. The most common joint replacements are performed on the hips and knees, but any large joint can be replaced when necessary.

A total hip joint replacement is an operation to replace a damaged or diseased hip joint. Your hip joint has two parts: the hip socket and the ball at the top of your thigh bone. During hip replacement surgery, the ball and the socket are replaced with smooth, artificial parts. 

Hip replacement surgery aims to relieve pain, reduce stiffness, and improve walking ability. Recovery from hip replacement surgery is not the same for everyone. Factors such as age, motivation, health, and response to rehabilitation all affect the rate of recovery.

Your clinical team is the first place to go for information about your hip replacement surgery. You should receive information from the hospital where your surgery will take place. Make sure you read all the information given to you and ask your clinicians any questions you may have.

Your hospital will give you clear advice and instructions about your hospital stay and what to expect at each stage. Make sure you read all the information provided to you and ask questions if it's not clear.

Other resources:

• Watch the Hip replacement surgery webinar
• Watch the Hip and Knee Replacement Kit demo
• Canterbury DHB have an in-depth guide to hip replacement surgery following the Enhanced Recovery After Surgery (ERAS) pathway. Most of the information is general, but some is specific to Burwood Hospital. Ask at the hospital where you will undergo surgery for their latest patient information
• Ministry of Health video guide to hip replacement surgery
• Prepare for Going Home After Surgery | Arthritis Foundation
• Health New Zealand | Te Whatu Ora has helpful information about recovering from surgery
• Our Osteoarthritis Online Support Group on Facebook offers invaluable first-hand experience and tips from people who have already been through the process

• If you smoke you are strongly advised to stop smoking before and after surgery. Continuing to smoke doubles your risk of complications and slows healing after your operation. If you need help quitting smoking, get in touch with your GP or Quitline (0800 778 778) or visit www.quit.org.nz
• Alcohol consumption significantly increases the risk of complications, slows healing, and affects sleep quality after your operation. Avoid or limit alcohol before and after surgery
• Building muscle strength in the weeks leading up to your surgery will speed up your recovery, so try to stay as active as you can in the weeks leading up to your surgery. This includes arm and core exercises that will make getting in and out of bed easier. Walking, cycling and swimming are good exercises to build strength and fitness
• If you are at a higher weight, a total hip joint replacement can be more challenging due to more tissue around the hip, and it may come with slightly higher risks. Any additional strain on your muscles and joints can make recovery more difficult. Weight loss is not always simple and may not be possible due to pain and limited mobility, but movement for cardiovascular health, strengthening parts of your body that you can and changes in diet, even without weight loss, can reduce your chance of complications after surgery
• Good nutrition is necessary to recover well. If your diet needs a bit of a shake-up, start making some healthy habit changes as soon as possible, so you already have good habits for your recovery
• At your pre-admission/anaesthetic clinic, you will be informed about any medications you are taking; make sure you adhere to these
• Prepare your home as much as you can before surgery. Remove rugs and mats, loose cords and anything that can be a trip hazard. Place commonly used items at waist height to prevent the need to bend. An Occupational Therapist or Physiotherapist may also contact you to discuss your home environment and what equipment you might need for recovery, such as crutches and handrails in the shower

Here are some items you might find helpful:

• It can be helpful to have a firm, preferably higher chair than usual, for recovery. If you have room, have one in the bedroom, too. This ensures you don’t breach your hip precautions and can sit with your hips higher than your knees
• A high stool to sit on while preparing food, washing up, and using the stove top if you don’t have someone to do the cooking for you
• Raised toilet seat and shower chair - you can hire or borrow these or purchase from a mobility or independent living store
• Grabber/reacher to pick up items off the ground.
• Slip-on shoes that you can slide on without bending over, preferably not loose-fitting jandals/sandals
• Long shoehorn for shoes that are not easy to slip on
• Sock aid to help get socks on your feet
• You will need to sleep with a pillow or two between your legs, both when you are on your back and on your side. It is best not to sleep on your side without two pillows between your legs for 6-8 weeks. You can purchase specially designed pillows that fit between your legs as well
• Battery-operated nightlights are helpful if you need to get up in the night. You could also keep a torch beside your bed or use the torch on your cellphone
• Cross-shoulder bag or an apron with pockets can be useful for carrying small items with you, so you don’t have to use your hands while using a walker or crutches
• Clothes horse for washing
• Trolley to move heavier items across the room if you live alone
• Good nutrition is necessary to recover well. You may lose your appetite or feel nauseous from medications, so it's a good idea to make and freeze meals in the weeks leading up to your surgery so that you have meals on hand
• An exercycle can be helpful for both pre-and post-surgery exercise

