Latest / The Total Knee Success Podcast: Your Essential Resource for Navigating Total Knee Replacement / Episode 102: Flying After Knee Replacement (Airports, Airplanes, and Blood-Clot Precautions)

Transcript

Episode 102: Flying After Knee Replacement (Airports, Airplanes, and Blood-Clot Precautions) · The Total Knee Success Podcast: Your Essential Resource for Navigating Total Knee Replacement

• 0:00
  A 2025 study found that people with total knee
• 0:02
  implants activated airport metal detectors more
• 0:05
  often than people without an implant. Screening
• 0:09
  equipment and procedures vary, so tell the security
• 0:12
  officer that you have an artificial knee before
• 0:14
  screening begins. It's not personal medical advice,
• 0:29
  just solid education to help you manage pain,
• 0:33
  regain mobility, and get back to living the life
• 0:35
  you love. Let's dive in. Welcome back to the
• 0:41
  Total Knee Success podcast. I'm Michelle. Robert
• 0:45
  was about five months out from his total knee
• 0:47
  replacement when he started planning a flight
• 0:49
  for his granddaughter's graduation. About a month
• 0:52
  earlier, after his surgeon had cleared him to
• 0:55
  fly, He had taken a short trip to visit his brother.
• 0:58
  He underestimated the airport walking, hurried
• 1:01
  after a gate change, wrestled a heavy carry -on
• 1:04
  into the overhead bin, and chose a window seat.
• 1:08
  He drank very little to avoid the airplane bathroom.
• 1:11
  By the time he arrived, his knee felt tight and
• 1:13
  swollen and he was too worn out to join his brother
• 1:16
  for dinner at one of his favorite restaurants.
• 1:19
  This time... He wanted a plan that would leave
• 1:22
  him with the energy to enjoy his granddaughter's
• 1:25
  graduation. Robert is fictional, although his
• 1:28
  experience is based on the kinds of travel problems
• 1:31
  people describe after knee replacement. We'll
• 1:34
  follow what he changed for the graduation trip
• 1:36
  from his front door all the way to the destination.
• 1:39
  This is the second episode in our four -part
• 1:42
  travel and outdoor activity series. Episode 101
• 1:45
  covered road trips. Today we're focusing on flying
• 1:48
  because an airport and an airplane come with
• 1:50
  their own set of challenges. Episode 103 will
• 1:53
  cover hiking, followed by cycling in episode
• 1:56
  104. By the end of this episode, you'll have
• 1:59
  several practical points to consider as you plan
• 2:02
  a flight and decide what you need to ask your
• 2:04
  surgeon or medical team. The first question most
• 2:07
  people ask is, how soon can I fly? I wish there
• 2:11
  was one simple answer, but the research doesn't
• 2:13
  give us one date that fits everyone. A 2023 review
• 2:17
  looked at the advice provided by surgeons, airlines,
• 2:21
  and travel insurers after hip and knee replacement.
• 2:24
  The recommended waiting periods ranged from 14
• 2:27
  to 180 days. That is a huge range, and it shows
• 2:33
  how much the answer can change based on the person
• 2:35
  and the trip. A 2025 review in JBJS Reviews came
• 2:40
  to a similar conclusion. The timing depends on
• 2:44
  how recently you had surgery, how long you'll
• 2:46
  be traveling, your mobility, your medical history,
• 2:49
  and your personal blood clot risk. A 2026 systematic
• 2:54
  review and meta -analysis included seven studies
• 2:57
  and almost 25 ,000 surgical patients. When the
• 3:00
  studies were combined, the researchers didn't
• 3:03
  find a definite increase in blood clots among
• 3:06
  people who flew close to the time of surgery.
• 3:08
  That is encouraging, although the evidence has
• 3:11
  important limits. All seven studies were retrospective.
