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Is it better to replace your hip or your knee first?

If patients are experiencing hip and knee pain on the same side, orthopedic surgeons at Salem Health always recommend replacing the hip first, for three main reasons.

“One, there’s a chance that the hip replacement will eliminate some of the knee pain,” said hip and knee replacement surgeon Mark Dolan, MD. “The second reason would be [if] a hip replacement has to be done first so that patients can properly rehab the knee replacement.”

Dr. Dolan said a third reason for starting with the hip is to ensure the knee replacement is aligned with the replaced hip joint. Typically, his team recommends waiting about three months between the two surgeries, so patients have time to recover.

Recovery after outpatient surgery

Both hip and knee replacements are outpatient surgeries. As such, pain and changes to your routine are to be expected. However, Dr. Dolan said with a hip replacement, patients can expect the most pain in the two to three days after surgery.

“It’s about getting confidence in your hips. You may need help getting up and down out of chairs or off the toilet,” he said. “Most patients who were fairly active before surgery will be off their walker by a week, typically two weeks in general.”

After four weeks, patients should be able to walk a mile a day and by six weeks, be back to normal routines.

Challenges following a knee replacement

While a knee replacement can vastly improve a patient’s life, there are things to keep in mind to help ease recovery. First? Slow down!

“Compared to hip replacement, knee replacement surgery is a little easier to get around initially, but it tends to be a bit more painful in the first two weeks,” said Dr. Dolan.

That’s because surgeons like him have found a correlation between swelling in the knee and the level of pain after surgery.

“The first two weeks, the more the patient does, the more the knee swells, the more pain they have bending the knee,” he said. “In the last few years, we’ve recommended patients slow down during that time to rest, ice and elevate.”

The surgeon notes physical therapy after a knee replacement tends to require pushing through more pain and discomfort. Patients usually use a walker for about three weeks and wrap up physical therapy within eight weeks. Six months is expected for a full recovery.

For those considering a joint replacement, Dr. Dolan recommends looking at quality of life and level of pain.

“Someone in their 60s and 70s dealing with pain and a compromised quality of life? A hip and knee replacement is probably a great option for them to live a more fulfilling life,” he said.

Orthopedic care

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