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Joint Replacement Recovery Progress Chart

Track Your Journey to Recovery After Joint Replacement Surgery

Orthopedics

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Template Content

Last updated: Mar 24, 2025

Patient Information

Name: _______________
Surgery Date: _______________
Joint Replaced: □ Hip □ Knee □ Shoulder
Surgeon: _______________

Daily Progress Tracking

Pain Level (0-10 Scale)

Week Mon Tue Wed Thu Fri Sat Sun
1
2
3
4

Range of Motion (Degrees)

Week Mon Tue Wed Thu Fri Sat Sun
1
2
3
4

Exercise Compliance

Check each day you complete prescribed exercises:

  • Week 1: □ □ □ □ □ □ □
  • Week 2: □ □ □ □ □ □ □
  • Week 3: □ □ □ □ □ □ □
  • Week 4: □ □ □ □ □ □ □

Medication Log

Date Medication Dosage Time Notes

Physical Therapy Goals

  • Walking distance goal: _____
  • Stair climbing: _____
  • Range of motion goal: _____
  • Other: _____

Warning Signs (Check if experienced)

□ Excessive pain
□ Unusual swelling
□ Redness or warmth
□ Fever above 101.5°F
□ Drainage from incision

Contact your healthcare provider immediately if you experience any warning signs

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