After Hip or Knee Replacement
Joint replacement surgery goes well for most people — but the first weeks at home matter a lot. Having the right equipment in place before you come home, knowing what therapy to expect, and understanding what Medicare covers can make the difference between a smooth recovery and a preventable setback. This guide gives you everything in one place.
Before Surgery — What to Do Now
The single most important thing you can do before joint replacement surgery is set up your home before you leave for the hospital. Coming home to equipment that isn't set up — or arriving to find you can't get into your bathroom — causes injuries that set recovery back weeks. Take care of this at least one week before your surgery date.
Order equipment before surgery, not after.
DME suppliers need a prescription from your surgeon and insurance authorization before delivering equipment. This process can take 3–7 days. Start it as soon as your surgery date is confirmed — don't wait until discharge.
Pre-Surgery Prep Checklist
Order your walker and mobility aids
A standard front-wheeled walker is the most common device for the first weeks after joint replacement. Your surgeon or PT will specify what type. Have it delivered and adjusted to the right height before surgery. If you live in a two-story home, you may need two walkers — one per floor.
Raise your toilet seats
After hip replacement in particular, you cannot bend your hip past 90 degrees. A standard toilet seat puts you too low. Raised toilet seat risers (3–4 inches) or a toilet safety frame are essential. Install them on every toilet you'll use.
Set up your shower
You'll need a shower bench or tub transfer bench so you can bathe seated. A handheld showerhead (attached by a flexible hose) lets you shower without standing or reaching. Grab bars near the shower entry and toilet are important safety additions. If you have a high step-over tub, a tub transfer bench is safer than a shower stall bench.
Get a reacher/grabber tool
After hip replacement, you cannot bend more than 90 degrees for 6–8 weeks. A reacher (a long-handled grabber) lets you pick things up, pull on socks, and retrieve items from low shelves — all without bending. A long-handled shoehorn is also helpful.
Arrange ice therapy
Icing the joint significantly reduces pain and swelling in the first weeks. A motorized ice therapy machine (cold therapy system) circulates cold water through a pad that wraps around your joint. This is far more effective and convenient than ice bags — many people find it essential. Some surgeons provide them; others prescribe rental through a DME supplier. Have large gel ice packs as a backup if a machine isn't available.
Home Safety Modifications
Remove tripping hazards
- → Roll up loose rugs and secure edges
- → Remove extension cords from walking paths
- → Move low furniture your walker might catch on
- → Secure pet gates and threshold strips
Reorganize for easy access
- → Move essentials to waist height (no bending or reaching)
- → Set up a recovery station (chair, side table, phone charger)
- → Pre-make and freeze meals for the first 1–2 weeks
- → Arrange for someone to drive you the first 2–4 weeks
📋 Before you leave for surgery, confirm: who will pick you up from the hospital, that all equipment is delivered and in place, that someone will be with you at home for at least the first 24–48 hours, and that your home health agency has been notified of your surgery date so they can schedule your first PT visit promptly after discharge.
Equipment by Recovery Phase
Your equipment needs change as you recover. Here's what's typically needed at each stage — and what to know about cost and Medicare coverage.
Maximum support — getting home safely
Walker (Standard or Front-Wheeled)
Primary mobility aid for first 2–4 weeksA standard walker provides maximum stability. A front-wheeled walker (two wheels, two rubber feet) lets you glide forward without fully lifting the walker at each step — often preferred for knee replacement, where full-weight bearing is usually allowed immediately. Your PT will specify which type is right for you.
Typical cost
$30–$100 purchased
Medicare Part B
Covers 80% after deductible when prescribed. Purchased upfront.
What to know
Height must be set correctly — wrist level when standing upright. Your PT will adjust it.
Raised Toilet Seat / Toilet Safety Frame
Essential — especially for hip replacementHip replacement patients must not bend the hip past 90 degrees for 6–8 weeks. A raised seat (3–4 inches) lifts you enough to sit without violating this restriction. A toilet safety frame (armrests that bolt to the toilet) adds grip for lowering and rising. Many people use both together.
