Knee Replacement vs Hip Replacement Recovery: What Are the Key Differences?

Both knee and hip replacements are highly successful procedures, but their recovery journeys differ significantly. Understanding these differences helps you prepare properly and set realistic expectations for your rehabilitation.

The fundamental difference

While both procedures replace damaged joints with artificial ones, the biomechanics and functional demands differ considerably. Hip joints are ball-and-socket joints designed for stability and weight-bearing with a wide range of motion, while knee joints are hinge joints that bear significant load while requiring precise alignment and control.

These structural differences directly impact how each joint recovers and what challenges you will face during rehabilitation.

Recovery timeline comparison

Pain and swelling differences

Hip replacement

Pain after hip replacement is generally well-controlled with medication. Most people describe it as deep aching rather than sharp pain, manageable within 2-3 weeks, with minimal localized swelling and night pain usually resolving within 4-6 weeks.

Knee replacement

Knee replacement pain tends to be more challenging. It is often more intense in the first 2-3 weeks, with sharp pain during movement (especially bending), significant swelling that can persist for months, and night pain that may continue for 8-12 weeks. Anterior knee pain at the front of the knee is common during recovery.

Why the difference? The knee has more nerve endings and soft tissue involvement. The quadriceps muscle at the front of the thigh is often weakened significantly, and regaining knee flexion requires stretching tight scar tissue.

Range of motion challenges

Hip replacement

Hip range of motion typically returns more easily. Most people regain functional range within 6-8 weeks. Hip precautions limit movement initially, but these are temporary, and stiffness is less common as a long-term issue.

Knee replacement

Achieving full knee range of motion is often the biggest challenge. For flexion (bending), aim for 110-120 degrees, but this takes dedicated work. For extension (straightening), achieving full extension is crucial for normal walking. Scar tissue can limit movement if not addressed early, and some people never regain their pre-surgery range, especially deep flexion.

This is why Hip & Knee Replacement Rehabilitation focuses heavily on range of motion exercises from day one.

Functional recovery differences

Stairs

• Hip replacement: Most people manage stairs within 2-3 weeks with a rail
• Knee replacement: Stairs remain challenging for 6-8 weeks, often requiring step-by-step technique initially

Getting up from sitting

• Hip replacement: Manageable within days, though high chairs are recommended initially
• Knee replacement: Can be difficult for 4-6 weeks, especially from low chairs

Walking distance

• Hip replacement: Many people walk 10-15 minutes by week 3-4
• Knee replacement: Walking is more uncomfortable initially; building distance takes longer

Exercise programme differences

Hip replacement exercises focus on

• Hip abduction (lifting leg to the side)
• Hip extension (lifting leg backwards)
• Gluteal strengthening
• Walking practice
• Respecting hip precautions

Knee replacement exercises focus on

• Achieving full extension (straight leg)
• Progressive flexion (bending)
• Quadriceps strengthening
• Reducing swelling
• Patellar mobility (kneecap movement)

Which is harder to recover from?

Most physiotherapists and patients agree that knee replacement recovery is generally more challenging than hip replacement. Here is why:

• More pain: Knee replacements typically cause more post-operative discomfort
• Greater swelling: Knee swelling can persist for many months
• Range of motion work: Achieving adequate knee flexion requires persistent, often uncomfortable exercises
• Functional demands: Knees are used constantly for sitting, standing, stairs, and walking
• Longer timeline: Full recovery takes 6-12 months versus 3-6 months for hips

However, both procedures have excellent long-term outcomes. The extra effort required for knee replacement is worth it for the pain relief and improved function you will gain.

Common complications comparison

The role of physiotherapy

Professional physiotherapy support is beneficial for both procedures, but it is particularly valuable for knee replacement recovery due to the greater challenges involved.

Hip & Knee Replacement Rehabilitation provides:

• Personalized exercise progression
• Hands-on treatment for range of motion
• Swelling management techniques
• Gait retraining
• Problem-solving when progress stalls
• Confidence building for functional activities

Tips for successful recovery

For hip replacement

• Follow hip precautions strictly for the first 6-12 weeks
• Focus on walking and building distance
• Strengthen your gluteal muscles
• Use high chairs and raised toilet seats

For knee replacement

• Ice regularly to control swelling (20 minutes, 3-4 times daily)
• Work on achieving full extension from day one
• Push through discomfort (not pain) with flexion exercises
• Elevate your leg when resting
• Be patient — improvement continues for a full year

The bottom line

While both hip and knee replacements are life-changing procedures, knee replacement typically involves a longer, more challenging recovery. Hip replacement patients often feel significantly better within 6-8 weeks, while knee replacement patients may take 3-6 months to feel truly comfortable.

Understanding these differences helps you prepare mentally and physically for your specific surgery. Regardless of which procedure you are having, consistent exercise, patience, and professional support are key to achieving the best possible outcome.

About the author

Lizzie Thornton is a specialist community physiotherapist with over 15 years of experience working with older adults. She is HCPC registered and a member of the Chartered Society of Physiotherapy. Lizzie has supported hundreds of patients through hip and knee replacement recovery, providing home physiotherapy visits across Staffordshire Moorlands and Cheshire East.

View Lizzie's profile