The holidays are a time to be with family, and a recent hip or knee replacement doesn’t have to keep you home. With some planning, most patients can travel safely, whether that means a flight across the country or a drive to a relative’s house a few hours away.
Travel after joint replacement does take more preparation than usual. Sitting for long periods raises the risk of blood clots, crowded airports and parking lots can be hard to navigate, and your new joint may set off airport security. Here is what to know before you go, and why your first step should always be a conversation with your surgeon.
When Is It Safe to Travel After Joint Replacement?
No single answer fits every patient. The right timing depends on how recently you had surgery, how your recovery is going, how far you are traveling, and your personal risk factors for blood clots.
The first several weeks after surgery are when the risk of blood clots is highest and when your mobility is most limited. For that reason, many surgeons recommend avoiding long trips, especially long flights, during the early weeks of recovery. A short car ride to a nearby family gathering is usually easier to manage than a cross-country flight.
If you have holiday travel planned, tell your surgeon before your surgery date or as early in your recovery as possible. Your care team can help you decide whether the trip makes sense, whether you need any changes to your blood thinner or other medications, and how to keep up with physical therapy while you are away.
Blood Clot Prevention: The Most Important Part of Your Travel Plan
After hip or knee replacement, your risk of deep vein thrombosis (DVT), a blood clot that usually forms in the leg, is higher than normal. Sitting still for hours on a plane or in a car further raises that risk. A clot that travels to the lungs, called a pulmonary embolism, is a medical emergency.
These habits help keep blood moving while you travel:
- Take your blood thinner exactly as prescribed. If you were sent home with a blood thinner, don’t skip doses because of travel days or time zone changes. Pack enough for the whole trip, plus a few extra days in case of delays.
- Get up and move regularly. Aim to stand and walk at least every hour on a plane, and stop every one to two hours on a road trip.
- Do ankle pumps while seated. Point and flex your feet, and circle your ankles, several times every 30 minutes. These are the same exercises you likely learned in the hospital.
- Stay hydrated. Drink plenty of water, and limit alcohol and caffeine, which can dehydrate you.
- Ask about compression stockings. Your surgeon may recommend them for long trips.
Warning signs to watch for
Call your surgeon right away if you notice new swelling, pain, tenderness, warmth, or redness in your calf or thigh, especially in one leg.
Call 911 or go to the nearest emergency room if you have sudden shortness of breath, chest pain that worsens with a deep breath, a rapid heartbeat, or you cough up blood. These can be signs of a pulmonary embolism.
Tips for Flying After Hip or Knee Replacement
Airports involve long walks, crowds, and hours of sitting in tight seats. A few choices made when you book can make the whole trip easier.
- Choose an aisle seat. It lets you stretch your leg into the aisle and get up to walk without climbing over other passengers. Bulkhead or extra-legroom seats give you even more space to keep your knee or hip in a comfortable position.
- Book nonstop flights when you can. Fewer connections mean less walking between gates and less risk of rushing.
- Request wheelchair or mobility assistance. Airlines provide this at no charge. An agent can take you from check-in through security to your gate, saving energy and reducing the risk of a fall in a crowded terminal. Ask about pre-boarding so you can get settled before the aisle fills up.
- Pack smart. Keep your medications, a copy of your medication list, and your surgeon’s contact information in your carry-on, never in checked luggage. Use a bag with wheels, and ask for help lifting it into the overhead bin.
- Bring your walking aid. Canes, crutches, and walkers can generally go through security and on board with you.
- Wear comfortable clothes. Loose pants and slip-on shoes with good grip make security, swelling, and getting to the restroom easier.
Getting Through Airport Security With a Joint Replacement
Expect security to notice your new joint. According to the American Association of Hip and Knee Surgeons, more than 90% of hip and knee implants set off airport metal detectors, including newer implants that combine metal with ceramic and plastic. This is completely normal and nothing to worry about.
Here is how to make screening go smoothly:
- Tell the TSA officer before screening starts. Let them know you have a hip or knee replacement and point to where it is. If you prefer to communicate discreetly, you can hand the officer a TSA Notification Card, which you can print from the TSA website.
- You don’t need a card or doctor’s note. You don’t need proof of your implant. Telling the officer, or showing a card, also won’t let you skip screening.
- Expect the body scanner and possibly a pat-down. You will usually be directed through the body scanner. Even then, an officer may need to pat down the area around your joint. You can ask for a private screening area, and you won’t need to show your incision.
- Bring support if you need it. If standing for a long time or raising your arms in the scanner is difficult, tell the officer.
- Allow extra time. Arrive earlier than usual so you aren’t rushing through the terminal.
- Call TSA Cares ahead of time. TSA Cares can answer questions about screening with a medical condition. Call at least 72 hours before your flight; in some cases, they can arrange extra help at the checkpoint.
- Consider TSA PreCheck. It can mean shorter lines and less time on your feet.
Making Long Car Rides More Comfortable
Driving to see family gives you more control over your schedule than flying, but hours in a car still carry the same blood clot risk.
- Plan stops every one to two hours. Get out, walk for a few minutes, and stretch before getting back in. Build these stops into your travel time so you aren’t tempted to skip them.
- Ride in the front passenger seat. Slide the seat all the way back and recline it slightly for more legroom. A firm cushion can raise a low seat, making it easier to get in and out, especially after a hip replacement.
- Get in and out the right way. Back up to the seat, sit down first, and then swing your legs in together, keeping your knees and hips moving as one. Placing a plastic bag on the seat can make it easier to swivel.
- Keep moving while you ride. Do ankle pumps and gentle leg movements throughout the trip.
- Don’t drive until you’re cleared. Driving requires quick, strong braking and full attention. Most patients need to be off opioid pain medication and cleared by their surgeon before driving, and the timeline depends on which leg had surgery and how your recovery is going.
- Keep an ice pack and medications within reach. A small cooler with ice packs can help with swelling during a long drive.
Staying Safe Once You Arrive
A relative’s home is set up for their routine, not your recovery. A few minutes of preparation can prevent a fall.
- Ask about the layout ahead of time. Find out whether you will need to climb stairs to reach the bedroom or bathroom, and whether there is a chair with armrests you can use.
- Watch for tripping hazards. Loose rugs, holiday decorations, cords, pets, and children’s toys are common culprits in a busy house.
- Be careful outdoors. In the Northeast, holiday travel often means snow and ice. Wear shoes with good traction, use your cane or walker outside if you still need it, and ask someone to clear and salt walkways.
- Keep up with your exercises. Holiday schedules make it easy to skip physical therapy exercises, but staying consistent protects the progress you’ve made. Pack any bands or equipment you use.
- Know where to get help. Save your surgeon’s office number in your phone, and find the nearest urgent care and emergency room before you need them.
Talk to Dr. Shen Before You Travel
Every recovery is different, and the safest travel plan is one made with your surgeon. Dr. Tony Shen is a fellowship-trained orthopedic surgeon at the Hospital for Special Surgery, specializing in robotic-assisted and minimally invasive hip and knee replacement. Whether you’re planning surgery around the holidays or recovering now and hoping to travel, Dr. Shen and his team can help you decide when and how to travel safely.
To schedule an appointment in Manhattan, Long Island, or Queens, call (212) 224-7988 or request an appointment online.
This article is for general information and isn’t a substitute for advice from your own doctor. If you have had joint replacement surgery, follow your surgeon’s specific instructions for travel, medications, and activity.
