Many people with a hip or knee replacement (total hip arthroplasty, total knee arthroplasty) want to travel again after their operation—including by plane. Modern, minimally invasive surgical techniques and effective pain management and mobilization protocols have generally made travel safer. Nevertheless, there are factors you should consider: the optimal timing after surgery, the risk of thrombosis on long-haul flights, proper thrombosis prophylaxis, an implant card, and practical tips for travel preparation and onboard behavior. Recommendations vary; therefore, consult your surgeon or treating physician beforehand.

In short:

Can I fly after a hip or knee replacement?

Yes — in many cases, flying is possible after hip or knee surgery. Modern surgical techniques and good aftercare mean that short-haul flights are fine for many patients after a few weeks. However, there's no one-size-fits-all approach: your surgeon needs to assess how well the wound has healed, your mobility, and whether any other risk factors are present. Preventing blood clots (thrombosis) is particularly important.

How do I know that I shouldn't fly yet?

Do not fly if you are experiencing severe pain, persistent swelling, fever, signs of infection, or a sudden decrease in mobility. Travel should also be carefully planned and discussed with your doctor if you have a known clotting disorder or a history of thrombosis.

Tips to make your flight with a prosthesis as safe as possible

• Talk to your team about anticoagulation and get written travel clearance.
• Wear medical compression stockings on long-haul flights.
• Get up regularly, drink plenty of water and avoid alcohol.
• Carry your implant card and surgical report in your hand luggage.
• Request airport assistance if you need further help.

Sitting on a plane after joint replacement – ​​what you should pay attention to

After hip or knee replacement surgery (total hip or knee replacement), prolonged sitting is often still unfamiliar or associated with discomfort. Therefore, you should choose an aisle seat with sufficient legroom so that you can stretch your operated leg and stand up frequently. Avoid crossing your legs, as this can restrict blood flow and increase the risk of thrombosis. Instead, make small movements while seated – such as circling your feet or alternately lifting your toes and heels. With a knee replacement, it is recommended not to bend the joint too sharply, but to regularly extend it into a more comfortable position. If you notice that your sitting posture is becoming painful, stand up briefly and walk a few steps in the aisle. These simple measures improve comfort and help promote blood circulation, ensuring that your flight is safe and pleasant even after joint replacement surgery.

Why is special care needed when flying after joint surgery?

Flying is generally safe in itself — however, for people who have had hip or knee replacement surgery, two relevant medical aspects apply:

1. Increased risk of thrombosis (VTE – venous thromboembolism): Leg surgery temporarily increases the risk of deep vein thrombosis (DVT) and pulmonary embolism. Prolonged sitting (e.g., on long-haul flights) further increases this risk. Studies show a correlation between flight duration and VTE risk – longer flights mean a higher risk.
2. Wound healing, swelling, pain, and mobility: Shortly after surgery, pain, swelling, and restricted movement are significant issues—flying can exacerbate these problems or complicate aftercare. Modern minimally invasive surgeries often reduce pain and the need for mobilization, thus facilitating early flying, but every patient is different.

How long should you wait to fly after hip or knee replacement surgery — recommendations and evidence

Important: There is no uniform international rule—recommendations vary widely between hospitals, professional societies, and studies. Available research shows a broad range of advice. One systematic review found that recommended waiting times for people without specific thrombosis risk factors ranged from 14 to 180 days for short-haul flights and from 35 to 180 days for long-haul flights; the median was approximately 45 days for short-haul and 90 days for long-haul. This means that many experts recommend 6–12 weeks for short-haul and 12 weeks (or longer) for long-haul; others suggest more conservative timeframes.

Additional official/clinical information:

• The Royal College / NHS information advises long flights for 4 weeks before and after surgery and informing doctors of travel plans; for hip and knee replacements, longer intervals (up to 12 weeks) are often recommended.
• Professional societies emphasize that mobility, individual risk factors and pain progression are crucial; many patients travel within a few weeks, but the data is limited.

Practical, patient-friendly rules of thumb

These timeframes are for guidance only — always consult your doctor!

