How long is the recovery period after surgery?
The recovery period after surgery depends on the patient and their individual needs and medical condition.
What is the rehabilitation after hip replacement surgery?
Rehabilitation and physical therapy are started immediately following surgery and continue throughout hospitalization and at home for one year after surgery. On the first day after surgery, the physical therapist will meet with you in your hospital room for an assessment. On the second day, you will go to the Physical Therapy department by wheelchair for treatment. Your physical therapist will monitor the strength and flexibility in your leg and hip, as well as your ability to stand and sit. In addition, a physical therapist will provide goals and instructions for you to complete while in the hospital and at home.Your doctor may determine that it is best for your recovery if you go to a rehabilitation center after discharge from the hospital. At the rehabilitation center, you will have concentrated time with a physical therapist and occupational therapist and will regain your strength, learn about all your exercises and the precautions that you’ll need to follow. Your length of stay at this facility is approximately 5 to 14 days. Your doctor’s physician assistant or nurse will discuss facilities available for your needs, and a Case Manager specializing in Discharge Planning will meet with you during your admission. The Case Manager handles all of the planning for your rehabilitation.
Positioning After Surgery
After surgery, your physical therapist will instruct you regarding hip movement precautions and any limitations you may have for range of motion. Keep in mind that your physical therapy and strengthening exercises will help you gain greater mobility and ensure an easier recovery following surgery. It is highly recommended that you continue therapy treatment for the recommended timeframe prescribed by your physical therapist.Your physical therapist will tell you that there are several basic rules about positioning that you should be aware of following surgery. Make sure that you do not bend forward more than 90 degrees, and do not lift your knee on the surgery side higher than your hip. Also, do not cross your legs or rotate your leg outward, or twist or pivot your operated hip. While sitting, make sure that you use a straight back chair with arm rests, and do not sit in chairs or sofas lower than knee height since they require excessive bending at the hips when sitting down and getting up. Do not sit on low soft sofas or on stools and remember not to lean forward or cross your legs. Since most toilet seats are lower than knee height, patients are recommended to use a toilet seat extension, which are available for purchase in the hospital or a medical supply store.
How can I manage at home during recovery from hip replacement surgery?
The following are recommendations for home care activities following hip replacement surgery:
General Safety Tips
Simplify your surroundings
- Remove clutter, keep stairs free of objects.
- Keep supplies in the same place.
- Remove small rugs throughout the house.
Keep walking areas safe
- Secure electrical wires and extension cords or move them away.
- Watch out for your pets when walking.
- Keep hallways/stairways well lit.
- Purchase night lights for bedrooms and bathrooms.
- Stairs should have securely fastened handrails. Non-skid threads on stairs add to safety. If you have problems with your vision, add a contrasting color to mark stair edges.
Stay prepared for an emergency
- Keep smoke detectors in good working order.
- Keep emergency numbers near the phone. If you have a speed dial phone, program the emergency numbers for automatic use. Cordless phones are recommended if walking is difficult, or if access to the phone is a problem.
When riding home from the hospital, make sure to stop every 45 to 60 minutes to get out of the car and do some walking. Also, do ankle pumps in the car while riding. If you are flying home, request an aisle seat and keep the operative leg extended in the aisle. You should request to be boarded last on the plane.
Resting and Sleeping
When resting or sleeping in bed, it is recommended that you lie on your non-operative side for the first 4 to 6 weeks following surgery. Make sure you have a pillow between your legs, and also a second pillow to support your foot and ankle. If you lie on your operative side, keep in mind that this may not be that comfortable in the initial weeks following surgery and is not recommended immediately following surgery. When you lie on your back, you must have a pillow between your legs. If you get up in the middle of the night, sit at the side of the bed for a few seconds to avoid dizziness.
For positioning during sexual relations, make sure to consult your physician or physician assistant. Intercourse may be resumed approximately 3 weeks after surgery, following the precautions outlined by your physician.
Reaching typically requires too much bending and is typically not comfortable for patients following surgery. It is recommended for the first four to six weeks after surgery that you use long handled reachers that may be obtained from your occupational therapist or a medical supply store.
For dressing, to prevent lifting your knee higher than your hip on the surgery side, you may be given a long shoehorn and a dressing stick which will help you in putting on and taking off your shoes, socks and pants independently. Remember to always put your operative leg in the pants first. If you wear tie shoes, elastic shoelaces may be used to eliminate the need for tying.
Your physical therapist will teach you the correct way to go up and down stairs using handrails and/or crutches. Remember to use your good leg first, followed by the crutches and the surgery leg. When going down stairs, the crutches and surgery leg go first, followed by the good leg.
