After hip or knee replacement when can I shower, drive, return to work, and have sex?

My team and I take tremendous pride in providing not only the best surgical outcome for our patients but also providing the best experience. We emphasize preoperative education and planning. Repeatedly, we see that when patients go into surgery with more knowledge, more confidence, and a clear plan what will happen to them after surgery, they get well faster, have a better experience and return to their full life sooner. This is our goal.

I decided to write this short blog on four common questions, topics I’m routinely asked about after someone has a hip or knee surgery. When is it ok to shower and get the incision wet, when it’s safe to drive, when should they plan on returning to work and the what factors drive that timing, and finally when it’s safe to resume sexual activities?

When can I shower after knee or hip replacement surgery?                                                             

Patients who have had a hip and knee replacement usually go home the afternoon of their surgery or the next day. I’m a firm believer in “soap and water” and encourage them to shower soon after getting home. I think a shower makes everybody feel better.

Both hip and knee replacement incisions are closed using a single subcuticular stitch. In my experience this creates a tighter initial seal of the incision, so I’m more confident encouraging my patients to shower sooner. Some studies also support that there may be a lesser infection rate with this type of closure.

Hip replacement incisions are covered with a special antimicrobial dressing that can “breath” and get wet, so showering can start the very day someone goes home. Partial or total knee incisions are also covered with this antimicrobial dressing, but one that is held in place with gauze wraps so showering is delayed 4 days to allow the incision to seal.

How soon can I have sex after my hip or knee replacement?                                                     

Returning to sex after a hip or knee replacement is fine, as long as it’s comfortable and feels good for both parties. That said, there may be some positions which simply aren’t comfortable or safe very soon after surgery. Most people wait about 3-6 weeks before having sex but some tell me they enjoy sexual relations with their partner much sooner. I teach them not to push the flexion for either the hip or knee replacement until healing is well underway.

In my career, I do not ever remember anyone telling me that they hurt themselves having sex too soon after their hip or knee replacement surgery. Many patients are initially embarrassed to discuss when they can resume sex but invariably all seem very pleased after we did.

How soon after hip or knee replacement surgery can I drive?                                                   

Everyone heals and regains their confidence and reflexes to resume driving safely at a different pace. In general, patients 70+ years old resume driving later than younger patients. Patients who had their right hip or knee replaced typically start driving later than those who had their left hip or knee replaced. Recent reports suggest that, at least following a hip replacement, reaction times improve to a least pre-operative levels four weeks after surgery and improve more quickly in individuals under 70 years old.

In my practice, many younger patients resume driving just two weeks after surgery, especially if they need to go to work. Some even sooner if they had a left hip or knee replacement. Many older individuals will wait six weeks or longer before they feel comfortable.

If they don’t feel comfortable, wait a week or two and try again. But not to push, not to drive if they feel uncomfortable and ABSOLUTELY not to drive if they’re still taking any narcotics.

How quickly can I get back to work following a hip or knee replacement?                               

The timing of when a specific patient returns to work depends on their motivation to return and their particular job. In general, patients that want to go back to work, return very quickly. Those that don’t, delay as long as they can.

Physicians, attorneys, accountants, business or restaurant owners who had their hip or knee replaced often return to their work place within a week of their surgery. Some even sooner. Most start with several hours a day and increase quickly as their stamina and confidence builds.

Other professions like teachers, fireman, policeman, nurses or folks who work for a large organization will often take two or even three weeks off before returning to work. Some of these folks also decide to go back much sooner, depending on their personal circumstances.

I care for other patients who would like to return to work quickly but the physical demands of their position prevents this. Sometimes they are able to return on “light duty” until they are more fully healed.  I support this. I think it’s therapeutic to get out of the house and back interacting with co-workers and worrying about “work stuff” rather than yourself.

So if you’re out a week, or two-three weeks or even a couple of months, almost everyone returns to their workplace after surgery if they’re motivated.

 Dr. William A. Leone is head of the Leone Center for Orthopedic Care at Holy Cross Hospital in Fort Lauderdale, Florida and has earned a reputation as one of the nation’s top orthopedic surgeons. An orthopedic surgeon for the past 29 years, his specialty is solving complex hip and knee problems. Call 954-489-4575 or visit HolyCrossLeoneCenter.com to schedule a consultation.