Typical cost
Raised seat: $20–$60 | Safety frame: $40–$120
Medicare Part B
May be covered when prescribed as medically necessary. Check with your supplier.
What to know
Measure your toilet before ordering — raised seats fit standard (round or elongated) bowls differently.
Shower Bench / Tub Transfer Bench
Allows safe bathing without weight-bearing on the jointA shower bench sits inside a walk-in shower stall. A tub transfer bench straddles the side of a bathtub — one pair of legs inside, one outside — letting you slide in from the outside instead of stepping over the tub edge. If you have a tub, you need a transfer bench, not a shower chair. Pair either with a handheld showerhead for the most flexibility.
Typical cost
Shower bench: $40–$120 | Transfer bench: $50–$130
Medicare Part B
Shower benches covered at 80% when prescribed. Transfer benches similarly covered.
What to know
Look for a model with adjustable legs, a back rest, and weight rating of at least 300 lbs.
Ice Therapy Machine (Cold Therapy System)
Highly recommended for pain and swellingCold therapy dramatically reduces pain and swelling in the first 2–3 weeks. A motorized cold therapy machine circulates ice water through a pad wrapped around your knee or hip — far more effective and consistent than ice bags. Many patients credit it as one of the most important recovery tools. Some hospitals send you home with one; others prescribe through your DME supplier.
Typical cost
Rental: $50–$150/mo | Purchase: $200–$500
Medicare Part B
Coverage varies — not always approved. Check with your supplier. Many rent directly.
What to know
Wrap in a cloth before placing on skin — never put the pad directly on bare skin.
Reacher / Grabber & Long-Handled Tools
Essential for hip precautionsA reacher lets you pick up objects, pull on socks, and operate light switches without bending — critical when hip precautions forbid bending past 90 degrees. A long-handled shoehorn helps you put on shoes. A sock aid (a flexible plastic shell on a rope) lets you put socks on without reaching your foot. Your OT will demonstrate all of these.
Typical cost
Reacher: $10–$30 | Long shoehorn: $8–$20 | Sock aid: $15–$25
Medicare Part B
Generally not covered separately — often included in a home health initial supply kit.
What to know
Buy two reachers — one for upstairs and one for down. They're inexpensive and you'll use them constantly.
Transition — building independence
Cane
Transitioning from walker, weeks 3–6 typicallyYour physical therapist will tell you when to transition from walker to cane — usually when you can walk steadily and bear full weight. A single-point cane is most common. Hold the cane on the opposite side from the surgical leg — this is counterintuitive but biomechanically correct and what your PT will teach you.
Typical cost
$15–$60
Medicare Part B
Covered at 80% when prescribed.
What to know
Height adjustment: elbow slightly bent when holding cane at your side. Your PT will check this.
Exercise Resistance Bands
Home PT exercises, weeks 3–12+Your physical therapist will prescribe a home exercise program with resistance bands for strengthening the muscles around the new joint. Light bands (yellow/red) are used first; you progress to heavier resistance as strength returns. Your PT will provide them or give you a specific brand/resistance level to buy.
Typical cost
$10–$30 for a set
Medicare Part B
Not typically covered separately as a supply item.
What to know
Do your home exercises every day. The difference in outcomes between those who do and don't is significant.
Find joint replacement equipment suppliers near you
Enter your ZIP code to see Medicare-enrolled suppliers for walkers, raised toilet seats, and bath safety equipment.
Physical Therapy & Recovery Timeline
Physical therapy is the most important factor in how quickly and fully you recover. Modern joint replacement protocols get you moving the same day as surgery. Here's what to expect at each phase.
In-Home PT vs. Outpatient PT — What's the Difference?
In-home PT happens at your house and is covered 100% by Medicare Part A when you're homebound. This is what you'll have for the first 4–8 weeks. Outpatient PT is when you travel to a clinic. Medicare Part B covers 80% of outpatient PT after your deductible, with no visit limit (but therapy must remain medically necessary). Many people transition from in-home to outpatient at weeks 4–6.
