What is a hip replacement?
Hip replacement surgery is the most common joint replacement surgery after knee replacements and is required for those suffering from post-accident trauma or hip arthritis (wear and tear of your hip joint).
After trying pain relief and/or physiotherapy for several months and seeing little or no improvement, your doctor will recommend a hip replacement in order for you to regain mobility.
Hip replacement is a major surgery and a big decision for you to make. Chronic hip pain together with mobility issues on a daily basis are reasons to consider this surgery.
This surgery involves removing and replacing the diseased cartilage and bone of the hip joint. The normal hip joint is known as a ball and socket joint and both these joints will be replaced with an artificial one.
What is the difference between a total hip replacement and a partial hip replacement?
Your doctor will assess whether you need a total hip replacement or a partial hip replacement. This often depends on the severity of the arthritis in the hip joint or the injury sustained. Your doctor will try to preserve as much of your own joint as possible.
If you opt for a total hip replacement, this means that both your joints, the femoral head, and joint socket are replaced. With a partial replacement, only the femoral head will be replaced leaving your original joint socket in place.
Is a hip replacement a major operation?
Yes. Hip replacement is a major operation and there are many things to consider before deciding to go ahead with this surgery.
Reasons why your doctor may be offering you a hip replacement include:
- Severe stiffness and pain that makes it hard for you to walk, get out of bed or a chair, and climb stairs easily
- Pain in your hip/groin area that is still there when you are resting and stops you being able to sleep at night
- Trying physiotherapy and medication but experiencing no improvement
What is the recovery time for a hip replacement?
After the operation the physiotherapist at the hospital will teach you some exercises to strengthen the muscles around your new hip. They will get you sitting up on the side of the bed before they get you to stand and start to walk. This will be very hard at first and you will need a frame or crutches for a while to keep your balance.
The hospital will manage your pain with medication making it easier for you to do the required physiotherapy.
Do I need physiotherapy after a hip replacement?
During your stay in hospital your physiotherapist will visit you daily with some gentle exercises and show you how to get out of bed safely.
It is recommended that patients undergo a programme of physiotherapy once they have been discharged from hospital. A physiotherapist will work with you and help you regain normal strength of the muscles around your new joint, which will in turn improve your walking pattern, get you back on your feet, and allow you to resume normal daily activities.
How long does it take to walk after a hip replacement?
While you are in hospital your physiotherapist will teach you how to use a walking aid that suits you best (this can be a stick, crutches, or frame). You will be discharged from hospital once the physiotherapist is happy that you can manage safely on your own at home. They are likely to discharge you home or ask you to purchase equipment such as a raised toilet seat, high kitchen stool, and chair raisers.
As your physiotherapy programme continues during the weeks after surgery, your physiotherapist will get you walking without any aids as soon as they see you are strong enough. You will also require fewer pain medications.
If you have been committed and working hard on your physio, you will notice a great improvement in your mobility and strength in week six.
What should I expect after three months recovery?
At three months you should notice that every day you are getting stronger and feeling more like yourself. As time progresses, your pain will have significantly reduced and all the swelling from the surgery will go down.
Moving around will be so much easier and you will probably be able to get back to your regular daily activities.
Everyone is different so every recovery is different. But the harder you work at your recovery, the better and quicker it will be.
When can I go back to work after a hip replacement?
Every patient differs, and every patient has a different type of job requiring different skills. Most patients do not return to work until at least week six of recovery, but it could take up to three months.
If your job is sedentary, your doctor may agree that you can go back to work earlier as long as your pain is being managed. A phased return is often recommended and your physiotherapist can guide you through this process.
Can I drive after hip surgery?
This would have been a big concern to you when you decided to undergo this surgery. As a general rule your surgeon will expect you to refrain from driving for at least six weeks. Your physiotherapist will be able to examine you before you start driving again as it is imperative that you are fully fit to perform an emergency stop if needed. It is strongly advised that when you return to driving you have someone in the car with you on your first journey.
How long will it be before I get back to playing sports?
During the first six weeks after your surgery you will be concentrating on reaching your goals, strengthening, balance, and progressing to walking without the use of an aid. During the six weeks that follow you will need to concentrate on regaining full strength, endurance, and functioning at home as best as you can.
Once all these physiotherapy goals have been met and you are pain free, you will be ready to return to sports. This is usually three to six months post surgery.
The best type of sports for you to participate in after your surgery would be low impact sports, such as swimming, tennis, golf, cycling, and rowing. All these activities also have a low falls risk which is vital for you to consider after surgery.
It is highly recommended that high impact and contact sports such as running, jumping, football, and rugby are avoided following a hip replacement.
Early post-operative exercises after a hip replacement
There are a few recommended early exercises that will help you recover from your surgery, increase your muscle flexibility and strength, and promote healing by increasing blood flow.
The quadriceps muscles are at the front of your thigh and help to control your hip and knee joints. Pushing your knee downwards towards the bed and contracting your thigh muscle for 20 seconds at a time will help you to strengthen this muscle.
Straight leg raise
Lifting your leg up straight without a bend in your knee will help strengthen your quadriceps muscle. You want to try and hold this position for 10-20 seconds at a time.
Rotate your ankles 10 times one way and 10 times the other way. This will help reduce any swelling in your lower leg.
The exercises above are considered to be a few of the early exercises which you are likely to do immediately after your surgery. You will need the guidance of a physiotherapist to help you progress these exercises further as they become easier.
How physiotherapy can help your hip replacement
We will do whatever we can to get you on the fastest route to recovery. Some of the treatment methods we use include:
- Strengthening exercises
- Myofascial trigger point release
- Cross-friction massage
- Stretching and range of movement exercises
- Functional exercises