• 3:15
  The results had wide confidence intervals and
• 3:18
  the people who were allowed to fly may have been
• 3:21
  healthier or lower risk to begin with. Individual
• 3:25
  studies have reported different findings. One
• 3:27
  found a higher blood clot rate among people who
• 3:29
  traveled by air around the time of lower limb
• 3:32
  joint replacement. Another found low rates in
• 3:35
  selected hip and knee replacement patients receiving
• 3:38
  their usual preventive care. The evidence still
• 3:41
  cannot give one person a flight date. When you
• 3:45
  ask your surgeon about flying, describe the actual
• 3:47
  trip, the dates, flight length, connections,
• 3:50
  ground travel, and return date. Remind the office
• 3:53
  about a previous blood clot or any recent health
• 3:56
  change, especially if the person you reach may
• 3:58
  not have your full chart in front of them. Also,
• 4:02
  check the airline's current policies before you
• 4:04
  buy a ticket. Some airlines may request medical
• 4:07
  documentation after recent surgery, and travel
• 4:10
  insurance policies may have exclusions or additional
• 4:12
  requirements. It's much easier to learn about
• 4:16
  that information before you pay for a ticket
• 4:18
  than at the check -in counter. Look at the full
• 4:21
  travel day. A two -hour flight can become part
• 4:24
  of a 10 -hour day once you include the drive
• 4:27
  to the airport, early arrival, security, time
• 4:30
  at the gate, baggage claim, and transportation
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  after landing. A connection adds another terminal
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  walk and another boarding process. The return
• 4:39
  trip may also feel different after several busy
• 4:41
  days away. Many airports are quite large, so
• 4:45
  you may need to walk a long distance from the
• 4:47
  curb to check in, then to security, a trainer
• 4:50
  shuttle, and finally the gate. Sometimes the
• 4:53
  gate changes after you've already crossed the
• 4:55
  concourse. That was one of Robert's biggest surprises
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  on his earlier trip. By the time he reached the
• 5:01
  new gate, he had already used a lot of the walking
• 5:03
  capacity he hoped to have after landing. If you're
• 5:07
  unsure whether you can comfortably cover that
• 5:09
  distance, Consider wheelchair or electric cart
• 5:12
  assistance through the airport. It can save your
• 5:15
  walking and standing capacity for the bathroom,
• 5:17
  boarding, and the activity you traveled to enjoy.
• 5:21
  Ask where the service begins. Search each airport's
• 5:24
  name plus accessibility before your trip. These
• 5:27
  pages often explain wheelchair arrangements,
• 5:30
  parking and shuttles, terminal maps, restrooms,
• 5:33
  and step -free routes. Cincinnati's airport provides
• 5:37
  step -by -step directions and indoor navigation.
• 5:41
  Denver recommends arranging wheelchair service
• 5:43
  throughout the airline at least 48 hours ahead,
• 5:46
  while Atlanta allows requests during booking
• 5:48
  or at the ticket counter. Check every airport
• 5:52
  on your itinerary because the process can differ.
• 5:56
  Wheelchair assistance and help with security
• 5:58
  are separate services. In the United States,
• 6:01
  TSA Cares can help travelers with medical conditions
• 6:04
  or mobility limitations understand the screening
• 6:06
  process and request a passenger support specialist.
• 6:10
  TSA Cares does not provide the airport wheelchair,
• 6:14
  so arrange that part through the airline or the
• 6:16
  airport. Give yourself some extra time. Shoes,
• 6:21
  luggage, an assistive device, and a busy terminal
• 6:23
  can slow things down. A little extra time lets
• 6:26
  you move at a comfortable pace instead of hurrying
• 6:29
  through the crowd with one eye on your bag and
• 6:31
  the other on the departure screen. Keep your
• 6:33
  boarding pass and flight details easy to reach.
• 6:37
  Many people use the airline app on their phone.
• 6:39
  I would also consider a paper copy, especially
• 6:42
  if your phone battery is low or the airport Wi
• 6:44
  -Fi is having one of those days. Keep your identification,
• 6:48
  medication, medication list, and important medical
• 6:51
  contact information in a light personal bag that
• 6:54
  stays with you. People also ask whether a knee
• 6:57
  implant will set off the airport alarm. It can.
