Knee Replacement Surgery Planning: How to Choose the Right Timing and Recovery Window
If you are considering a knee or hip replacement this year, you are not alone. For many active adults and families across Mid-Missouri, joint pain slowly turns everyday life into a negotiation, stairs become a strategy, sleep becomes broken, and the activities you love start to disappear from the calendar.
The good news is that planning a joint replacement does not have to feel overwhelming. The best outcomes often come from two things working together: the right clinical decision and a realistic life plan around it.
To help you think through that decision, we asked Columbia Orthopaedic Group physician Dr. Alan G. Anz, Hip and Knee Replacement specialist, a set of practical questions that patients ask every day. Below, you will find his guidance, along with a simple framework for planning your year around surgery, recovery, and getting back to what matters.
Step 1: Know what "the right time" really means
A common misconception is that there is a perfect calendar moment for surgery, like "after summer" or "once the holidays are over." In reality, timing should start with one question: how much is your joint limiting your life right now?
Dr. Anz put it plainly: "The right time for a hip or knee replacement starts with how the joint is affecting your day-to-day life." He looks at the things patients often try to push through:
- Pain levels and whether pain is becoming constant
- Mobility and stability, including fear of falling
- Work demands and what you can realistically do right now
- Sleep quality
- Whether the painful joint is forcing compensation that stresses other joints
He also emphasizes that timing is personal because your goals are personal. "Just as important are your goals, expectations, and what you want to get back to doing." For one patient, who is walking around the neighborhood without stopping. For another, it is keeping up with grandkids. For another, it is returning to golf, pickleball, hunting, or a physically demanding job.
What your surgeon will evaluate with you
Once quality of life is on the table, the timing conversation typically includes three additional factors:
- Response to conservative care
Dr. Anz explains that the team will consider whether treatments such as medications, physical therapy, injections, and activity modifications are still providing meaningful relief or are no longer effective. - Imaging and joint condition
X-rays help show the severity of arthritis, joint space loss, and deformity. That information matters because it clarifies what is causing the symptoms and what can realistically be improved without surgery. - A decision that develops over time
Many patients assume one appointment leads to a surgery date. That is rarely how it should work. As Dr. Anz notes, "For most people, this decision isn't made in a single visit. It usually develops over time through ongoing conversations."
When symptoms, imaging, and the failure of conservative options align, and you feel ready, knee replacement surgery is often the right next step.
Step 2: Plan your recovery like you would plan a major life event
The biggest planning mistake people make is underestimating recovery logistics. Not because recovery is "terrible," but because it is real life. You still have responsibilities, and your body needs space to heal.
When asked what recovery looks like early on, Dr. Anz focuses on three priorities: "moving safely, keeping swelling under control, and being comfortable enough to handle basic daily activities and light physical therapy."
That framing is helpful because it resets expectations. In the first couple of weeks, your main job is not "getting back to normal." Your job is to make steady progress without setbacks.
Knee replacement: the first few weeks, realistically
Dr. Anz explains that assistive device use varies based on pre-surgery activity level: "After a knee replacement, whether someone needs a walker or a cane depends a lot on how active they were before surgery." Many people only need support for a short time.
One of his most practical tips is to use a cane even if you do not feel you need it. "Even if you don't feel like you need a cane, it's smart to have one when you're out during those first couple of weeks." Why? It provides stability when fatigue sets in and signals to others that you need space.
He also highlights a psychological moment many patients experience: "The first two weeks are often when people realize, 'Okay, I really did have surgery and need to take it easy.' After that, most start to notice steady improvement."
Hip replacement: similar goals, often quicker momentum
Hip replacement recovery can feel faster early on, which is exciting, but it comes with a trap: doing too much too soon.
Dr. Anz notes, "With a hip replacement, the same things tend to happen, just sooner." It is not unusual to see patients out with a cane about a week after surgery, and some feel so good they forget they are still healing. "After hip replacements, I often have to remind patients to slow down, feeling good doesn't mean the body is fully healed yet."
The theme is clear: early progress is great, but pacing is the difference between smooth recovery and avoidable setbacks.
