Principal Director & Unit Head, Orthopaedics, Fortis Memorial Research Institute, Gurgaon
Part 8 of 9 in Recent Advances in Joint Replacement
Recovery, Pain Management and Rehabilitation After Joint Replacement
April 13, 2025
What happens after surgery has changed as much as the surgery itself. Dr. Jangid described a rehabilitation and pain management protocol that looks very different from what joint replacement patients were told a decade ago.
Rehabilitation is now largely unrestricted
Older protocols limited what patients could do after surgery. Dr. Jangid's current approach is, in his words, more or less unrestrictive: patients are free to resume ordinary activity without special limits, with the specific exception of running, jumping and other high-impact sports, which place repeated stress on the implant.
Pain control without the stomach, kidney or liver risk
Rather than relying on oral tablets and injections that can affect the stomach, kidneys or liver, his post-operative pain protocol favours a transdermal skin patch or a nasal spray, both delivering opioids at a low dose. Patients get effective pain relief without sedation, headache or nausea. The only tablet used alongside this is paracetamol, which does not carry the same stomach or kidney risk as other painkillers.
What recovery timelines actually look like
The case examples Dr. Jangid shared give a concrete sense of pace: patients walking unaided by the second day after robotic knee surgery, a bilateral partial knee replacement patient comfortable and walking well within two weeks, and a patient with bilateral knock-knee deformity fully recovered, walking with a straight leg and no residual bowing, within three weeks. For patients travelling from abroad, straightforward cases can mean leaving India within about ten days of surgery, needing only a dressing change once they are home.
This article is based on a Jivo Masterclass session conducted by Dr. Subhash Jangid, Senior Director, Orthopaedics & Joint Reconstruction, Fortis Memorial Research Institute, Gurgaon. The article has been summarised with the assistance of an AI tool from the original masterclass recording. Watch the full Masterclass recording
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This guide is based on a live Jivo Masterclass: Dr. Subhash Jangid taught doctors across Africa on April 13, 2025.
FROM THE LIVE Q&A
Moderator
Could the presentation be shared as a PDF in French as well as English, and was a translator available for the French-speaking doctors on the call?
Dr. Subhash Jangid
Yes to both. The English PDF was shared with the group, the French version had already been sent separately, and a dedicated French translator was present throughout the session to help the doctors from Congo follow along.
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Frequently Asked Questions
Could the presentation be shared as an English-language PDF?▼
Yes, the English PDF was shared again on request.
One attendee thanked Dr. Jangid for the presentation and asked about opportunities to train under him.▼
Doctors from Africa can apply for a one-year fellowship programme in India to learn joint replacement surgery. Interested doctors need to email the team and register with India's National Medical Council before joining for the year-long training.
Is there an age limit for hip or knee replacement surgery?▼
There is no fixed age limit at either end. Hip replacement is generally offered from skeletal maturity onward if the joint is badly damaged, and partial knee replacement is usually done from around age 40, occasionally as early as 30, though most patients present between 45 and 50. Modern implants can last more than 30 years, so age by itself is not the deciding factor.
Could an 80-year-old patient with a knee fracture still be considered a candidate for joint replacement surgery?▼
Yes. Age alone should never be the reason to deny treatment. What matters is whether the patient is physiologically fit and medically able to tolerate surgery, not their chronological age. Every patient deserves the chance to keep leading an active life, fracture or not.
Most post-operative painkillers are known to affect the liver. What pain medication is recommended after joint replacement that avoids this?▼
Opioids are used at a very low dose, delivered through a transdermal skin patch or a nasal spray rather than as tablets or injections, giving good pain control without sedation, headache or nausea. Alongside this, the only oral tablet used is paracetamol, which does not affect the stomach or the kidneys.
What activities are restricted after modern joint replacement surgery?▼
Very few. Dr. Jangid describes the current rehab protocol as largely unrestrictive, with the main exception being running, jumping and other high-impact activities that place repeated stress on the implant.
What pain medication is used after surgery to avoid affecting the stomach or kidneys?▼
A transdermal patch or nasal spray delivering a low dose of opioids, combined with paracetamol as the only oral tablet, since neither carries the same stomach, kidney or liver risk as standard oral painkillers.
In This Series: Recent Advances in Joint Replacement
- 1.Recent Advances in Joint Replacement
- 2.Who Needs a Knee or Hip Replacement: Symptoms and Warning Signs
- 3.Partial or Total Knee Replacement: Matching the Procedure to the Patient
- 4.How Robotic Surgery Is Changing Joint Replacement
- 5.Hip Replacement Surgery: Implant Design, Materials and Durability
- 6.When Joint Replacement Surgery Should Be Delayed or Avoided
- 7.Correcting Severe and Bilateral Knee Deformities
- 8.Recovery, Pain Management and Rehabilitation After Joint Replacement
- 9.Joint Replacement Surgery in India: What International Patients Should Know