• Wearing loose-fitting underwear after surgery can prevent elastic digging into any stitches. E.g. boxers for men, boyleg style for women. Wearing elasticated loose pants or shorts may also be more comfortable due to swelling and a more limited range of movement
• Initially you won't be able to bend your leg more than 90°, so clothing with pockets are useful to hold your phone or items you need, leaving your hands free to utilise crutches or a walker
• You can expect to go on an emotional rollercoaster ride after surgery, so it is important to take your time, not rush and be kind to yourself. This video may be helpful with these feelings and emotions after surgery - What is radical acceptance and how does it help with arthritis?
• You will probably need to ask your whānau or friends for help in the first couple of weeks, and whilst you are using crutches or a walking frame. Every day tasks such as showering, getting dressed and undressed, removing compression socks, cooking and cleaning, food shopping, and getting in and out of the car will be challenging on your own. If you live alone you might want to ask someone to come and stay with you for a while
• You may be unable to drive for six weeks after surgery. Be prepared for this, and discuss it with your surgeon
• Putting on and removing compression socks can be tricky, so you may like to look at getting a sock-aid. Visit out our tools and equipment page
• Sitting for long periods of time can cause more swelling in the foot and leg that was operated on. Keeping your feet raised while sitting can help, along with regular short walks around the house
• Continue to use your mobility aids, such as crutches or a walker, until your surgeon advises you to stop. Take them to your follow-up appointment and discuss them with your surgeon
• If you don’t tolerate pain killers well, talk to your GP or specialist at the hospital about some sleep aids if you have trouble sleeping
• Along with the advice from your surgeon or GP, set a goal each day. For example, "today I am going to shower myself" or "today I am walking to the letterbox". Having these goals in place will help you to keep moving and improving each day
• Have some easy activities like reading, jigsaw puzzles, colouring, word puzzles or knitting ready. You might find yourself feeling bored at points so having a variety on hand is a good idea
• You will be given exercises to do at home after your surgery. You will also generally have a follow-up appointment with your surgeon to discuss if you need to see a physiotherapist. Discuss with your surgeon what type of activity you would like to return to. Your surgeon will help you with the best plan to help you to return to doing what you usually enjoy
• Sexual activity - think about the hip movements and positions that you need to avoid. Consider using pillows to help with positioning. You can ask your occupational therapist for more information about this
• Avoid flying in the first six weeks after your surgery unless necessary, as you are at greater risk of a blood clot.
• If your job involves bending, stooping, or lifting, you may need more than six weeks before returning to work. Talk to your surgeon about this at your follow-up appointment
• Some people recovering from hip surgery have found recliner lift chairs to be a helpful aid when getting up from sitting and to assist with staying active in the early stage of recovery from total hip replacement

A total knee joint replacement is an operation to replace a damaged or diseased knee joint. A knee replacement is also thought of as a knee resurfacing because generally only the surfaces at the ends of the femur and tibia bones are removed and replaced with metal or plastic components.

There are two types of knee replacement surgery:

• Total Knee Replacement (TKR): entire joint surface is replaced. A TKR can last many years (or even decades)
• Partial Knee Replacement (PKR): only one compartment of the knee is replaced. A PKR may not last as long as a TKR if arthritis develops in other parts of the knee later on 

Knee replacement surgery is only done when all other treatment options have been exhausted and your pain, function and mobility have not improved and your quality of life is negatively affected. Knee replacement surgery isn't a cure for arthritis, but it can relieve some of the symptoms. The aims of knee replacement surgery are pain relief, reduced stiffness, and improved ability to walk.

Your clinical team is the first place to go for information about your knee replacement surgery. You should receive information from the hospital where your surgery will take place. Make sure you read all the information given to you and ask your surgeon any questions you may have.

Other resources:

• Watch the Hip and Knee Replacement Kit demo
• Canterbury DHB have an in-depth guide to hip replacement surgery following the Enhanced Recovery After Surgery (ERAS) pathway. Most of the information is general, but some is specific to Burwood Hospital. Ask at the hospital where you will undergo surgery for their latest patient information
• Our webinar on knee replacement surgery presented by Orthopaedic Surgeon Dr Simon Young has lots of information about what to expect before, during and after knee replacement surgery
• Ministry of Health video guide on knee replacement surgery
• Health New Zealand | Te Whatu Ora has helpful information about recovering from surgery
• Our Osteoarthritis Online Support Group on Facebook also offers valuable first-hand experience and tips from people who have already been through the process

