What is a Hip Replacement?
Your hip is one of the body's largest joints. It is a ball-and-socket joint. The bone surfaces of the hip joint are covered with articular cartilage, a smooth tissue that cushions the ends of the bones and enables them to move easily. When significant damage occurs to the hip joint it may not naturally repair. When other conservative forms of treatment such as physiotherapy fails to assist your hip pain, the hip joint itself may need to be replaced with a prosthetic hip joint, known as a hip replacement.
What Conditions Can Lead to a Hip Replacement?
The most common reasons for needing a hip replacement are:
Childhood Hip Disease
When is Hip Replacement Recommended?
There are several reasons why you may be recommended a hip replacement. People who benefit from hip replacement surgery often have:
What Occurs in a Hip Replacement?
In a hip replacement, the damaged bone and cartilage is surgically removed and replaced with prosthetic components.
Post-Hip Replacement Treatment
You will most likely be admitted to hospital for 4 to 7 days depending on your recovery. The surgical procedure normally takes a couple of hours. You will be put under general anaesthetic before your Orthopaedic Surgeon performs the surgery. After the surgery, you will be placed in recovery to ensure you come out of the anaesthetic safely.
After surgery, and in some cases prior to your surgery, your orthopaedic team will provide you with adequate pain medication to make you feel as comfortable as possible.
You may have stitches or staples running along your wound or a suture beneath your skin. The stitches or staples will be removed approximately 2 weeks after surgery. Avoid getting the wound wet until it has thoroughly sealed and dried. You may continue to bandage the wound to prevent irritation from clothing.
Blood Clots/Deep Vein Thrombosis (DVT)
Blood clots in the leg veins or pelvis are one of the most common complications of hip replacement surgery. Your orthopaedic team will outline a prevention program which will likely involve wearing compression stockings for several weeks. You may also be given blood-thinning medications, inflatable leg coverings and ankle pump exercises.
Sometimes after your hip replacement, one leg may feel longer or shorter than the other. Your Orthopaedic Surgeon will make every effort to make your leg lengths even but may lengthen or shorten your leg slightly in order to maximize the stability and biomechanics of the hip. Sometimes you'll experience this leg length difference because your leg was actually shorter prior to the operation and that is what you were used to.
Some patients may feel more comfortable with a shoe lift after surgery. Your physiotherapist will be able to assess you after your surgery and advise you on the appropriate action required.
Precautions for Your Initial 3 Months Post-Hip Replacement
Your risk of hip dislocation is greatest in the first few months after surgery while the tissues are healing. Luckily, dislocation is uncommon. To decrease the risk of dislocation the following is advised:
Several modifications to your home can help protect your hip in the early stages following your surgery and support your recovery. The following items may help with daily activities:
Post-Hip Replacement Physiotherapy
Rehabilitation post-hip replacement starts immediately after your surgery. Sometimes even just a few hours after your operation. Your hospital physiotherapist will ensure that you are doing some early bed exercises to promote your recovery and get you back on your feet ASAP. This will ensure that you have a safe and efficient hospital discharge.
The whole rehabilitation period for a hip replacement can take between 3 to 6 months, but in some cases, it may last longer depending on your progress.
During this time your Physiotherapist will:
Rules for Sleeping
Use an ordinary pillow between your legs for sleeping for approximately one month after discharge. You may lie on your non-operated leg side as long as you have a pillow between your legs to keep them apart.
Rules for Sitting
You are allowed to sit in the first week after the operation when your surgeon allows. Remember, you must not sit in low chairs and the chair should preferably have arms. The length of time you sit is determined by comfort. However, it is advisable not to sit for too long in the first few days. Avoid excessive hip bend and sit with your knees slightly apart.
Rules for Walking
If you are using a stick, always use your stick in the hand opposite to your operated leg and move your stick forwards with your operated leg. The stick should be used for approximately one month after discharge or longer if necessary.
If you are using crutches, then you should remain partial weight bearing on crutches for six weeks after the operation unless otherwise instructed by your doctor or physiotherapist.
Rules for Stairs
It is recommended that you walk upstairs on your non-operated leg first, then operated leg, then stick or crutches.
Going down stairs lead with your stick/crutches first then operated leg, and finally, your non-operated leg.
Tip: Good legs go UP first - Bad legs go DOWN first.
What to Expect from Your New Hip Replacement
The majority of patients achieve pain-free walking, hiking, bending, stair & ladder climbing, kneeling, crawling and return to low-impact sports such as golf, swimming, cycling, social tennis, and most gym exercises. Some activities that require extreme flexibility (such as some yoga positions) may not be possible as it is best to avoid extreme positions, to prevent dislocation of the hip.
Many younger patients are able to jog (at least a short distance) although this is generally not advised, as it is an activity that involves impact loads to the joint. Sexual activity can be resumed when comfortable, although not recommended in the first six weeks postoperatively.
You may feel some numbness in the skin around your incision. You also may feel some stiffness, particularly with excessive bending. These differences often diminish with time, and most patients find these are minor compared with the pain and limited function they experienced prior to surgery.
Your new hip may activate metal detectors required for security in airports and some buildings.
Any questions? Please discuss with your hip physiotherapist or doctor.
Common Hip Treatments
Helpful Products for Hip Replacement
Related Hip Injuries
Hip Joint Pain
Lateral Hip Pain
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