Not only have hip and knee replacement operations become more common, less invasive and more effective, the recovery has gotten better too. And patients play an important role in that recovery.

Novant Health orthopedic surgeons estimate 20% of a successful outcome for knee or hip replacement surgery comes down to the surgery itself, and 80% is based on how the patient recovers. Those who play what he calls an “active” role have a much greater chance for a successful outcome.

When patients are more passive and fall behind in their physical therapy, scar tissue can build up. In a worst-case scenario, the patient could need more surgery.

The typical knee replacement requires three months for a patient to get back to 90% strength, while hip replacement patients typically need one month.

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There was a time when joint replacement patients used to spend three days in the hospital and often went directly to a rehabilitation center for two weeks afterward. Now patients are typically home the same day, within a few hours, and most of the recovery is done at home.

Here's what to expect during recovery and what gives you the best chance for a successful outcome.

Better pain management

Joint replacement operations are often done with spinal anesthesia, rather than general anesthesia, which cuts down on recovery time and allows patients to get moving sooner.

And after surgery, pain can often be managed with minimal narcotics, using an assortment of nerve blockers, Tylenol, NSAIDs, and Lyrica, a medication for nerve pain.

Most orthopedic surgeons have moved away from using narcotics, which can make patients drowsy and lethargic, and not want to participate in physical therapy. (And some people prefer to avoid narcotics because of their addictive qualities and side effects.)

Hip replacement patients now require considerably fewer prescription narcotics. Even knee replacement patients only require about half of what they used to for post-operative pain control.

Different surgical procedures make for faster recovery

Two new approaches to hip and knee surgery are helping reduce pain and increase function during the recovery. One is based on where the hip incision is made for hip replacement, and the other is eliminating the use of a tourniquet to limit blood flow during knee replacement.

The hip surgery itself is a direct anterior approach, which has become more popular in the last five to 10 years. It goes between muscles instead of cutting through muscles like, in the posterior approach, which takes more time to heal.

Patients who have had severe arthritis tend to notice instant improvement right away and are that much quicker to begin their recovery.

On both knee and hip replacements patients are usually walking within an hour after surgery.