SAH After Hip or Knee Replacement Surgery

Joint replacement surgery, total hip and total knee, is one of the most successful interventions in modern medicine. Most patients are walking within a day, home within 3-5 days, and back to most of their pre-surgery function within 3-6 months. But that recovery isn't automatic. The first 6-12 weeks at home need active support, and that's where SAH comes in.

This post is a practical guide for older Australians and their families navigating SAH for the recovery period after hip or knee replacement.

Plan before the surgery

The biggest single mistake we see: families wait until after discharge to start the SAH conversation. By then it's too late, services typically can't be set up for 2-4 weeks after the application, exactly when they're most needed.

If your surgery is scheduled, start the SAH conversation 4-6 weeks before:

• Ring My Aged Care to begin an assessment (or re-assessment if already on SAH)
• Discuss with the surgeon's office what discharge support looks like
• Identify a SAH provider (use the price comparison tool)
• Set up an OT home visit before surgery to identify modifications

This pre-surgical planning is sometimes called "prehabilitation." It transforms recovery quality.

Re-assessment for higher needs

If you're already on SAH at a lower Classification, the post-surgery period typically qualifies for a higher Classification temporarily. Re-assessment after discharge captures this.

Typical pattern:

• Pre-surgery: Classification 3 (mild support needs)
• Discharge: needs surge to Classification 5-6 for 8-12 weeks
• 3-6 months post-surgery: gradual return to Classification 3 or 4

Don't be reluctant to ask for re-assessment because "I don't want to be a higher Classification permanently." The system supports temporary increases. SAH is not punishing you for asking.

What to fund in the first 6 weeks

The first 6 weeks post-discharge is the highest-need period. Useful services:

Personal care, showering and dressing are difficult after hip surgery in particular. Daily personal care visits in the first 4 weeks are standard.

Physiotherapy, 100% government-funded clinical service. Aim for 2-3 sessions per week in the first 6 weeks. The exercises matter more than almost anything else. Don't skip.

Transport, to physio appointments, GP follow-ups, post-surgical reviews. Critical because driving is restricted post-surgery (typically 2-6 weeks for a knee, longer for hip).

Meal preparation, fatigue is common. Reduce the cooking load.

Domestic assistance, bending, lifting and reaching are restricted post-surgery. Cleaning, laundry, gardening should all be outsourced for at least 6 weeks.

Social support, isolation increases during recovery. Companionship hours help mood and wellbeing.

Home modifications

Often the most overlooked element. Under SAH, the assistive technology pool funds modifications separately from your operating budget. For joint replacement recovery, the typical menu:

• Raised toilet seat, for hip replacement, where deep flexion is restricted
• Toilet frame or rails, for sit-to-stand support
• Shower bench or chair, for safe showering during the no-standing-for-long period
• Grab rails in bathroom and stairwell, for stability
• Bed rail, for safe transfers
• Mobility aids (walker, crutches), though often supplied by the hospital initially

An OT home visit before discharge identifies what's needed. Quality providers will book this proactively if surgery is on the calendar.

For a deeper view of what's funded, see our home modifications under SAH post.

A typical 12-week recovery plan

Indicative care intensity by week, for a typical Classification 5 post-knee participant:

Adjust based on actual progress. Some clients are ahead of this; some are behind.

What good physiotherapy looks like

Physio is the single biggest lever for recovery quality. What to look for:

• Initial home visits in the first 2 weeks while mobility is most restricted
• Transition to clinic by week 3-4 for higher-intensity work
• Specific protocols for the surgery you've had (different for hip vs knee)
• Strength training (not just range-of-motion exercises) from week 4+
• Functional goals (climbing stairs, walking distance, sit-to-stand)
• Discharge plan with maintenance exercises

Avoid providers whose physio is generic or under-resourced. The quality of physio is the strongest predictor of long-term outcome.

When it goes well

Most joint replacement recoveries follow a predictable arc:

• Week 1: pain managed, walking with aid, basic ADLs supported
• Week 2-4: pain reducing, mobility improving, less reliance on aids
• Week 6: most patients off the walker, on a stick or independent
• Week 12: return to most baseline activities (driving, walking, gardening)
• Month 6: function approaching pre-surgery levels
• Month 12: full benefit of the surgery, ideally exceeding pre-surgery quality of life

When it doesn't go to plan

A minority of recoveries hit complications:

• Persistent pain, sometimes due to soft tissue, sometimes hardware-related
• Wound infection, early signs need urgent attention
• DVT (deep vein thrombosis), requires immediate medical response
• Falls during recovery, the period of partial mobility is risky
• Slow recovery, often related to other conditions (cardiac, diabetes, dementia)

Quality care is set up to spot these early. Workers should be trained to escalate concerns; nurses should be available for assessment within 24 hours of a flag.

Watch for de-conditioning

A specific risk in older adults post-surgery: de-conditioning from prolonged inactivity. Each week of bed rest can cost months of muscle strength. SAH support workers should encourage activity, not just provide it. The mindset is "do with" not "do for."

The step-down conversation

Once recovery is well-established (usually 3-6 months post-surgery), schedule a care plan review to step services back down. Reasons:

• Lower Classification reduces basic daily fee (slightly) and contribution
• Lower service hours reduce admin overhead
• Frees up budget headroom for other priorities (e.g. allied health maintenance)

Quality providers will initiate the step-down conversation themselves. Lower-quality ones will keep you at the high level because it's higher revenue. Watch for this.

Compare on clinical capability

For surgical recovery, what matters most is the quality and accessibility of physiotherapy and the operational discipline of post-surgical care. Use the price comparison tool to find providers with strong allied health connections, then ask specifically about their joint-replacement recovery protocols.

For the broader allied health picture, our allied health under SAH deep-dive covers what's funded and how to access it.