Most people who worked before a joint replacement go back, and the job decides when.

What the studies report

A systematic review of 19 studies, covering 3,872 hip replacement patients and 649 knee replacement patients, found that the majority of people employed before surgery returned to work afterward ¹. After hip replacement the proportion returning ranged from 25 to 95 percent at 1 to 12 months, and the average time to return varied from 1.1 to 13.9 weeks; after knee replacement, 71 to 83 percent had returned by 3 to 6 months, with average times of 8 to 12 weeks ¹. The authors rated the quality of the studies moderate to low and noted that differences in how return to work was measured make the studies hard to compare ¹.

A later review of 37 hip replacement studies reported a mean return to work of 69 percent, with the time to return ranging from 1 to 17 weeks across studies ². The American Academy of Orthopaedic Surgeons puts the same answer in plainer words: depending on the type of work and the speed of recovery, it may take from several days to several weeks, and the doctor advises when it is safe ³.

What decides the timing

A review of the factors that influence return to work after hip and knee replacement found four that mattered most: age, the patient's motivation, whether they were employed before surgery, and the type of job ⁴. A physically demanding job sits at the long end of the ranges above; a desk job at the short end.

A prospective study followed 67 hip and 56 knee replacement patients under 65 who were working before surgery. At twelve months, 13 percent of the hip patients and 19 percent of the knee patients had returned only partially, and 7 percent and 11 percent had not returned ⁵. Being absent from work before surgery was associated with not returning fully after both operations; for hip patients, self-employment and, unexpectedly, a better pre-operative daily-activity score were also associated ⁵. The authors concluded that hip and knee replacement should be considered separately when planning return to work ⁵.

In practice, the gate that often decides the week is driving. The academy ties driving to being off opioid pain medication with strength and reflexes near normal ³; our page on driving after hip or knee replacement sets out the brake-reaction studies behind that.

Why the advice is often inconsistent

A qualitative study interviewed ten patients about returning to work after knee replacement. Three themes emerged: delays in getting to surgery, limited and often inconsistent advice from healthcare professionals about returning to work, and the absence of rehabilitation aimed at work rather than at daily living ⁶. The authors concluded that there is no consistent process for getting working-age patients back to work after knee replacement ⁶.

That is worth knowing before the visit, because it means the question has to be asked rather than waited for.

• Hip replacement: return to work between 1 and 17 weeks across studies, with about seven in ten returning overall ¹².
• Knee replacement: average return between 8 and 12 weeks, with 71 to 83 percent back by three to six months ¹.
• The job type, age, motivation and pre-operative employment are the main determinants ⁴⁵.

Planning the return

The pieces the studies point to are the ones to settle before surgery: what the job physically asks, whether a graded or part-time return is possible, when driving is expected back, and what the surgeon expects for a joint like yours. Writing that expectation down is part of the expectations work in the TJV Readiness Score, described on our page about preparing for surgery.

• What does my job ask of the joint, and which parts of it should come back first?
• Given that, what week would you expect me to return, and to what duties?
• Is a graded return, or a change of duties for a period, something you would support in writing?
• When do you expect me to be able to drive?

The ranges here come from groups of patients in several countries. Your surgeon decides from your joint and your job.