Are you headed for
Hip Replacement Surgery?

Considering having hip replacement surgery? I’m sure you have plenty of questions. I know my patients do. If osteoarthritis treatment has failed to help reduce your hip joint pain, surgery is a reasonable option. Knowing what to expect can help to minimize stress and help you prepare for what’s ahead. Learn what you need to know now before the big day arrives.




Why should you have Hip Replacement Surgery?

One of the most common orthopedic surgeries is hip replacement surgery. Surgery to replace the hip joint is recommended when severe hip osteoarthritis is present and conservative measures for the osteoarthritis symptoms have failed. Typical conservative treatment options include activity modification, weight loss, physical therapy, and anti-inflammatory medications.


hip arthritis


Of course, the most important reasons for deciding on hip replacement surgery are hip joint pain and limitation in function. X-rays alone are not what should motivate you to undergo surgery. Surgery may be warranted if you are having difficulty walking, negotiating stairs, getting in and out of a car, or getting shoes, socks and pants on/off. Pain when trying to sleep at night is also a common reason why people decide that surgery is the best option.


What is Hip Replacement Surgery?

The hip is a ball and socket joint between the femur and the pelvis. Total hip replacement surgery involves replacing the head of femur (ball) and the acetabulum of the pelvis (socket).


total hip replacement


Advancements in techniques for hip replacement surgery have made recovery easier and less complicated. In the past, the most common technique has been the posterior lateral approach. When access to the hip is made through the posterior lateral aspect of the hip, specific precautions must be followed in order to ensure the post surgical hip does not dislocate. These precautions include: limiting hip flexion to 90 degrees, no rotation of the hip inward, and no crossing of the leg past midline. Advances in techniques, such as the anterior approach, have allowed for alternative approaches, allowing freedom of movement to occur immediately after surgery.

An alternative to having a total hip replacement is hip resurfacing. With this surgery, the arthritic surface of the femur is removed allowing the head of the femur to remain intact. Because the incision is smaller and there is less bone removal, recovery is easier. Risk of dislocation is also minimized with this approach. Hip resurfacing is often recommended for younger candidates.


hip resurfacing


With a variety of surgical options available, make sure you consult with your surgeon as to what approach will be the best fit for your situation. Having this information will help prepare you for what to expect in the weeks following your procedure.


What to expect following hip replacement surgery

Surgery for hip replacement will require a minimum of a few of days in the hospital. Each surgeon will have their own protocol based on the techniques used. Methods to attach the prosthesis are done with or without cement. If cement is used, you will be able to be up and walking with a walker within the first day or two following surgery. If cement was not used, the amount of weight allowed on the leg will be limited.

Your rehabilitation team of physical and occupational therapists will guide you as to which method was used and teach you what range of motion limitations you will have based on the surgical approach performed. You may not be allowed to sit in low chairs, cross your legs, travel in low sitting cars, and may need to use a raised toilet seat. Bending to tie your shoes may also be limited.

Because allowing your leg to cross the midline may be limited, maintaining an appropriate sleeping position can be difficult. Use of a body pillow can help to keep your knees apart and maintain appropriate hip positioning.


sleeping with body pillow


In addition, because complications of hip replacement surgery can include swelling and blood clots, the use of compression stockings after surgery is common.

Immediately after surgery the physical therapist in the hospital will teach you about getting in and out of bed, moving from sitting to standing, and simple movement exercises. Be prepared to start walking immediately. Walking will initially be done with a walker and may progress to crutches or a straight cane depending on pain tolerance and weight restrictions.


rolling walker


Following the hospital stay, transfer to an inpatient rehabilitation center may occur. The focus at the center is to help prepare you to return home. You will receive physical and occupational therapy at least twice a day with the goals of improving walking tolerance, achieving independence in getting in and out of bed, and independence in hygiene and dressing.

In preparing for the return home following hip replacement surgery, some areas should be addressed in advance. As walking stairs can be difficult after surgery, plan to have sleeping arrangements available on the first floor of your home. Being that flexing the hip greater then 90 degrees might be limited, obtaining a raised toilet seat in advance is suggested.


raised toilet seat


Slip on shoes should also be available as bending to tie your shoes might be also contraindicated. Finally, in order to limit pain and swelling, plan to have ice packs available to use for frequent icing of the hip.


Physical Therapy

Following discharge from the hospital or rehabilitation facility, in home or outpatient physical therapy may or may not be recommended. Recovery is greatly facilitated by walking therefore frequent walking is encouraged. Often if complications do not occur, performing home exercises and walking will be all that will be necessary to recover and regain function. As a means of controlling postoperative swelling and pain, utilize ice packs 10 to 15 minutes at a time, three times a day.

Finally, performing simple exercises can help your hip regain its strength and mobility. Here is a link to some typical exercises following hip replacement: hip replacement surgery exercises


Summary

• Only have your hip replaced if you are experiencing hip joint pain and limited function (not just because of an x-ray).

• Talk with your surgeon about the exact type of surgical procedure that will be performed.

• Know in advance how quickly you will be able to put weight on your leg and if you will have any restrictions in motion.

• Pre-plan your return home with having a raised toilet seat, a walker, body pillow, and ice packs available.

• Start moving as quickly as you are allowed. Walking and light exercise is key!


Although hip replacement surgery is a major undertaking, recovery does not have to be difficult. Preplan for your post operative care, follow the recommendations of your doctor and physical therapist, and get moving early. Doing so will result in a successful outcome with your hip replacement surgery.

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Brian Davies Not rated yet
i had my first hip replacement 27 years ago at the age of 27, 3 months ago i had my second replacement this was carried out at the world famous Wrightington …

moving forward Not rated yet
I had a total hip replacement 4 months ago. I still have swelling and walk with a cane. Because I had non cement I had a longer haul.I couldn't put weight …

Deeb  Not rated yet
Ahoy mateys! Thought that an appropriate greeting since we're all pretty much in the same boat. Some of us, such as myself, may have a bit less common …

LLD problem 13 weeks post op Not rated yet
I am now 13 weeks post op from a THR and my affected leg is now 1/4 inch (measured by my PT) longer than the other. My OS says that this is the case because …

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