Hip replacement rehabilitation

Hip replacement surgery is a treatment option considered for individuals who suffer from joint damage secondary to osteoarthritis, trauma or other debilitating conditions. While a hip replacement was once only considered after an individual reach the age of 50, today technology has improved to the extent that this surgery is a consideration for those even in their 40s.

If you and your surgeon decide that a hip replacement is an appropriate measure for your particular situation then there may be several things that you can do to prepare for surgery. Preparing for the replacement prior to surgery will also help to improve your success during rehabilitation after surgery. It is important for an individual to fully address other medical concerns and health problems that may be present such as diabetes, high blood pressure or limited kidney function. It may be necessary to lose weight and initiated exercise program. And your healthcare practitioner will most likely request to stop smoking if you are a smoker. Any dental work should be finished prior to the surgery to prevent bacteria from entering your bloodstream and infecting the joints. It is likely that you will require blood during surgery and you may want to donate your own blood ahead of time for self transfusion.

Immediately after surgery you will have intravenous antibiotics to prophylactically treat any potential infection. You will also receive medications to help control pain and prevent blood clots. During the first few days you will probably still be taking medication but will need less and less pain medication. Your rehabilitation may very depending upon whether the surgeon used a cement or cementless means of attaching the joint to the surface of the bone. This will also determine how much weight you can put on your leg immediately after the surgery. Your surgeon will let you know your limitations.

Generally people will be out of bed with help on the day after surgery. In the next few days you will learn how to walk with a walker or crutches. Your therapists will teach you how to exercise, walk and do activities of daily living within the limitations placed on you by your physician. You will learn how to keep your hip from dislocating. Such precautions as not allowing your leg to cross an imaginary centerline of your body, not crossing your legs, not rotating the leg too far in or out and keeping the toes pointed straightforward will be outlined and discussed with you by both your therapist and your physician.

It may be necessary to use a walker or crutches for several weeks after surgery until the physician allows you to their full weight on your leg. How long you need to use the crutches or walker will depend upon the type of surgery done and the condition of your bones. Physical therapy will continue after you go home from the hospital until you are able to function more independently. Total rehabilitation after surgery will take at least six months and as much as a year depending upon your overall physical abilities. This is why preparation prior to surgery including taking care of your general health, starting an exercise program and losing weight can only help to improve the length of time it takes to finalize rehabilitation.

Your physical therapist will give you an exercise program to follow when you get home which will include individual exercises as well as taking short walks several times each day. Most physicians recommend that if you notice any soreness you should use a cold pack on your hip and perhaps decrease the activity slightly but don\’t stop completely. Before doing anything which involves exercise after a hip replacement always confirm with your physician or surgeon.

In some cases individuals do not progress far enough in their rehabilitation after three to five days in the hospital that they are able to live independently. If patients are unable to return to their home, an inpatient rehabilitation program may be recommended to allow for further work with the therapist and 24 hour support.

Rehabilitation for a total hip replacement is usually broken down into four phases. The first phase occurs in the first week after surgery and involves protocols to help reduce swelling and control pain as well is learning how to walk properly and prevent dislocation. The second phase is probably the most important and involves improving range of motion and flexibility, proprioception or the ability to recognize where the leg is in space and strength and endurance.

The third phase involves a continuation of phase 2 with more testing by the therapist. And in the fourth phase of rehabilitation the individual returns to their recreation and play activities. While some individuals are able to complete this entire rehabilitation in 3 to six months most people find that they require six months and longer. The length of rehabilitation necessary will depends upon the type of joint replaced, general health, weight and patients compliance with the program.

Once home the physical therapist will give individuals exercises which can be accomplished independently in order to move towards improved strength and endurance in the muscles which support and control the hip. This rehabilitation will allow individuals to return to their previous lifestyle with little to no limitations.

RESOURCES

Patient Education Institute: Hip Replacement Physical Therapy

Duke Orthopedics: Physical Therapy Instructions After Hip Replacement

University of California: Recovering From Hip Replacement Surgery

Get BoneSmart: Recovering from Total Hip Replacement Surgery