What should I ask before a hip or knee replacement?

I wish more people would ask me what success looks like after a joint replacement. I also wish they would ask what a disappointing result could look like, how much pain to expect, and what recovery will ask of them.

Those questions help us decide whether the operation fits your life. They also give us a chance to prepare for the weeks after surgery, when you are doing the work of getting better at home.

Going home the day of surgery still means you have had a major operation. A short stay does not tell you how much healing remains. I want patients to understand both the potential value of a replacement and the commitment involved before deciding to proceed.

What would success look like for me?

Start with something you want to do more comfortably: walk around the grocery store, climb the stairs at home, or get back to a particular activity. These are examples of goals to discuss, not promises about what surgery will deliver.

Then ask: “How likely is this operation to help with that goal, and what might it leave unchanged?”

The AAHKS guidance on setting expectations encourages patients and surgeons to discuss pain relief and function before surgery. I want that conversation to be specific. Being able to walk farther and returning to a demanding sport are different expectations.

A useful answer should explain what improvement is reasonable for your joint and health, what limitations may remain, and how we will assess progress. If we are discussing hip replacement or total knee replacement, the plan should follow the problem we are trying to treat.

It is also worth asking whether further nonsurgical care is reasonable, and what we would monitor if you choose to wait. An appointment does not commit you to an operation.

What would a disappointing result or a complication look like?

“Failure” can mean different things. It might mean an implant that needs another operation. It might also mean persistent pain or difficulty doing something that matters to you, even without a revision.

Ask your surgeon to explain both. A discussion of implant durability alone cannot answer whether you will be satisfied with the result.

A 2025 systematic review of long-term pain after hip and knee replacement found that some patients continued to report pain months or years later. Estimates varied, and differences between studies and loss to follow-up reduced confidence in the exact proportions. Persistent pain deserves assessment; it does not automatically mean the implant has failed or that another operation is needed.

Complications also belong in the conversation. Infection, blood clots, nerve injury, and implant problems are among the risks described in AAOS joint-replacement guidance. Ask which risks matter most for your health and what the team does to address them.

How much pain should I expect?

Expect pain after surgery. Replacing the joint does not remove the discomfort of an operation or the time needed for tissues to heal.

There is no honest pain score I can promise every patient. The more useful discussion is what discomfort may be expected at each stage, how it will be managed, and what should prompt a call.

Ask about the first few days, the following weeks, and the longer recovery. Ask what you may feel when getting out of a chair or doing your prescribed exercises. Your team should also explain the medication plan, side effects to watch for, and what to do if pain is preventing sleep or the movement they have asked you to do. AAHKS pain guidance is a useful starting point for that discussion.

Do not assume that every new or worsening symptom is something to push through. Before leaving the surgical facility, know the warning signs your team wants reported and how to reach someone after hours. Sudden chest pain or shortness of breath needs emergency care. Increasing wound redness or drainage, fever, or new calf swelling warrants prompt medical assessment. AAOS recovery guidance describes these warning signs.

If I go home that day, what does that actually mean?

Same-day discharge means your team has assessed whether you can continue recovering safely at home. It does not mean your joint has healed or that you can immediately resume your usual routine.

AAHKS outpatient guidance describes checks such as safe walking with an aid, stable vital signs and pain controlled with oral medication. The home-support plan matters too. Not everyone is a candidate for same-day discharge.

Ask who should stay with you, what help you will need, and what would make an overnight stay appropriate. Arrange practical help with meals, transport and daily tasks before surgery.

What will recovery require from me?

Recovery continues over weeks and months. Your surgeon and therapist should explain the exercises, walking plan and activity limits for your particular operation. AAOS guidance describes rehabilitation as an individual process that includes restoring movement and strength.

Ask for milestones rather than one date when everything is supposed to be finished. What should you be working toward early on? When might driving or work be reasonable? What would make the team reassess your progress?

I want patients to understand that rehabilitation takes effort. I also want them to tell us when pain, fatigue, transport or responsibilities at home are making the plan difficult. We need to know where help is needed. A slower recovery is not a measure of your character or how much you wanted the operation to work.

How should I prepare mentally?

This deserves a place in the first conversation. Tell your surgeon what worries you about pain, needing help, sleep, or being away from your usual activities. If you already receive care for anxiety or depression, include that in the preparation discussion.

A review of systematic reviews found associations between several psychological factors, including anxiety and depression, and persistent pain after hip or knee replacement. Those associations do not establish that thoughts cause a poor result or that positive thinking prevents one.

For me, this is a reason to make support part of preparation. Ask whom you can contact if you feel overwhelmed and how your surgical team and existing clinicians can help. You do not need to arrive at surgery pretending to have no concerns.

Before your appointment, write down the activity you most want to regain and the part of recovery you feel least prepared for. Our joint conversation guide can help you organize what to bring. I would rather discuss an uncomfortable question before surgery than have you face it for the first time afterward.