• Short-haul flights (<3–4 hours): often possible a few weeks after uncomplicated hip or knee replacement surgery.
• Medium-length flights (4–6 hours): more likely from 6–12 weeks , depending on mobility and risk of thrombosis.
• Long-haul flights (>6–8 hours): conservatively from 12 weeks ; in case of risk factors (obesity, previous thrombosis, cancer, coagulation disorder) often even later or only with intensive prophylactic support.

Who is at higher risk? When should you not fly?

Some patients should be especially careful and may need to postpone air travel or only travel with strict medical supervision:

• Previous DVT/PE (thrombosis/pulmonary embolism) in the past
• Known clotting disorder or active cancer
• Obesity (significantly increased body weight)
• Heart or lung conditions that could be aggravated by travel
• Impaired wound healing, persistent severe swelling or signs of infection at the surgical joint
• Uncontrollable pain or limited mobility (e.g., not being able to stand up safely or climb stairs)

If any of these points apply to you: discuss your travel plans with your family doctor, surgeon or a thrombosis specialist.

Thrombosis prophylaxis for air travel after joint surgery — what is necessary?

Thrombosis prophylaxis is one of the central issues when flying after leg amputation/surgery — and after joint replacement.

Types of prophylaxis

1. Drug prophylaxis (anticoagulation):

• Following hip or knee replacement surgery, many patients receive postoperative pharmacological prophylaxis (e.g., low-molecular-weight heparin – LMWH – or DOAC/NOAC preparations) for a period that can range from 10 to 35 days or longer, depending on the hospital. If air travel is planned, it is important that oral/subcutaneous anticoagulation is continued or adjusted during the peri- and postoperative risk phase. Guidelines for pharmacological prophylaxis in orthopedics are extensive; the treating team makes the decision as to whether the dose needs to be changed before, during, or after the flight.

1. Mechanical measures:

• Compression stockings (medical compression stockings, class II if required) — especially recommended for long-haul flights.
• Movement while sitting and standing (see below) — regular walking, foot and ankle exercises.

1. Hydration & alcohol avoidance:

• Dehydration increases the risk of VTE; drink plenty of water and reduce alcohol.

Before flying with an artificial joint: Checklist & preparation

Prepare your flight thoroughly — this list will help you not to overlook anything important.

Medical preparation

• Appointment with your surgeon/family doctor: Discuss planned departure dates and whether the trip is medically advisable. Obtain written travel clearance if possible.
• Plan your thrombosis prophylaxis: Clarify whether your current anticoagulation should be adjusted or extended. Ask about onboard protocols (e.g., dosage on the day of travel).
• Implant ID card: Ask for your implant ID card (see chapter Implant Card). You should carry this with you.
• Bring medications and prescriptions: Sufficient painkillers, anticoagulants, and possibly physiotherapy exercise sheets. Also bring a doctor's letter including the surgery date and the clinic's contact information.
• Travel insurance / repatriation: Check for exclusions in case of recent surgery; if necessary, take out repatriation insurance or medical travel expense insurance.
• Check your mobility: Can you manage longer distances at the airport? If necessary, request a wheelchair or assistance at the airport (specify this when booking).

Packing list

• Implant ID card + surgical report (copy)
• Sufficient medication and a doctor's certificate for hand luggage (especially syringes/LMWH, if needed)
• Compression stockings (one pair, medical)
• Loose-fitting clothing, non-slip shoes
• Aids: Walking stick, Trelleborg splint or similar, if you use one
• Emergency contacts, telephone number of your rehabilitation clinic/surgeon

At the airport with an artificial joint: Tips for the process

• Airport assistance: Request help (wheelchair/assistance) from your carrier for long distances or extended waiting times. Many airports offer assistance from check-in to the gate.
• Security Check & Implants: Metal implants can trigger metal detectors. An implant card will help if you are stopped; inform security personnel before proceeding. (Note: Some countries/airports use body scanners, but the implant card is still useful.)
• Check-in time: Please allow extra time; don't rush.

