The Evidence on Joint Replacement, Without the Hype

Key takeaways

• Most common: hip and knee replacement
• Prehabilitation: exercise before surgery improves recovery
• Most useful single change: Do prescribed exercises before surgery, not only after.
• Commonest mistake: Delaying so long that muscle loss makes recovery harder.
• See a doctor if any of the signs under "When to speak to a doctor" below apply to you.

What it is

Surgical replacement of a damaged hip or knee joint with an artificial one. It sits within Bone And Joint. The figures below are the ones published guidance uses, rather than the ones that circulate.

The numbers, in one place

What helps

Here is what the evidence supports doing. Some of it will already be familiar.

• Do prescribed exercises before surgery, not only after
• Stop smoking before surgery; it reduces wound complications
• Arrange home support and equipment in advance
• Follow the rehabilitation programme fully, including when it is dull

What to avoid

These come up often, and several of them sound like good ideas.

• Delaying so long that muscle loss makes recovery harder
• Stopping rehabilitation when pain settles
• Ignoring signs of infection around the wound

Where to go next

• Joint Replacement: The Practical To-Do List
• Myths About Joint Replacement, Checked Against the Guidance
• Joint Replacement — the reference entry
• Tendon Problems: What the Evidence Actually Says
• What the Guidance Really Says About Vitamin D and Bone

When to speak to a doctor

Seek urgent help for increasing pain, redness, heat or discharge around the wound, fever, or a sudden inability to weight-bear — prosthetic joint infection needs immediate assessment. Call 999 for calf pain and swelling, chest pain or sudden breathlessness, which can indicate a clot.

Where this comes from

• NICE — Joint replacement (primary): hip, knee and shoulder
• NHS — Hip replacement

How this page was put together

Every figure, recommendation and warning above is taken from the guidance named in Where this comes from. Nothing on this page is inferred, summarised or generalised beyond what those bodies publish: where they give a number, it is their number, and where they are silent, so are we. Pages are rebuilt whenever the underlying record changes. Sign-off by a named clinician, where it has happened, is shown at the top of the page along with the date.

Medical disclaimer

This article is general information, not medical advice. It cannot account for your own history, medication or circumstances. Always speak to a GP, pharmacist or another qualified health professional before making changes that affect your treatment, and never delay seeking medical advice because of something you have read here. In an emergency, call 999.