Before surgery
Optimise health, understand exercises and prepare the home and support needed after surgery.
Enhanced Recovery
Enhanced Recovery After Hip & Knee Replacement
A structured pathway designed to prepare patients well, minimise avoidable delays and support safe mobilisation and discharge after joint replacement.
Recovery starts before surgeryPreparation · anaesthesia & pain control · early mobilisation · discharge planning
Quick Answer
What is enhanced recovery?
Enhanced recovery is not a single technique or a promise of faster healing. It is a coordinated peri-operative programme covering preparation before surgery, care during the operation and structured recovery afterwards.
Key elements can include
- pre-operative education and optimisation
- planning for anaesthesia and multimodal pain relief
- early eating, drinking and mobilisation when appropriate
- physiotherapy and functional assessment
- clear discharge criteria and support at home
The Pathway
What happens at each stage?
Day of surgery
Use a planned anaesthetic and pain strategy, with early return to normal activity where clinically appropriate.
Early mobilisation
NICE recommends rehabilitation on the day of surgery if possible and no more than 24 hours after primary hip or knee replacement.
Going home
Discharge is based on safety, mobility, pain control and individual circumstances rather than a fixed target.
Can joint replacement be done as day-case surgery?
Some carefully selected patients can return home on the day of surgery. Suitability depends on the procedure, health, mobility, pain control, home support and achievement of agreed discharge criteria.
Same-day discharge is available for selected patients who meet appropriate clinical and discharge criteria. An overnight or longer stay is recommended whenever it is safer or more appropriate.
Does enhanced recovery mean less pain?
The pathway includes modern pain-management strategies, but pain after joint replacement is expected and varies between people. The goal is to control symptoms sufficiently to support safe movement, sleep and rehabilitation — not to promise a pain-free recovery.
How soon will I walk?
For primary elective hip and knee replacement, NICE recommends rehabilitation — including mobilisation — on the day of surgery where possible and no more than 24 hours after surgery, unless there is a clinical reason to delay.
What happens after discharge?
Patients receive advice on exercises, wound care, medication, warning symptoms and who to contact with concerns. Recovery continues at home and the pace is individual.
Evidence & Further Reading
UK enhanced-recovery guidance
The pathway is grounded in NICE peri-operative and joint-replacement recommendations.
NICE NG180 — Perioperative care in adults
Enhanced recovery programmes for elective major or complex surgery.
View NICE guidance →NICE NG157 — Joint replacement rehabilitation
Rehabilitation on the day of surgery where possible and within 24 hours.
View NICE guidance →NHS — Hip and knee replacement recovery
General patient information about mobilisation and recovery after surgery.
Hip recovery →Common Questions
Enhanced recovery FAQs
Is everyone suitable for same-day discharge?
No. It is only appropriate when clinical, mobility and home-support criteria are met.
Is staying overnight a failure of enhanced recovery?
No. Enhanced recovery is about safe, coordinated care. An overnight stay may be entirely appropriate.
What can I do before surgery to help recovery?
Follow your pre-operative advice, maintain activity and strength as able, optimise nutrition, stop smoking if relevant, manage medical conditions and plan practical support for home.