• 7:00
  A 2025 study found that people with total knee
• 7:03
  implants activated airport metal detectors more
• 7:06
  often than people without an implant. Screening
• 7:10
  equipment and procedures vary, so tell the security
• 7:12
  officer that you have an artificial knee before
• 7:15
  screening begins. An implant identification card
• 7:18
  may be helpful, especially for international
• 7:20
  travel, but it doesn't allow you to skip screening.
• 7:24
  Depending on the equipment and your mobility,
• 7:26
  you may go through advanced imaging, a walk -through
• 7:28
  detector, Screening with a handheld device or
• 7:31
  a pat -down. If standing without your cane or
• 7:34
  walker is difficult, tell the officer before
• 7:36
  your device goes through the scanner. Ask for
• 7:39
  a chair or another stable place to hold while
• 7:41
  it's out of reach. The same goes for removing
• 7:44
  shoes or walking through the equipment. Explain
• 7:46
  what you can safely do before the process begins.
• 7:50
  Now let's talk about luggage because having too
• 7:52
  much to handle can wear you out before you even
• 7:54
  reach the gate. Robert remembered how awkward
• 7:57
  he felt balancing while lifting his carry -on
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  during the earlier trip, so he decided to check
• 8:02
  his larger suitcase this time. A rolling suitcase
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  is usually easier than carrying a bag, although
• 8:07
  you still have to guide it over carpet thresholds,
• 8:10
  ramps, and crowded turns. Four -wheel spinner
• 8:13
  bags move easily on smooth floors and can roll
• 8:16
  away on a slope. Two -wheel bags follow behind
• 8:19
  you and may pull you to one side. Use the style
• 8:23
  you can control without changing the way you
• 8:25
  walk. The overhead bin can be another problem.
• 8:29
  Lifting a heavy suitcase overhead takes balance,
• 8:31
  reaching, and enough control to handle a bag
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  that may shift as you lift it. Checking a larger
• 8:36
  bag or traveling with someone who can lift it
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  may be a better option. A flight attendant may
• 8:42
  be able to help, but airline policies and crew
• 8:44
  responsibilities vary. Keep the smaller bag light
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  enough that you can handle it throughout the
• 8:49
  day. Preboarding can give you more time to walk
• 8:53
  down the jet bridge, put away your belongings,
• 8:55
  and get settled before the aisle fills. Ask the
• 8:59
  airline how to request it. Use the larger airport
• 9:02
  restroom before you enter the boarding line,
• 9:03
  since preboarding also means you may be seated
• 9:06
  longer before takeoff. If you use a walker, crutches,
• 9:10
  cane, or wheelchair, confirm how far you can
• 9:12
  take it and where it will be returned after landing.
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  Label anything that will be gate -checked and
• 9:18
  remove loose accessories that could fall off
• 9:20
  during handling. Seat choice can make a real
• 9:23
  difference. Robert chose an aisle seat for the
• 9:26
  graduation trip because the window seat had made
• 9:28
  him reluctant to stand or use the bathroom on
• 9:31
  his earlier flight. An aisle seat usually makes
• 9:33
  it easier to stand and reach the bathroom, although
• 9:36
  your aisle -side leg is closer to carts and other
• 9:39
  passengers. A window seat keeps you away from
• 9:42
  the aisle and you have to move past the people
• 9:44
  beside you whenever you get up. Think about which
• 9:48
  knee was replaced, how easily you can stand from
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  a low seat, and how often you expect to move.
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  Seat pitch is the distance between your seat
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  and the seat in front of you. More seat pitch
• 9:59
  usually gives you more room to change position,
• 10:02
  even when you cannot fully straighten your knee.
• 10:05
  Bulkhead rows may have more open space with personal
• 10:08
  bags stored overhead during takeoff and landing.
• 10:11
  Exit rows have emergency responsibilities and
• 10:14
  may be inappropriate if your mobility is limited.
• 10:17
  Check the aircraft and seat map before booking
• 10:20
  because planes vary within the same airline.