In-Hospital PT — First Steps
A hospital physical therapist will get you standing and walking — even if just a few steps — on the day of your surgery or the next morning. This is intentional. Early movement prevents blood clots, reduces swelling, and starts the healing process immediately. Don't be surprised or alarmed; this is the standard of care.
Home Health PT — Setting Up for Recovery
Your home health PT will visit 2–3 times per week. The first visit (usually within 24–48 hours of discharge) includes a full assessment, a home safety walk-through, and your first set of exercises. These exercises will seem simple — ankle pumps, quad sets, heel slides — but they are critical. Do them every day, multiple times a day, as directed.
Increasing Strength — Stair Training & Gait Work
By weeks 3–4, most patients are walking farther and working on stair training. Your PT will teach you the "good leg up, bad leg down" rule for stairs. Pain is decreasing and swelling is coming down. Many knee replacement patients begin bending the knee to 90 degrees by week 4. Hip replacement patients are still observing hip precautions (no bending past 90 degrees, no crossing legs).
Transitioning to Cane — Discharge from Home Health
Most patients transition from walker to cane around week 4–6, once they can walk steadily and bear full weight. Your PT will evaluate readiness. Home health PT is typically discharged around this point, as you're no longer homebound. You'll likely continue with outpatient PT for another 4–8 weeks to build full strength and range of motion.
Outpatient PT — Building Full Function
Outpatient PT focuses on building the strength, balance, and range of motion needed for full activity. Knee replacement patients work toward walking without any assistive device by weeks 8–12. Hip replacement precautions (no bending, no crossing legs) are typically lifted around week 6–8 based on your surgeon's protocol. At your 6-week follow-up, your surgeon will x-ray the joint and confirm healing.
Return to Full Activity
Most people return to normal daily activities — driving, grocery shopping, walking at their own pace — between 3 and 6 months. Driving after hip replacement is typically cleared at 4–6 weeks (sooner for knee replacement on the left side for automatic transmission). Full recovery — meaning maximum strength and minimal pain — takes about 12 months for most people, even if daily function is excellent much sooner.
📌 Home exercise program tip: Your PT will give you 3–6 exercises to do at home on non-visit days. Do them. Twice a day if instructed. The difference in outcomes between patients who consistently do their home program and those who don't is dramatic — more range of motion, faster return to walking without a device, and less chronic pain at 12 months.
What Insurance Covers
Medicare covers most of what you need after joint replacement — but the details depend on whether you have Original Medicare or Medicare Advantage.
A Equipment (Durable Medical Equipment) — Medicare Part B
- →Medicare Part B pays 80% of the approved amount for walkers, crutches, shower benches, raised toilet seats, and canes after you meet your annual deductible ($257 in 2025).
- →You (or your Medigap policy) pay the remaining 20%.
- →Equipment must be medically necessary and prescribed by your doctor or surgeon in writing.
- →You must use a Medicare-enrolled, accredited DME supplier. All suppliers on DMEHelper show their enrollment status.
- →Most joint replacement equipment is purchased (not rented), so the 20% is a one-time cost.
B Home Health Physical Therapy — Medicare Part A
✅ Home health PT is covered at 100% under Medicare Part A — with no copay.
- →Covers physical therapy, occupational therapy, and skilled nursing visits at home.
- →Your doctor must order home health care, and you must be "homebound" (leaving home requires considerable effort).
- →Coverage is approved in 60-day episodes, renewable if still medically necessary.
- →The home health agency must be Medicare-certified.
C Outpatient Physical Therapy — Medicare Part B
Once you're no longer homebound and transition to outpatient PT:
- →Medicare Part B covers 80% of the Medicare-approved amount for outpatient PT.
- →There is no annual visit limit for PT, but therapy must remain medically necessary.
- →A Medicare "therapy cap" may trigger a review at $2,230/year, but will not stop necessary therapy.