Behavior on the plane — How to reduce risks and stay comfortable

Seat selection

• Choose an aisle seat: This makes frequent standing and walking easier (recommended to mobilize leg veins).
• More legroom: Economy Plus / Premium Economy or an exit-row seat (if medically possible) can significantly increase comfort. Some airlines allow medically necessary seats with extra legroom upon presentation of a doctor's certificate.

Mobility on board

• Get up and walk around every 30-60 minutes: short walks in the cabin, foot/calf exercises on the pitch.
• Foot and ankle exercises: foot circles, toe movements, heel/toe raises — repeat regularly.
• Avoid crossing your legs: Avoid cramped sitting positions or crossed legs.

Compression stockings

• Medical compression stockings (recommended by many clinics/guidelines) are an important form of protection during long-haul flights and after joint surgery. Ask your doctor about size and class.

Fluids & Nutrition

• Drink plenty of water , avoid or reduce alcohol. Dehydration increases blood viscosity and can raise the risk of thrombosis.

Pain management

• If necessary, take a well-tolerated pain reliever as prescribed before your flight (in consultation with your doctor) to ensure you remain mobile. Pain crises can reduce mobility and indirectly increase the risk of thrombosis.

Implant ID card — why it's important and what it should contain

Since the EU Medical Device Regulation (MDR), there have been requirements for the information that patients should receive about implantable medical devices. The implant card contains key information:

• Patient name, surgery date
• Manufacturer name, model, serial number / UDI (Unique Device Identifier)
• Contact details of the clinic and the manufacturer
• Instructions for emergency personnel / specific risks

The implant card helps with security checks, emergency management, and recalls/field safety notifications. Make sure you have the card in your hand luggage when traveling by air.

Modern (minimally invasive) surgical techniques — do they affect the ability to travel?

Minimally invasive approaches and improved perioperative concepts (pain management, early mobilization, ERAS protocols) have shortened the recovery time for many patients. This means that some patients are mobile sooner and feel fit for short trips more quickly. However, this does not automatically change the risk of thrombosis or wound healing complications—the decision to travel by air should therefore still be made on an individual basis. In short, modern techniques help, but they do not replace individual risk assessment.

Case studies / typical scenarios when flying with a prosthesis

1) Mrs. Müller, 68 years old, hip replacement, no risk factors

• Surgery 8 weeks ago, good mobility, no complications. Plan: 2-hour flight for vacation.
• Recommendation: Speak with the surgeon; often possible while continuing the recommended VTE prophylaxis, compression stockings and frequent mobilization.

2) Mr. Schmidt, 72 years old, knee replacement, obesity, early postoperative phase

• Surgery 4 weeks ago, still swelling and dependent on crutches. Plan: Long-haul flight.
• Recommendation: Postpone flight; high risk of VTE and limited mobility. If absolutely necessary: ​​consult your doctor thoroughly, possibly with an increased anticoagulation.

(The examples are for illustrative purposes only — individual medical assessment is mandatory.)

Legal Information & Airline Rules

• Airlines have different rules for flights after surgery. Some require a doctor's certificate or information on when you can fly again. Check the airline's regulations before booking and find out about options for onboard medical care or medical escort for very short-notice repatriations.
• Travel insurance : Some policies exclude coverage shortly after major surgery. Check your policy terms and consider purchasing additional coverage if necessary.

Summary — the most important points in brief

• There is no universally applicable timeframe ; recommendations vary widely. Experts advise 4–8 weeks for short/medium-haul flights and 8 weeks or longer for long-haul flights — depending on mobility and risk factors.
• Thrombosis prophylaxis is crucial: medication, compression stockings, regular mobilization and fluid intake.
• your implant card with you — important for security checks and emergencies; in the EU there are clear regulations regarding what the card should contain.
• Modern minimally invasive techniques facilitate mobility, but do not replace individual risk assessment.

Conclusion — personal recommendation

If you are planning a flight after hip or knee surgery: Speak with Prof. Kutzner at the ENDOPROTHETICUM Rhein-Main , discuss thrombosis prophylaxis, bring your implant card, and plan your trip so that you have sufficient mobility, breaks, and medical support. For short flights, many patients are well-prepared to travel after a few weeks; for long flights or in the case of additional risk factors, a more conservative approach is advisable.