Step 3: Build a real calendar, not a hopeful one
If you are planning knee replacement surgery around work, family obligations, and travel, you need a conservative buffer. Dr. Anz recommends a protected recovery season: "I usually tell patients to think in terms of a two-month window after surgery where nothing major is scheduled."
That does not mean you will be "down" for two months. It means you give yourself room to recover and be human. Healing is not perfectly linear, and planning for the best-case scenario can create unnecessary stress if you hit a slower week.
Weddings, trips, and big milestones
If you have an important event, Dr. Anz advises avoiding surgery in the weeks leading up to it: "If there's a big event like a wedding or a long-planned trip, it's best not to schedule surgery just a few weeks beforehand." The goal is not to simply attend the event, but to enjoy it.
Returning to work: timeline depends on the job
Work planning is one of the most important parts of scheduling knee replacement surgery, and it varies widely:
- Some people can return to work in 2 to 4 weeks (typically less physical roles)
- Others may need 6 weeks or more
- For very physical jobs, 6 to 12 weeks may be needed for safe return
Dr. Anz's planning principle is worth repeating: "I usually encourage patients to plan for a little more time off than they think they'll need." It is much easier to return earlier than expected than to scramble for more time later.
He also emphasizes that this plan should be built together, based on your actual life: "Understanding what you do for a living and what your expectations are helps us make that plan together."
Step 4: Prepare before surgery, because it changes the recovery experience
People often ask what they can do to improve outcomes. The answer is not about perfection; it is about preparation and clarity.
Dr. Anz brings the decision back to quality of life and readiness: "When patients ask me whether this is the right year for surgery, I usually tell them it comes down to one main thing: how much that hip or knee is affecting their quality of life."
If you are avoiding activities you love, working around constant pain, or feeling limited day to day, and conservative options are no longer helping, then delaying purely out of fear can be costly. Dr. Anz notes that in some cases, "delaying for years just to delay can actually lead to worse outcomes than if the surgery had been done sooner."
At the same time, he is clear that you should not rush. "If a cortisone injection, exercise, or simple activity modifications give you meaningful relief and allow you to do what you want to do, then it's probably not the right year yet, and that's okay!"
A practical "pre-op" checklist to discuss with your care team
Every patient is different, but here are common planning topics to ask about as you consider knee replacement surgery:
- What conservative treatments have we tried, and what is left to try?
- What does imaging show, and how does that connect to my symptoms?
- What strength, mobility, or swelling goals should I work on before surgery?
- What help will I need at home for the first week or two?
- What does my return-to-work plan look like based on my job demands?
- What time of year best fits my life, responsibilities, and support system?
Dr. Anz also points out that personal factors matter: "There are also practical, personal factors only you can weigh, how your joint affects your work, what time of year makes the most sense, and how surgery fits into your life and schedule." Some people prefer winter recovery. Others plan around travel, farm responsibilities, or busy work seasons.
His bottom-line guidance is simple and calming: "There's no single 'right' calendar year, just the right time for you."
Why a coordinated care journey matters when you choose surgery
When you are planning something as significant as knee replacement surgery, you want the path to feel clear, not fragmented.
Columbia Orthopaedic Group serves active adults and families across Mid-Missouri with coordinated orthopaedic care from evaluation through recovery, all under one roof. That means fewer handoffs, clearer next steps, and a care journey designed to help you move forward with confidence. As an independent practice, Columbia Orthopaedic Group also prioritizes cost clarity, including no facility fee, so patients can make informed decisions without unnecessary surprises.
If you are unsure, start with a conversation, not a commitment
If you are on the fence, you do not need to decide today. You do need clarity.
Dr. Anz's closing advice is a helpful standard for anyone weighing surgery: "The goal is to choose surgery because you need it, not because you're rushing, and not because you're avoiding it out of fear."
A thoughtful evaluation can help you understand where you are in the process, what options remain, and what a realistic timeline would look like if knee replacement surgery becomes the best next step.
If your knee or hip pain is keeping you from work, sleep, recreation, or the life you want to live, schedule an orthopaedic evaluation and get a clear plan you can trust.