• 10:23
  Once you're in the air, change your position
• 10:25
  when you can. Your surgeon or therapist may have
• 10:27
  already given you simple movements to use while
• 10:29
  sitting. When the seatbelt sign is off and the
• 10:32
  crew says it's safe, you may be able to stand
• 10:35
  or walk briefly. Turbulence can happen quickly,
• 10:38
  so follow the crew's instructions and return
• 10:40
  to your seat when asked. Movement and hydration
• 10:44
  may support comfort and circulation. Continue
• 10:47
  following the blood clot prevention plan your
• 10:49
  medical team gave you. A venous thromboembolism
• 10:52
  or VTE includes a deep vein thrombosis and a
• 10:55
  pulmonary embolism. Knee replacement temporarily
• 10:58
  raises that risk, especially closer to surgery,
• 11:02
  and long periods of sitting may add concern for
• 11:05
  some people. Keep taking your medications as
• 11:08
  prescribed. If you have any questions about this,
• 11:11
  Absolutely contact your physician. If you'll
• 11:15
  cross time zones, ask your pharmacist or prescribing
• 11:18
  clinician how to keep your dosing schedule on
• 11:20
  track. Make sure you follow your physician's
• 11:24
  instructions. Carry medication in its labeled
• 11:26
  container in the bag that stays with you. Compression
• 11:30
  garments also need to match your medical instructions.
• 11:33
  If your clinician recommended compression, use
• 11:36
  the correct length, size, and millimeters of
• 11:38
  mercury. More pressure can cause problems. If
• 11:41
  a garment rolls, bunches, digs into your skin,
• 11:44
  or creates a painful pressure area, stop and
• 11:46
  check the fit with the clinician who recommended
• 11:48
  it before wearing it again. The compression socks
• 11:51
  sold in airport shops are still compression products,
• 11:54
  even when they're displayed beside travel pillows
• 11:57
  and snacks. Follow the fluid recommendations
• 12:00
  that fit your health. People sometimes drink
• 12:03
  less because they worry about the small bathroom,
• 12:05
  the aisle, or asking seatmates to move. That
• 12:08
  can leave you thirsty, light -headed, or even
• 12:11
  constipated. Robert tried it once and planned
• 12:14
  for the bathroom this time. Fill a bottle after
• 12:16
  security, use the airport restroom before boarding,
• 12:19
  choose an aisle seat when it suits you, and go
• 12:22
  before the need feels urgent. If you have heart,
• 12:24
  kidney, or fluid restrictions, continue following
• 12:27
  your healthcare provider's plan. Airplane bathrooms
• 12:31
  are small, and standing from the toilet may be
• 12:33
  difficult. An aisle seat shortens the route.
• 12:36
  When the seatbelt sign is off and the aisle is
• 12:39
  calm, take your time getting there. Use the handholds
• 12:42
  provided and avoid pulling on the door. During
• 12:44
  a connection, use the larger airport restroom
• 12:47
  even if the next gate looks close. A gate reassignment
• 12:51
  can turn a short walk into a long one. Your knee
• 12:54
  may feel tighter or look more swollen during
• 12:57
  or after the flight. A small pillow can support
• 13:00
  your back or help you change your position, but
• 13:02
  avoid continuous pressure behind your knee. Using
• 13:06
  cold packs on the airplane can be awkward because
• 13:09
  cold packs may leak, lose temperature, or be
• 13:12
  restricted. Check the current security and airline
• 13:15
  rules before packing them. For many people, using
• 13:18
  clinician -approved cold therapy after arriving
• 13:20
  at the hotel is easier. Compare connections by
• 13:24
  total travel time, expected walking, and available
• 13:27
  assistance. A short layover can leave you rushing
• 13:30
  between terminals. A long layover gives you more
• 13:33
  time and adds more sitting. A direct flight removes
• 13:36
  an extra boarding process, but it may keep you
• 13:39
  in the airplane seat longer. For international
• 13:42
  travel, check medication documentation, entry
• 13:45
  requirements, airline medical policies, travel
• 13:48
  insurance, and access to medical care at your
• 13:50
  destination. Carry the generic names of your
• 13:53
  medications because brand names may be different
• 13:55
  in another country. Read the travel insurance
• 13:58
  policy carefully because recent surgery may affect
• 14:00
  coverage. Your travel day continues after the
• 14:04
  plane lands. You may still have a long walk,
• 14:06
  baggage claim, a shuttle, a rental car counter,
• 14:09
  and a hotel check -in. Arrange assistance through
• 14:12
  the arrival airport if you need it, and let someone
• 14:15
  else handle the heavy suitcase when help is available.
