Why do people have hip replacement surgery?
People undergo hip arthroplasty (hip replacement) surgery to replace damaged or diseased parts of the hip when the loss of mobility and function has greatly impacted their quality of life. Some common conditions that might lead to hip replacement surgery are:
1. Arthritis: Osteoarthritis is the most common condition that hip replacements are performed for but individuals with Rheumatoid Arthritis or Post-Traumatic Arthritis may also undergo the surgery.
2. Hip Fracture
3. Avascular Necrosis
4. Some congenital hip disorders
Why are there precautions to follow after hip replacement surgery?
Certain precautions need to be taken following hip replacement surgery in order to reduce the risk of complications, such as dislocation, and to ensure optimal healing and outcomes. Your surgeon will prescribe specific precautions depending on their surgical approach. These precautions will generally be in place for approximately 6 to 12 weeks.
What are the post-op precautions for a hip replacement with a posterior approach?
- No hip flexion beyond 90 degrees (L) for the first 6-12 weeks after surgery. This is to protect the healing tissues and to reduce the risk of dislocation. It means not raising your knee above the level of your hip and avoiding sitting on low chairs/couches, low toilet seats and low car seats. It also means avoiding leaning your body forward over your legs while you sit down or stand up, or bending over to put on socks and shoes, as well as crouching or squatting. Instead, when standing up from or sitting down on a chair, bed or toilet you will need to keep your operated leg straight out in front of you. There are aids that can help you to follow these precautions such as; using an elevated toilet seat and shower seat; using a wedge cushion when sitting; using a reacher to pick items up off of the floor; and using a sock aid to help with dressing.
- No crossing the legs or feet or bringing the operated leg across the midline of the body. This is also to minimize stress on the surgical site and reduce the risk of dislocation. Keeping a pillow between your knees when you’re in bed and sleeping on your back can help.
- Not letting the operated leg turn inward or outward too much. Again it may help to place a pillow between your legs while in bed to keep the toes pointing forward, not to either side.
What are the precautions for a hip replacement with an anterior approach?
There are fewer precautions for this approach than for the posterior approach as there is less risk of dislocation. The precautions can vary from surgeon to surgeon but typically they include:
- Avoiding excessive hip extension. That means avoiding moving the operated leg too far backwards when standing or walking, or walking backwards. This is to avoid placing too much strain on the surgical site and to guard against dislocation.
- Not allowing the operated leg to rotate externally (turn outwards).
- No crossing the legs.
What is involved in rehabilitation after hip replacement surgery?
Working closely with a physiotherapist is very important in optimizing recovery after surgery and they will begin working with you right after surgery to improve general mobility, joint range of motion and strength. Each person’s rehabilitation needs are different and your physiotherapist will tailor your treatment plan to your specific needs, challenges and goals.
Your physiotherapist will help you to manage post-operative pain through the use of proper positioning, the use of assistive devices like walkers or canes, manual therapy, movement techniques and the use of cold or heat therapy.
Your physiotherapist will provide specific exercises and may use manual techniques to restore your range of motion and improve your mobility. They will also provide you with a targeted, progressive exercise program to strengthen the muscles around the hip, legs and core, as well as balance and gait training in order to enhance stability, joint function and overall functional mobility.
Your physiotherapist will also provide guidance regarding your post-operative care to prevent complications, moving safely, a home exercise program, maintaining a healthy lifestyle and gradually returning to your regular activities and exercise with confidence.
1. How long is the recovery after hip replacement surgery?
This can vary depending on several factors including the individual’s overall health, age and the surgical approach used. Most people are able to resume daily activities (eg. driving, increasing walking endurance) and activities such as swimming, walking on a treadmill, tai chi, pilates and golf (putting and chipping only) within 6 to 8 weeks.
However, it will take longer to maximize your strength fully and to resume other activities. You should always follow the advice and guidance of your surgeon and physiotherapist specific to your recovery. As a general guideline, individuals can return to gardening, golfing, outdoor cycling, bowling, curling and weight training (no leg press beyond 90 degrees of hip flexion) after 3 months. Between 3 and 6 months, other activities such as skiing, skating, hockey, snowshoeing, horseback riding, paddling activities, doubles tennis/pickleball and yoga may be permitted with the approval of your surgeon.
2. Can I do high-impact activities after hip replacement surgery?
High-impact activities (contact sports, jogging, running, squash/racketball, sports involving jumping) are generally not recommended after total hip replacement surgery. However, we have had clients who have successfully returned to these activities.
3. Can I do heavy lifting after a hip replacement?
It is generally not recommended to lift over 50 lbs after a total hip replacement.
4. What other long-term precautions should I be aware of after hip replacement surgery?
As a general rule, always stay within a comfortable range of motion for all activities. Forceful or repetitive maximum bending of the operated leg towards the trunk should always be avoided.
Are you having or have you had hip replacement surgery?