What to Expect After a Total Hip Replacement
A total hip replacement surgery is a common orthopedic surgery performed due to arthritis or certain hip fractures to relieve severe pain, improve hip mobility, and restore function. A hip replacement involves removing damaged bone and cartilage from the hip joint and replacing it with prosthetic parts. Physical therapists play an important role in pre-surgery preparation and post-hip replacement rehabilitation, helping to improve mobility, manage pain, regain strength, and restore function in your new hip.
What is a Total Hip Replacement?
A total hip replacement is a common orthopedic surgery performed to relieve severe pain, improve mobility of the hip joint, and restore or improve the ability to perform functional activities. A total hip replacement removes damaged bone and cartilage from the femur (ball of the hip joint) and hip bone/pelvic bone (socket of the hip joint) and replaces it with prosthetic parts made of metal or durable synthetic materials.
Total hip replacement is often the last treatment option after conservative treatments have failed to treat osteoarthritis of the hip, rheumatoid arthritis, loss of bone tissue, or certain hip fractures. According to the American Academy of Orthopedic Surgeons, 450,000 total hip replacement surgeries are done in the United States each year and hip replacements are most often performed in adults aged 60-80 years old.
Prehabilitation before Surgery
The more prepared you are for hip replacement surgery, the more likely you are to have a successful recovery. One of the key ways to prepare for hip replacement surgery is through pre-surgery physical therapy, or “prehabilitation.” Prehabilitation is an exercise conditioning program to increase a patient’s stamina, flexibility, and joint mobility; normalize movement patterns prior to surgery; and enhance overall fitness. Studies have shown that patients who engage in pre-surgery physical therapy regain function faster than those who did not do so, have less operative pain, fewer complications, and decreased hospital stay and recovery time.
The physical therapist can also provide pre-operative education about what to expect and design a home exercise program that the patient can begin immediately after surgery prior to returning to outpatient physical therapy post-surgery. During prehabilitation, the therapist teaches the patient flexibility and strengthening exercises for lower extremities, helps patients learn how to use a walker or crutches, and provides recommendations about how to prepare the home for safety, such as installing a raised toilet seat, handrails on the stairs, grab bars in the shower, and removing trip hazards like loose rugs.
What to Expect During Recovery & Rehabilitation After Hip Replacement Surgery
Nearly 90% of people who undergo hip replacement surgery feel better and can get back to normal activities within a few months and sometimes even weeks after surgery. Rehabilitation generally takes between 4-6 weeks post-surgery to feel stronger, have less pain, and have greater ease in walking.
In the weeks prior to the surgery, you will likely undergo several tests such as blood work, x-rays, or an MRI to confirm the necessity of the procedure and that you are healthy enough to undergo surgery. You will also be instructed to stop certain medications, such as blood thinners, for a period before surgery.
Day of Surgery & Hospital Stay: An orthopedic surgeon performs the surgery, which generally lasts an hour. You will receive an anesthetic to numb the lower half of the body. The surgeon makes an incision over the front or side of the hip, removing the damaged bone and cartilage from the joint and replacing it with prosthetic parts.
Following surgery, you are moved to a hospital room where your vitals are taken. Within the first few hours post-surgery, a physical therapist will work with you to help you learn how to put weight on the affected leg, use a cane or walker, and begin to gently move, get in and out of bed, walk, and navigate up and down a step. Most patients stay 1-2 days in the hospital, though some may discharge the day of surgery.
Recovery at Home: Once discharged to your home, it’s important to maintain your prescribed home physical therapy exercises and engage in gentle walking. Avoid overreaching or bending down and avoid crossing your legs at the knees for several weeks. To manage swelling and pain, elevate the leg above the heart, use ice and heat, and use compression socks.
Physical Therapy After a Total Hip Replacement
Physical therapists play an important role on your healthcare team, helping you prepare for and successfully recover from a hip replacement. Physical therapists help you restore movement and range of motion post-surgery and strengthen your hip and leg muscles. Outpatient physical therapy is critical in the four to six weeks post-surgery to help you return to your daily activities, work, and sports.
Physical therapy after a total hip replacement can include:
Pain management using ice and heat modalities: heat is used to warm up tight muscles prior to exercise and ice is used to reduce swelling and soreness after exercise.
Range of motion exercises involve gentle movements to progressively restore full range of motion to the hip as the hip heals.
Flexibility and stretching exercises help to loosen up muscles and tendons and prevent scar tissue from building up.
Targeted muscle strengthening, particularly of the hip and leg muscles, is critical to provide support to the new hip and ensure ease of movement and restored mobility.
Balance training works to help your muscles relearn to respond to changes in your environment. The therapist will progress you to agility exercises to regain full movement in the hip.
Proper posture and body mechanic training is critical as proper walking is one of the best ways to help your hip recover.
Functional training specific to your work and sports activities helps you return to work and sport with confidence that your new hip can handle the tasks with strength.
A total hip replacement surgery is a major surgery requiring careful preparation and a thorough rehabilitation process. Our physical therapists are here to support you throughout the process, helping you effectively prepare for surgery and restore movement, strength, and function safely after surgery.
