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

In brief:

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 acceptable for many patients after a few weeks. However, there is no "one-size-fits-all" approach: Your surgeon must assess how well the wound has healed, your mobility, and whether other risk factors are present. Prevention of blood clots (thrombosis) is particularly important.

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

Do not fly if you are still experiencing severe pain, persistent swelling, fever, signs of infection, or an acute deterioration in mobility. Even if you have known clotting disorders or have previously experienced thrombosis, your trip should be carefully planned and discussed.

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 ID card and surgical report in your hand luggage.
• Request airport assistance if you need further assistance.

Sitting on an airplane after joint replacement – ​​what you should pay attention to

After a hip or knee replacement (hip or knee replacement), sitting for long periods is often still unfamiliar or associated with discomfort. Therefore, on an airplane, you should choose an aisle seat with sufficient legroom so that you can stretch the operated leg and stand up more often. Avoid crossing your legs, as this can restrict blood flow and increase the risk of thrombosis. Instead, engage in small movements while sitting—such as foot circles or alternately lifting your toes and heels. With a knee replacement, it is advisable not to bend the joint too sharply, but to regularly adjust it to a more comfortable stretched position. If you notice that sitting 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 remains safe and enjoyable, even after a joint replacement.

Why do you need to be extra careful when flying after joint surgery?

Flying is generally safe per se, but for people who have undergone hip or knee replacement, there are two relevant medical aspects:

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 link between flight duration and VTE risk—longer flights mean a higher risk.
2. Wound healing, swelling, pain, and mobility: Pain, swelling, and limited mobility are common issues shortly after surgery. Flying can exacerbate these symptoms or complicate aftercare. Modern minimally invasive surgeries often reduce pain and the need for mobilization, making early flying easier. However, every patient is unique.

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

Important: There is no uniform international rule—recommendations vary widely between hospitals, professional societies, and studies. Available research shows a wide range of advice. A 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 flights and 90 days for long-haul flights. This means that many experts recommend 6–12 weeks for short-haul flights and 12 weeks (or longer) for long-haul flights; others recommend more conservative periods.

Additional official/clinical information:

• The Royal College of Surgeons and NHS advises avoiding long flights for four 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 data are limited.

Practical, patient-friendly rules of thumb

These time periods are a guideline – always ask your doctor!

• Short-haul flights (<3–4 hours): often possible a few weeks after a complication-free hip or knee replacement.
• Medium flights (4–6 hours): more likely from 6–12 weeks , depending on mobility and risk of thrombosis.
• Long-haul flights (>6–8 hours): conservative treatment from 12 weeks ; in cases 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 avoid flying?

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

• Previous DVT/PE (thrombosis/pulmonary embolism) in the past
• Known coagulation disorder or active cancer
• Obesity (significantly increased body weight)
• Heart or lung conditions that could be worsened by travel
• Wound healing disorders, 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 during 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):

• After hip or knee replacement, many patients receive postoperative prophylactic medication (e.g., low-molecular-weight heparin (LMWH) or DOAC/NOAC preparations) for a period that can last 10–35 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 perioperative and postoperative risk phase. Guidelines for prophylactic medication in orthopedics are extensive—the decision as to whether the dosage needs to be adjusted before, during, or after the flight is made by the treating team.

1. Mechanical measures:

• Compression stockings (medical compression stockings, Class II if necessary) — especially recommended for long-haul flights.
• Sitting and standing exercise (see below) — regular walking, foot and ankle exercises.

1. Hydration & Avoiding Alcohol:

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

Before flying with an artificial joint: Checklist & preparation

Prepare your flight thoroughly—this list will help you avoid missing anything important.

Medical preparation

• Appointment with your surgeon/family doctor: Discuss your planned departure dates and whether the trip is medically justifiable. Obtain written travel clearance , if possible.
• Plan thrombosis prophylaxis: Clarify whether your current anticoagulation needs to 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 the Implant Card chapter). You should carry this with you.
• Bring medications and prescriptions: Sufficient painkillers, anticoagulants, and possibly physiotherapy exercise sheets. A doctor's letter including the surgery date and the clinic's contact information.
• Travel insurance/repatriation: Check for exclusions if you have had a recent surgery; consider purchasing repatriation insurance or medical travel expense coverage.
• Check your mobility: Are you able to manage longer distances at the airport? If necessary, request a wheelchair or assistance at the airport (indicate this when booking).

Packing list

• Implant ID + surgical report (copy)
• Sufficient medication & medical certificate for hand luggage (especially syringes/LMWH, if necessary)
• 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 assistance (wheelchair/assistance) from your carrier for long journeys or extended waiting times. Many airports offer escorts from check-in to the gate.
• Security Check & Implant: Metal implants can trigger metal scanners. An implant ID card is helpful if you are stopped; inform security personnel before passing through. (Note: some countries/airports use body scanners, but the implant card is still useful.)
• Check-in time: Allow some extra time; don't rush.

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

Seat selection

• Choose an aisle seat: Facilitates frequent standing and walking (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 medical-related seats with more legroom upon presentation of a medical certificate.

Mobility on board

• Get up and walk every 30–60 minutes: short walks in the locker room, foot/calf exercises at your desk.
• Foot and ankle exercises: Foot circles, toe twirls, heel/toe raises — repeat regularly.
• No crossed legs: Avoid cramped sitting positions or crossed legs.

compression stockings

• For long-haul flights and after joint surgery, medical compression stockings (recommended by many hospitals and guidelines) are important protection. Ask your doctor about size and class.

Fluids & Nutrition

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

Pain management

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

Implant ID card — why it is important and what it should say

Since the EU Medical Device Regulation (MDR), there have been requirements regarding the information 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
• Information for emergency personnel / special risks

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

Modern (minimally invasive) surgical techniques — does this 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 the susceptibility to wound healing—the decision to travel by air should therefore still be made on an individual basis. In short, modern techniques help, but do not replace individual risk assessment.

Case studies / typical scenarios when flying with a prosthesis

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

• Surgery 8 weeks ago, good mobility, no complications. Plan: 2-hour flight to vacation.
• Recommendation: Talk to your surgeon; often possible with continued recommended VTE prophylaxis, compression stockings, and frequent mobilization.

2) Mr. Schmidt, 72 years old, knee prosthesis, 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: ​​intensive medical consultation, possibly extended anticoagulation.

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

Legal & Airline Rules

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

Summary — the most important points briefly

• There is no universal timeframe ; recommendations vary widely. Experts recommend 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; the EU has clear guidelines on what the card should contain.
• Modern minimally invasive techniques facilitate mobility but do not replace individual risk assessment.

Conclusion — personal recommendation

If you're planning a flight after hip or knee surgery, talk to Prof. Kutzner at ENDOPROTHETICUM Rhein-Main , discuss thromboprophylaxis, bring your implant card, and plan your trip so that you have sufficient mobility, breaks, and medical support. For short trips, many patients are well-equipped to travel after a few weeks; for long trips or if you have additional risk factors, more conservative planning is advisable.