• 14:18
  If you plan to drive a rental car, make sure
• 14:20
  you've been medically released to drive and can
• 14:22
  safely control an unfamiliar vehicle. At the
• 14:25
  hotel, ask about elevator access, the distance
• 14:28
  from the entrance to your room, toilet height,
• 14:31
  and the shower or tub. If your clinician recommended
• 14:34
  cold therapy, ask whether you'll have access
• 14:36
  to a refrigerator or freezer. Put your suitcase
• 14:39
  on a luggage rack or another stable surface so
• 14:42
  you aren't repeatedly bending toward the floor.
• 14:45
  For the graduation trip, Robert chose a direct
• 14:48
  flight, arranged wheelchair assistance, checked
• 14:50
  his larger suitcase, and booked an aisle seat.
• 14:54
  He used the airport restroom before pre -boarding,
• 14:56
  kept water within reach, and stood when the crew
• 14:58
  said it was safe. His daughter managed the rental
• 15:01
  car and hotel luggage. He arrived with enough
• 15:04
  energy to have dinner with his family and attend
• 15:06
  the graduation the next morning. The earlier
• 15:09
  trip had shown him where the day could get away
• 15:11
  from him. This plan helped him protect the part
• 15:14
  of the trip that he cared about the most. Pay
• 15:18
  attention to symptoms during and after air travel.
• 15:21
  New pain or tenderness in one calf, unusual warmth
• 15:23
  or discoloration, or a sudden increase in swelling
• 15:26
  in one leg warrants prompt medical guidance.
• 15:30
  Sudden shortness of breath, chest pain, fainting,
• 15:33
  coughing blood, or a rapid unexplained heart
• 15:36
  rate requires emergency evaluation. The purpose
• 15:40
  of planning is to help you get back to the people,
• 15:42
  places, and activities you enjoy. A wheelchair
• 15:45
  through the terminal, an aisle seat, a checked
• 15:47
  bag, or a little more time between flights may
• 15:50
  help you spend more of your energy on the reason
• 15:53
  you wanted to travel. Optional travel items discussed
• 15:57
  today, including rolling luggage, a small support
• 15:59
  pillow, and a refillable water bottle, are linked
• 16:02
  in the show notes. When you're walking through
• 16:04
  a large airport, this is also a good time to
• 16:07
  use the techniques in my book, Walking Like Yourself
• 16:09
  Again, after knee replacement. And if you need
• 16:12
  something to read on the flight, there you go.
• 16:14
  The paperback and Kindle editions are linked
• 16:16
  in the show notes. Some links in the show notes
• 16:19
  are affiliate links, which means I may earn a
• 16:21
  commission if you purchase through them. Thank
• 16:23
  you. For ongoing practical education, join the
• 16:27
  free Total Knee Success Insider. I share new
• 16:29
  podcast episodes, helpful knee replacement education,
• 16:33
  and selected resources. You can sign up totally
• 16:35
  free at TotalKneeSuccess .com. In episode 103,
• 16:40
  we'll continue the travel and outdoor activities
• 16:42
  series with hiking after knee replacement. We'll
• 16:45
  look at hills, uneven ground, trekking poles,
• 16:48
  footwear, trail choice, backpack weight, fatigue,
• 16:51
  and how to decide when it's time to turn around.
• 16:55
  Thanks for joining me. I'm Michelle and this
• 16:57
  has been the Total Knee Success Podcast. This
• 17:03
  podcast is for educational purposes only. Discover
• 17:07
  more at TotalKneeSuccess .com and be sure to
• 17:10
  subscribe and share because every step forward
• 17:13
  takes you closer to living the life you love.