3 cheers for your new hip! HIP HIP HOORAY! HIP HIP HOORAY! HIP HIP HOORAY!!
What is a Total Hip Replacement?
Total hip replacement (THR) is a surgery that involves the removal of damaged and worn out areas of the hip joint and replacing it with prosthetic implants.
The hip joint is a ball and socket joint with the femoral head (part of thigh bone) being the “ball”, and the acetabulum (part of pelvis) being the “socket”. This allows for a large range of movements including rotation about the main axes.
In a THR, the damaged femoral head will be replaced with metal alloy and the acetabulum will be replaced with a highly crosslinked polyethylene insert in a metal cup.
Femoral prosthesis anatomy
Do I need one?
The main goal for a THR is for pain relief and restoration of a functional hip for improved quality of life.
Some common candidates for a THR include people with:
- End-stage degenerative and symptomatic hip osteoarthritis
- Avascular necrosis (i.e. disruption of blood supply to the hip)
- Development abnormalities of the hip (i.e. Hip dysplasia)
Your doctor or surgeon will do a thorough assessment to determine if you are a suitable candidate for a THR, based on the degree of damage to your joint as well as your pain and activity levels.
What happens after a THR?
Contrary to popular belief that you should rest in bed after a surgery, you might be surprised that you are able and should start moving within a day after a THR surgery! Since the hip joint is a weight-bearing joint, it is important that we load the joint and get it moving immediately after surgery to prevent any stiffness.
In collaboration with your Physiotherapist, our goal is to get you up and moving independently and regain normal function as soon as possible! It is also important to note that there are varying precautions you should take depending on the approach your surgeon has taken for the hip replacement. Your surgeon will work in collaboration with your Physiotherapist to ensure that these precautions are adhered to, in order to realise the full benefits of the hip replacement.
The road to recovery
It has been shown that prompt commencement of Physiotherapy rehabilitation can help speed up your recovery process and lead to improved outcomes. You can expect to resume your daily routine and activities independently within 4-6 weeks, although some pain and stiffness during activity is normal.
Day 0-1:
You will start walking with the help of a mobility aid (i.e. rollator) and weight bear as tolerated. Your Physiotherapist will assist you with gentle range of motion exercises and teach you some basic strengthening and bed mobility exercises (eg. sitting and getting out of bed). You will also be advised on resting and sleeping positions, as well as positions to avoid such as crossing your leg past the midline, and any other positions depending on the type of approach used for your surgery.
6 weeks post-op:
At this stage, you should be able to walk freely without a mobility aid. You will also begin with exercises to improve the strength and control of your hip muscles.
Exercises for 0-6 weeks:
Heel slides with towel
Thigh muscle (inner range quadriceps) contraction
6 weeks – 12 weeks post-op:
By now, you are strongly encouraged to return to normal activities of daily living (as tolerated) as much as possible!
Exercises for 6-12 weeks:
Straight leg raise
Bridge progression
Once you have sufficient strength and flexibility, your Physiotherapist will start to mobilise you on stairs. Take baby steps! Start off with step ups and downs (shown below). Something you can keep in mind to help you gain confidence when navigating the stairs initially…“Unoperated up, operated down!”.
Step ups
Step downs
Book now or give us a call to schedule an appointment to see our Physiotherapist who will be able to partner you to recovery after your total hip replacement!
DISCLAIMER: These advice and exercises should not replace the need for a consultation with a Physiotherapist especially if your condition doesn’t improve. Therapeutic exercise should be carefully selected to suit your condition.
Ref:
Cleveland Clinic Foundation. (2015). A Patient’s Guide to Total Joint Replacement and Complete Care. https://my.clevelandclinic.org/ccf/media/Files/Ortho/patient-education/total-joint-replacement-patient-guide.pdf.
Madara, K. C., Marmon, A., Aljehani, M., Hunter-Giordano, A., Zeni Jr, J., & Raisis, L. (2019). Progressive rehabilitation after total hip arthroplasty: a pilot and feasibility study. International journal of sports physical therapy, 14(4), 564.
Filed under: Hip
