Hip replacement patients typically stay in the hospital for 2 to 5 days after surgery. Patients who need extra attention or do not have home support may be transferred from the hospital to a rehabilitation center.

Depending on the surgeon’s preference and surgical technique, the patient may be given "hip precautions" to prevent the implant from dislocating. These "precautions" include: avoiding crossing the legs, as well as excessive bending or rotating of the hip. Special pillows will be put between the legs to help avoid those positions and to keep the patient comfortable.

Within 24 hours after surgery, most patients can sit at the side of the bed and stand, and most will be encouraged to walk with help. A nurse or physical therapist will teach patients how to move safely while protecting the new hip as it heals. For those patients with "hip precautions" they must continue to avoid crossing the legs and deep hip bends for a minimum of 6 weeks.

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Patients may be asked to wear special compression stockings and may be given blood thinners for several days to weeks to reduce the chances of developing blood clots in the legs.

It takes most patients between 6 weeks and 3 months to stop taking pain medication and regain the ability to walk and do most daily activities. During that time a patient may be using walking aids such as a walker, crutches or cane. Patients should not drive or do other physical activities without doctor approval.

Physical Therapy

A successful long-term recovery depends largely on following a physical therapy routine and not stressing the new joint to the point of risking injury. Under the supervision of a physical therapist, a patient will learn stretches and exercises that—

  • promote blood flow to the hip joint
  • increase muscle strength
  • reduce the development of scar tissue and increase the hip’s range of motion.

By gradually building strength and flexibility, the patient can eventually walk unaided.

Pain should be controlled well enough for patients to participate in physical therapy. Some pain during physical therapy is okay, and it is often helpful to take some pain medications approximately half an hour before therapy to be able to participate fully with the exercises. Patients can use warm or cold compresses for 10 to 20 minutes to help warm up the joint before and/or control swelling after therapy. Patients who experience a lot of pain should tell their physical therapists or doctors.

Living with a Hip Replacement

After recovery, a patient should continue an exercise routine to keep the hip muscles strong and flexible. Physicians typically recommend low impact aerobic activities such as walking, bicycling (or stationary biking), and swimming or pool therapy.

Even after a successful recovery, a replacement hip will typically be less flexible than a healthy, natural hip. For example, while hip replacement surgery improves most patients’ ability to put on shoes and socks, some patients may still need a reaching tool to do so. Other activities that might stress the hip, such as sitting cross-legged on the floor (“Indian style”), may remain difficult to perform.

Despite limitations of the new hip, most patient expectations are met. One study14 found that more than 87% of the expectations set by patients were met post-surgery. Additionally, 90% or more of patients said their expectations were completely met when it came to eliminating medications, relieving nighttime pain, improving the ability to walk, and improving their ability work and participate in recreational or social activities.

References:

  1. Mancuso et al. Fulfillment of Patients' Expectations for Total Hip Arthroplasty. The Journal of Bone & Joint Surgery. 2009 Sep;91(9):2073-2078.
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