For bathing, do not attempt to get into the bathtub to take a bath or to use an overhead shower. The excessive bending at the hips needed to get into and out of the bathtub should be avoided. Make sure not to use a walk-in type shower or take a sponge bath until 11 days following your surgery. Keep a portable commode (or a urinal) if a bathroom is far from your bedroom.
Remember not to bend too far or stoop when performing household chores. Chores that you should avoid that may involve excessive bending include cleaning the floor, taking out the rubbish, and making beds.
Following surgery, you will need to use a walker or crutches based on your condition, which your occupational or physical therapist will provide for you. Make sure to stay on your crutches or walker until your doctor or physical therapist advises that you use a cane. Your doctor will decide how much weight you can put on your surgery leg. In most cases, you will be able to put 100 percent of your weight on your surgery leg, unless otherwise notified. Your physical therapist will help you learn how to use your walker or crutches correctly and help you to obtain the appropriate equipment for use at home. A bag or basket attached to your walker will allow you to carry small items when walking.Keep in mind that walking does take effort following surgery. While physical therapy will help patients learn how to correctly use a walker or crutches, an individual’s recovery is based on their dedication to therapy and exercises following surgery.
Eating and Exercising
Eat well-balanced meals and make sure to complete the exercises that you have been taught in physical therapy 3 times a day. Keep in mind that it can take over a year for your muscles to become strong, so it is extremely important to do your exercises to help ensure a safe and effective recovery. Also remember to elevate both of your legs when sitting to minimize swelling.
It is recommended that you not drive for 8 weeks following surgery. You may go out in a car (as a passenger) approximately 3 weeks after you return home, but make sure to avoid sports cars and cars with bucket seats because of the low seat height. To get in and out of a car, park the car several feet away from the curb. Stand on the street and turn your back to the car and sit down. Slowly slide back on the seat, keeping your legs straight, not leaning forward. Get into the car by swinging your legs around to the front of the seat, keeping your legs straight.
How should I get into a car after my total hip replacement?
- The front passenger car seat should be pushed all the way back before you enter the car.
- Have the driver park on a flat surface and/or near the driveway ramp.
- Walk toward car using the appropriate walking device.
- When close to the car, turn and begin backing up to the front passenger car seat. Never step into the car! (see figure 1)
- Placing a plastic bag on a fabric seat may make moving easier.
- Reach with your right hand and hold the door frame or headrest. Place your left hand on the car seat or dashboard. (see figure 2)
- Slowly lower yourself to the car seat. (see figure 3)
- Slide yourself back onto the car seat.
- Swing your legs into the car. Try to move one leg at a time. Keep your toes pointed upward. (see figure 4)
- Do NOT cross your legs! (see figure 5)
- Reverse these steps to get out of a car.
When taking extended car rides, make sure to take breaks every 30 to 45 minutes. Get out of car and walk/stand for a few minutes so you don't become too stiff.
How to Sit Down and Stand Up After a Total Hip Replacement
To sit after a hip replacement:
- Back up to the bed/chair until the back of your knees are touching the bed/chair.
- Reach your hands back for the armrests of the chair. Maintain your weight-bearing status!
- Lower your body slowly into a seated position. Avoid bending forward at your trunk.
- Sit on a firm chair with straight back and armrests. Keep hips and knees at 90 degrees (i.e., knees below hips).
- DO NOT sit on low, soft or overstuffed furniture that may cause excessive bending of your hip.
- Follow the precautions and weight-bearing status as instructed by your doctor or therapist.
- Scoot to the edge of the bed/chair. Avoid bending forward at your trunk.
- With your hands on the bed or chair, push up to the standing position. Bring one hand at a time up to your walker.
How frequently should I schedule follow up appointments with my doctor following surgery?
Post-operative visits help your surgeon know that your hip is healing well. Make sure to schedule your first evaluation within the recommended timeframe indicated by your surgeon. This recommended timeframe is 4 to 6 weeks following your hip replacement surgery. Also request that any X-rays be sent to your orthopaedic surgeon’s office. X-rays are typically taken the week of surgery, at 12 months and then yearly.If you have a problem before you schedule your return appointment, make sure to call your doctor’s physician assistant immediately.In addition to the first follow up appointment after discharge, this additional schedule is recommended:
- Three to six months following the date of surgery
- One year following the date of surgery
- Annually on the anniversary date of surgery
It is important to comply with this schedule and to see your doctor regularly for routine office visits to ensure safe and effective recovery from total hip replacement.