• If you smoke, you are strongly advised to stop smoking before and after surgery. Continuing to smoke doubles your risk of complications and slows healing after your operation. If you need help quitting smoking, please get in touch with your GP or Quitline (0800 778 778) or visit www.quit.org.nz
• Alcohol consumption significantly increases the risk of complications, slows healing, and affects sleep quality after your operation. Avoid or limit alcohol before and after surgery
• Building muscle strength in the weeks leading up to your surgery will speed up your recovery, so try to stay as active as you can in the weeks leading up to your surgery. This includes arm and core exercises that will make getting in and out of bed easier. Walking, cycling and swimming are good exercises to build strength and fitness. Using an exercycle is particularly helpful for building leg strength. Aim for 20 - 30 minutes per day, 4 - 5 times per week. You might also want to see a physiotherapist or clinical exercise physiologist to make a plan for your exercise before and after surgery
• If you are at a higher weight, a total knee joint replacement can be more challenging and may come with slightly higher risks during surgery and of developing an infection. Any additional strain on your muscles and joints can make recovery more difficult. Weight loss is not always simple and may not be possible due to pain and limited mobility, but movement for cardiovascular health, strengthening parts of your body that you can and changes in diet, even without weight loss, can reduce your chance of complications after surgery
• Good nutrition is necessary to recover well. If your diet needs a bit of a shake-up, start making some healthy habit changes as soon as possible, so you already have good habits for your recovery
• At your pre-admission/anaesthetic clinic, you will be informed about any medications you are taking; make sure you adhere to these
• Prepare your home as much as you can before surgery. Remove rugs and mats, loose cords and anything that can be a trip hazard. If you live in a multi-storied home you might want to think about whether you could have your bed moved to the same level as your kitchen and bathroom in order to reduce time going up and down stairs. You may also be contacted by an occupational therapist or physiotherapist to discuss your home environment and what equipment you might need for recovery, such as crutches and handrails in the shower
• Arrange for help with meals and transport. Daily tasks such as cooking and showering will be more difficult. Make sure you have family and/or friends available to help you during this time. If you do not have help available, talk to your doctor about local support services or staying at a rehabilitation centre after surgery
• You may be required to attend an assessment at the hospital before your surgery. This is a good chance for you to ask questions about your surgery and recovery
• You will probably need to follow a physiotherapy or exercise programme after surgery. Be ready for several weeks or even months of exercise Remember, the amount of effort you put in can make a big difference in how well you recover

Soon after your surgery, you will generally be able to walk with a cane, crutches or a walker, but other everyday tasks will be more difficult. The knee is the largest joint in the body, and we use our knees for almost every daily activity. It is, therefore, important to have extra support from friends or whānau when you are recovering for things such as preparing food, household chores, driving and moving around. Recovery from knee replacement surgery is not the same for everyone. Factors such as age, motivation, health, and response to rehabilitation all have a role to play in the rate of recovery.

Tips for recovering well after knee replacement surgery:

• Wearing elasticated loose pants or shorts may be more comfortable due to swelling and a more limited range of movement
• Clothing with pockets can be useful to carry your phone or items you need, leaving your hands free to utilise crutches or a walker
• You can expect to go on an emotional rollercoaster ride after surgery, so it is important to take your time, not rush and be kind to yourself. This video may be helpful with these feelings and emotions after surgery - What is radical acceptance and how does it help with arthritis?
• You will probably need to ask your whānau or friends for help in the first couple of weeks and whilst you are using crutches or a walking frame. Everyday tasks such as showering, getting dressed and undressed, removing compression socks, cooking and cleaning, food shopping, and getting in and out of the car will be challenging on your own. If you live alone you might want to ask someone to come and stay with you for a while
• You may be unable to drive for six weeks after surgery. Be prepared for this, and discuss it with your surgeon
• Putting on and removing compression socks can be tricky so you may like to look at getting a sock-aid. Visit out our tools and equipment page
• Sitting for long periods of time can cause more swelling in the foot and leg that was operated on. Keeping your feet raised while sitting can help with swelling for short periods of time, along with regular short walks around the house. Check in with your physiotherapist or occupational therapist about the best way to improve the flexion in your knee gradually (the amount your knee can bend)
• Continue to use your mobility aids, such as crutches or a walker, until your surgeon advises you to stop. Take them to your follow-up appointment and discuss them with your surgeon.
• If you don’t tolerate pain killers well, talk to your GP or specialist at the hospital about some sleep aids if you have trouble sleeping
• Along with the advice from your surgeon or GP, set a goal each day. For example, "today I am going to shower myself" or "today I am walking to the letterbox". Having these goals in place will help you to keep moving and improving each day
• Have some easy activities like reading, jigsaw puzzles, colouring, word puzzles or knitting ready. You might find yourself feeling bored at points, so having a variety on hand is a good idea
• You will be given exercises to do at home after your surgery. You will also generally have a follow-up appointment with your surgeon to discuss if you need to see a physiotherapist. Discuss with your surgeon what type of activity you would like to return to. Your surgeon will help you with the best plan to help you to return to doing what you usually enjoy
• Sexual activity - think about the hip movements and positions that you need to avoid. Consider using pillows to help with positioning. You can ask your occupational therapist for more information about this
• Avoid flying in the first six weeks after your surgery unless necessary, as you are at greater risk of a blood clot
• If your job involves bending, stooping, or lifting, you may need more than six weeks before returning to work. Talk to your surgeon about this at your follow-up appointment

The information on this page does not take the place of any information given to you by your clinical team and operating hospital. It also does not cover everything you need to know about your operation.