Rehab at Home

Recover at home following total hip or knee replacement

(pending surgeon and health fund approval)

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Rehab at Home

While total hip or knee replacements (known as THR and TKR respectively) are relatively common operations, they are nonetheless major surgical procedures, and it takes time for patients to recover. It is well documented that better outcomes post THR and TKR are associated with three key factors:​

  1. Good health before your operation: optimizing your bodyweight, fitness, lower limb strength and management of any other medical conditions.​
  2. An experienced surgeon: not necessarily an older surgeon, but someone who does a high volume of THR or TKR procedures.​
  3. Completing a rehabilitation program post-operatively.

Sequence of events

  • Pre-operative

  • Procedure

  • Acute care (2-7 days)

  • Rehab & recovery

What does good pre-operative care look like?​

Traditional ‘pre-hab’ involves six to 12 weeks of low impact, low load muscle strengthening and mobility exercises. More contemporary programs also help optimise body weight and mental health. Every 1kg of body weight equates to between 4kg (walking) and 10kg (running, or going downstairs) of force through your knee joints, so taking off five kilos can make a significant difference to your pre- and post-op discomfort. ​

There is a proportion of people who engage in their pre-hab and achieve such significant improvements in their pain and function that they decide to defer their surgery altogether. Led by a physiotherapist, exercise physiologist, dietitian, health coach, or any combination of these, this kind of conditioning should always be part of a treatment journey.

What should I expect immediately after my operation?​

  1. Depending on the type of surgery, your health status and your surgeon’s protocols, you’ll spend between 2-7 nights in hospital on a surgical ward.​
  2. You’ll then move from the surgical ward to your rehabilitation destination – either home, or a rehabilitation ward. Most patients are reliant on only a single stick or occasionally a 4 wheel walker by the time they leave the surgical ward.​​
  3. You’ll need strong (usually opiate-based) pain medication for 2-3 weeks post-op.
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What are my post-operative rehabilitation options?

Home
(self directed)

  • Self-direct your own recovery.
  • See a private practice physiotherapist in the community as needed.

Home
(remote support)

  • Recover at home with phone, SMS, virtual clinic or app-based support and exercise progressions.
  • See a private practice physiotherapist in the community as needed.

Home
(face-to-face support)

  • Recover at home with your physiotherapist coming to you.
  • Your physiotherapist can provide education, exercise progressions and strategies to get you back on your feet.
  • Transition to services in the community (e.g. private practice physio, gym, pool) as able.

Extended hospital stay (supervised)

  • Additional 1-2 weeks in hospital.
  • Best suited to patients who are unsafe to go home following their surgical ward stay (e.g. live alone, significant number of stairs, high falls risk, confusion, other medical issues, poor compliance with instructions.

What are my post-operative rehabilitation options?

Home
(self directed)

  • Self-direct your own recovery.
  • See a private practice physiotherapist in the community as needed.

Home
(remote support)

  • Recover at home with phone, SMS, virtual clinic or app-based support and exercise progressions.
  • See a private practice physiotherapist in the community as needed.

Home
(face-to-face support)

  • Recover at home with your physiotherapist coming to you.
  • Your physiotherapist can provide education, exercise progressions and strategies to get you back on your feet .
  • Transition to services in the community (e.g. private practice physio, gym, pool) as able.

Extended hospital stay (supervised)

  • Additional 1-2 weeks in hospital.
  • Best suited to patients who are unsafe to go home following their surgical ward stay (e.g. live alone, significant number of stairs, high falls risk, confusion, other medical issues, poor compliance with instructions.

Which is the best rehab option for me?​

Completing a post-operative rehab program is important… all other things being equal, the type of program you complete is not ​ ​

There is strong evidence that:​

  • Inpatient rehabilitation does NOT improve outcomes in uncomplicated THR and TKR patients when compared to rehab at home. ​
  • Post-operative hydrotherapy does NOT deliver improved outcomes compared to land-based exercise after THR or TKR​

This means that patients who are medically and functionally safe to go home following their stay on the surgical ward lose nothing in terms of outcomes such as pain control, functional capacity, return to driving and so on. Many patients don’t want to stay in hospital any longer than is absolutely necessary and prefer to recover in their own home, surrounded by their family and friends, and following their own routines. If this sounds like you, please ask us for more information on your home-based rehabilitation options following total hip or knee replacement.

​ What can I expect from a Rehab at Home physiotherapist?

The same experienced private practice clinician each time

2-3 visits in your first week at home, and then 2 visits per week thereafter, until you reach a point where you can safely and comfortably access services in the community (typically 2-4 weeks)

A strong focus on your satisfaction and outcomes meaningful to you; it’s completely 1 : 1​

Regular communication with your surgeon and GP as required

Participating Health Funds

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