We put our Total knees and hips into the pool day 3-4 post surgery. They wear a waterproof dressing and we are fastidious regarding the chemistry, and would cancel patients if levels not OK. We do a combination of standing, walking and supine exercises for ROM, strength, Stability and function and also look at balance. Some patients will swim day 6-7 with close supervision. we use flippers for kicking on the pool plinth (bed) from Day 5-6 if the patient has met our anticapted outcomes to that point. A physio in our parctice has done a study to show the benift of this approach. It fulfilled masters requirements and I believe will now be used as a basis for a PHD. It was presented as a poster presentation at the Australian Physiotherapy Association conference in Sydney May 2002