Can I fly after hip replacement surgery?

Flying After Hip Replacement Surgery: Safety Guidelines

Patients should wait at least 1 week after hip replacement surgery before flying to allow for proper wound healing and minimize risk of complications, including lead dislocation and venous thromboembolism (VTE).

Risk Assessment and Timing Considerations

Air travel after hip replacement surgery involves two main considerations:

1. Surgical wound healing

   • Initial healing period of approximately 1 week is critical
   • Risk of wound complications decreases after this period

2. Venous thromboembolism (VTE) risk

   • Both hip arthroplasty and extended travel are recognized risk factors for VTE
   • Chemical VTE prophylaxis significantly reduces this risk

Evidence on Safety

Research shows that with appropriate VTE prophylaxis, flying after hip replacement appears relatively safe:

• A study of 608 patients who traveled an average of 1,377 miles at an average of 6.5 days after surgery (462 by airplane) showed only 5 cases (0.82%) of symptomatic deep vein thrombosis, with no pulmonary embolisms or deaths when patients received appropriate VTE prophylaxis 1

• Another study found no differences in VTE rates between patients who flew home at a mean of 2.9 days after surgery compared to those who did not fly 2

Practical Recommendations for Safe Air Travel

Before Flying:

• Complete at least 1 week of recovery after surgery
• Ensure the surgical wound is healing properly with no signs of infection
• Continue prescribed VTE prophylaxis (enoxaparin, dalteparin, fondaparinux, or warfarin)
• Obtain clearance from your surgeon

During Flight:

• Stay well-hydrated
• Move legs periodically to prevent blood pooling
• Avoid excessive movement of the operated hip
• Consider wearing graduated compression stockings for flights longer than 4 hours 3
• Take prescribed pain medication before the flight if needed

Movement Restrictions:

• Restrict movement of the operated side for at least 1 week after surgery
• Avoid lifting the affected leg above hip level during early recovery
• No heavy lifting (>5 pounds) with the affected side
• Avoid carrying heavy luggage with the operated side

Special Considerations

For Higher-Risk Patients:

• Patients with additional VTE risk factors (cancer, history of VTE, obesity) should consider:
  • Extended VTE prophylaxis
  • Graduated compression stockings
  • More conservative timing before flying (2-3 weeks)

Practical Travel Planning:

• Request wheelchair assistance at airports
• Book aisle seats for easier movement
• Consider upgrading to seats with more legroom
• Check with specific airlines about their policies, as some require medical clearance 4
• Verify insurance coverage for travel after surgery 4

Common Pitfalls to Avoid

1. Flying too soon after surgery - The first week is the highest risk period for both wound complications and VTE
2. Neglecting VTE prophylaxis - Continue prescribed anticoagulation as directed
3. Dehydration during flights - Maintain adequate fluid intake
4. Remaining immobile during long flights - Perform ankle pumps and periodic movement
5. Overexertion with luggage - Arrange assistance with baggage

While some variation exists in recommendations from surgeons, airlines, and insurance providers 4, the evidence suggests that with appropriate precautions and VTE prophylaxis, air travel after the initial healing period (at least 1 week) appears to be reasonably safe for most patients following hip replacement surgery.