Walking Frames After Hip or Knee Surgery: Weeks One to Six

Why a frame first

After surgery, muscles are weak, the joint is sore and balance is unsteady, often combined with the effects of anaesthesia and pain medicines. A walking frame gives a wide base and two hands to take some weight, so that the person can stand, walk and begin to rebuild strength safely. It also reduces the risk of falling, which can damage a new joint.

Weight bearing: what the words mean

Your surgeon will specify how much weight may be placed on the operated leg. Common terms:

• Full weight bearing: you may put as much weight on the leg as is comfortable. Many joint replacements are in this group, with a frame for balance and comfort.
• Partial weight bearing: you may put some weight through the leg, such as 25 or 50 per cent, often used after certain fractures or cemented-less implants.
• Toe-touch or non-weight bearing: you must keep the foot off the ground or only touching lightly, common after some fractures. A frame or crutches is used to hop or step without weight.

Make sure you know which applies, write it down and tell every helper. Putting more weight than allowed on the leg can damage the repair.

The usual path: frame to stick

Typical timings vary with the operation and the person, but a common pattern for a hip or knee replacement is:

Days 1 to 3 (in hospital). First steps with a frame and a physiotherapist, short walks around the ward, practice of standing, sitting and the stairs if needed. Pain control, blood-thinning measures and exercises begin.

Week 1 to 2 (at home). Walking with the frame inside the home, with short, frequent walks every hour or two while awake. Exercises daily. A helper nearby.

Weeks 2 to 4. More confidence. Many people progress from the frame to two sticks or crutches, or to a single stick, if the surgeon and physiotherapist agree. Some stay on the frame longer.

Weeks 4 to 6. A single stick or no aid for short distances indoors, with the frame or stick outdoors. Walking longer distances. Return to light activity.

After six weeks. Further progress, depending on the operation, often with outpatient physiotherapy. Full recovery for joint replacement can take three to twelve months.

Do not drop the aid early because it feels easier. A limp, a stumble or a fall can set recovery back. Move to the next aid only when the physiotherapist says so. See signs it is time to move from a stick to a walker for the opposite direction, and how to use a walking frame correctly for technique.

Using the frame after surgery

The basic sequence after a hip or knee replacement on the right leg is:

1. Move the frame forward a short step. 2. Step forward with the operated leg into the frame. 3. Step through with the good leg.

For stairs, the rule is "up with the good, down with the bad": the non-operated leg leads going up; the operated leg leads going down, usually with a handrail and a stick or crutch. Follow the physiotherapist's method.

For hip replacements, additional hip precautions may apply, depending on the surgical approach. These can include not bending the hip beyond 90 degrees, not crossing the legs and not twisting the hip. Follow them exactly. They affect how you sit, dress and use the toilet.

Getting the home ready before surgery

If the operation is planned, prepare in advance.

• Clear the paths. Remove rugs, cables and clutter, and rearrange furniture so the frame has room to pass, ideally 75 cm wide.
• Arrange one-floor living, with a bed, toilet and kitchen on the same level, at least at first.
• Set up a chair with firm seat, arms and a seat height of about 45 to 50 cm, possibly with a cushion; see choosing a chair for an older person and cushions after hip replacement.
• Raise the toilet seat or add a frame; see raised toilet seats.
• Fit grab bars and a shower chair; see bathroom setup after hip replacement.
• Prepare the bed at the right height, with a firm mattress.
• Stock food, medicines and a pill organiser.
• Place frequently used items at waist height.
• Set up a night light between bedroom and bathroom.
• Arrange help for the first week or two: a family member, a nurse or an attendant.
• Plan transport home, with a car that your parent can enter easily; see getting an elderly person in and out of a car.

For equipment lists, see hip replacement recovery equipment and knee replacement recovery equipment. A hospital bed may be rented for a few weeks if the bed at home is too low; see renting or buying a wheelchair for rent-or-buy thinking.

Daily routine in the first weeks

• Walk little and often. Short walks of a few minutes every hour or two keep the joint moving and the blood flowing.
• Do the prescribed exercises daily, as shown by the physiotherapist.
• Rest and elevate the leg when sitting, as advised, to control swelling.
• Manage pain with prescribed medicines before exercise or walks, so that movement is possible.
• Wear supportive shoes, not slippers; see walking aids and footwear.
• Use compression stockings if prescribed; see compression stockings guide.
• Eat well and drink fluids; see protein for older adults.
• Sleep with pillows as advised.

Warning signs

Contact the surgeon or hospital promptly if there is:

• increasing redness, warmth, swelling or pus at the wound, or fever, which may indicate infection;
• sudden severe pain, or a new inability to bear weight;
• a calf that is swollen, red and painful, which may be a blood clot;
• sudden breathlessness or chest pain, which can be a clot in the lung: call an ambulance (112);
• numbness, tingling or a cold, pale foot;
• a fall, especially with a hit to the new joint; or
• dislocation signs after hip surgery: a sudden pop, severe pain, a shortened or twisted leg.

Helping the person at home

A helper should stand slightly behind and to the side, hold a transfer belt if advised and let the person do the work; see how to use a transfer belt. Encourage, but do not push. Keep a diary of exercises and walks. Watch mood: low mood and frustration are common during recovery. Respect the instructions, even when your parent feels well and wants to do more.

Buying or renting the frame

If the need is a few weeks, renting a frame is often sensible; for longer use, buying is more cost-effective. Make sure the frame is set to height and in good condition, and keep it until the physiotherapist says it is no longer needed. See walking frame buying guide.

When to ask a professional

Physiotherapy after joint surgery is part of treatment, not an optional extra. Ask the hospital which exercises to do and when to review, and arrange home physiotherapy if travel is hard. Our care advisors can arrange a physiotherapist, a nurse and equipment for the first weeks at home. See post-surgery recovery at home.