D Medicare Advantage Plans — Important Differences
⚠️ If you have a Medicare Advantage plan (Humana, UHC, Aetna, etc.), the rules are different:
- →Equipment requires prior authorization — your supplier must get pre-approval before ordering your walker, shower bench, or other equipment. This can take 1–5 business days.
- →You must use in-network suppliers and home health agencies — using an out-of-network provider can mean full cost comes to you.
- →Call the number on the back of your insurance card before surgery to confirm which equipment is covered, which suppliers are in-network, and whether prior authorization is needed.
The First Week Home
The first week at home is the highest-risk period for complications. Here's what to expect — and what to watch for.
Pain Management Tips
Stay on the pain medication schedule
Take pain medication on a schedule as prescribed — not just when it becomes unbearable. Staying ahead of pain is much more effective than chasing it. Ask your doctor about a tapering schedule for opioids.
Ice for 20 minutes, not continuously
Apply ice (or your cold therapy machine) for 20 minutes at a time, 4–6 times per day. Always wrap ice in a cloth — never put it directly on skin. After 20 minutes, your skin needs to return to normal temperature before the next application.
Elevate the leg when resting
Keep the surgical leg elevated above heart level when resting — on a pillow stack or a recliner. This dramatically reduces swelling. Don't let the leg hang down for extended periods in the first two weeks.
Walk as directed — rest between
Your PT will give you a walking program — typically 10–15 minutes several times a day. Do not overdo it or extend walks significantly beyond what's prescribed. Rest between sessions. Overdoing it early causes increased swelling and sets recovery back.
Movement Do's and Don'ts
✅ DO
- → Use your walker every time you stand — no exceptions in week 1
- → Do your PT exercises as prescribed, multiple times daily
- → Ice regularly for swelling control
- → Elevate when resting
- → Wear compression stockings as directed by your surgeon
- → Hip replacement: keep the "pillow between knees" when sleeping, as directed
🚫 DON'T
- → Hip replacement: don't bend past 90 degrees (no reaching to the floor)
- → Hip replacement: don't cross your legs at the knee or ankle
- → Hip replacement: don't rotate the operated leg inward (toes pointing inward)
- → Don't drive until your surgeon clears you
- → Don't skip pain medication and then try to push through pain for exercises
- → Don't take hot baths until the incision is fully healed (typically 4–6 weeks)
When to Call Your Surgeon vs. Go to the ER
🚨 Go to the ER or Call 911 Immediately
- →Chest pain, shortness of breath, or fast heartbeat — possible pulmonary embolism (blood clot in lung)
- →Sudden calf pain, redness, or significant swelling in your lower leg — possible DVT (blood clot in leg)
- →The surgical leg suddenly looks shorter, rotated, or you have a new "pop" with severe pain — possible dislocation (hip replacement)
- →Incision is actively bleeding or has significant drainage
⚠️ Call Your Surgeon's Office (During Business Hours) For
- →Fever above 101°F — possible infection
- →Incision redness, warmth, or swelling that is getting worse or spreading
- →Increasing pain at the joint (not the expected soreness from exercises)
- →Wound opening, discharge, or unusual smell from the incision
- →Numbness, tingling, or weakness in the foot/leg below the surgery site
Fall Prevention in the First Week
- →Use your walker every single time you stand in the first week — no exceptions, not even just to cross the room.
- →Never rush to the bathroom. Urgency causes falls. If you tend to have urgency, keep a urinal or bedside commode nearby at night.
- →Get up slowly. Sit at the edge of the bed for 30 seconds before standing to prevent dizziness from pain medications.
- →Don't walk barefoot. Wear supportive shoes or non-slip slippers every time you walk.
- →Have someone nearby for the first 48 hours. The first two days home are when falls most often happen.
Recovery Checklist
Check off items as you arrange them. Start this list at least one week before surgery.
Equipment to Order Before Surgery
Home Prep & Services
Your checkboxes save automatically as you check them.
Questions About Your Recovery?
Dottie can walk you through equipment options, explain what Medicare covers, help you find Medicare-enrolled suppliers, and answer your questions in plain English.
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