Continuing Your Recovery - Hip Surgery
How long does it take to recover?
Most hip replacement patients are able to participate in a majority of daily activities by 6 weeks. Overall by 2 months most patients have regained much of the endurance and strength lost around the time of surgery and are able to participate in daily activities without restriction.
What restrictions will I have?
Depending on how your surgeon performs your surgery, you may have slight differences in your rehabilitation instructions including restrictions. In general, most surgeons prefer that you avoid certain positions of the hip that can increase your risk of dislocation of the hip for about 6 weeks following surgery. After 6 weeks the soft tissues involved in the surgery have healed and restrictions are often lifted allowing more vigorous activity. Many surgeons suggest that patients avoid any repetitive impact activities that can increase the wear on the implant such as long distance running, basketball, or mogul skiing. Otherwise limitations following hip replacement surgery are few.
- Avoid pivoting your leg
- Sleep on your back or operated side only for 6 weeks after surgery or as directed by your surgeon
When can I walk after surgery?
Rapid rehab protocols which emphasize increasing mobility and activity, aids a quicker recovery. You will be out of bed, sitting in a chair and walking beginning the day of, or the day after the surgery. You will attend physical therapy sessions two times a day starting the morning after your surgery. You will use a walker at first and, depending on your progress, may practice walking with a cane before you are discharged from the hospital. There are exercises to achieve mobility and strengthen the muscles around the knee replacement, but initially these are relatively easy. You will wean to a cane or no assistive device by 2-3 weeks post-operatively.
When can I shower?
Most surgeons do not like the wound to be exposed to water for 5-7 days. However, becoming more popular with surgeons are waterproof dressings that allow patients to shower the day after surgery. Patients then remove the dressing at 7-10 days after surgery. Once dressings are removed you still shouldn't soak the wound for 3-4 weeks until the incision is completely healed.
When can I drive?
If you had surgery on your LEFT hip, you may return to driving as you feel comfortable, if you have an automatic transmission. If surgery was on your RIGHT hip, you should not drive for 1 month (4 weeks) after surgery. However, some surgeons do not allow their patients to drive until after they have been seen in the office at 4-6 weeks after surgery. Check with your surgeon for more specific direction.
When can I return to work?
Returning to work is highly dependent on the patient's general health, activity level and demands of the job. Depending on the type of job, you may resume work whenever you feel able. More demanding jobs requiring more lifting, walking, or travel may need up to 3 months for full recovery. Always discuss your plan with your surgeon to obtain the proper clearance to resume work.
Do I need physical therapy after surgery, if so for how long?
Initially most patients will receive some physical therapy while in the hospital and depending on preoperative conditioning and support, may or may not need additional therapy as an outpatient. Much of the therapy after hip replacement is walking with general stretching and thigh muscle strengthening which many patients can do on their own, without the assistance of a physical therapist.
If you go directly home from the hospital, you will have in-home physical therapy about 3 times a week, for 2 weeks. It is advisable to continue physical therapy on an outpatient basis after you are discharged from in-home physical therapy. You should call the outpatient physical therapy facility soon after arriving home to schedule your first appointment (for the third week after surgery). This is to prevent a lag in your progress. You can call Towson Sports Medicine in Towson at 410-337-8847, in Bel Air at 410-569-8587, UM SJMC's Outpatient Physical Therapy/Rehab at 410-337-1336 (press 2), or a facility of your choice that is within your insurance network to make an appointment.
If you go to an inpatient rehab facility or transitional care unit from the hospital, you should contact the Outpatient Physical Therapy Facility as soon as you arrive home to set up appointment to continue your physical therapy.
You will also be taught a series of exercises that you can perform on your own without supervision. For the first 6-12 weeks after surgery you should spend some time each day working on both flexion and extension of your knee. It is a good idea to change positions every 15-30 minutes. Avoid a pillow or roll under your knee. A roll under the ankle helps improve extension, prevent a contracture and relieve pressure on the heel. Aquatic exercising, swimming, and exercise bike are good exercise options, and can be continued indefinitely and independently.
What are the major complications?
Total hip replacement is an excellent pain relieving procedure and most patients receive approximately 95% pain relief. Although complications are relatively rare (1-5% of patients), patients may experience a complication in the postoperative period. These include very serious and possibly life threatening complications such as heart attack, stroke, pulmonary embolism which is (a blood clot to lungs) and kidney failure.
Infection is one of the most debilitating complications and often may require prolonged antibiotics with additional surgeries to rid the infection.
A blood clot in the leg is also a relatively uncommon complication requiring some type of blood thinner following surgery to reduce the incidence.
Another complication specific to hip replacement is dislocation of the joint (1%) that may require additional surgery if dislocation becomes recurring.
Leg length differences following surgery are also a possibility and may be difficult to avoid sometimes in order to insure a stable hip. Often this leg length discrepancy is mild and rarely needs treatment.
How long do I have to follow up?
It is important to follow up with your surgeon after your joint replacement. In most cases, joint replacements last for many years. You need to meet with your treating doctor after surgery to ensure that your replacement is continuing to function well.
In some cases, the replaced parts can start to wear out or loosen. The frequency of required follow up visits is dependent on many factors including the age of the patient, the demand levels placed on the joint, and the type of replacement.
Your surgeon will consider all these factors and tailor a follow-up schedule to meet your needs. In general seeing your surgeon every 1-2 years is recommended.