Total hip replacement surgery can significantly enhance your quality of life by alleviating pain and improving mobility. As a physiotherapist, one of our most important roles is preparing and helping individuals through this journey. Effective preparation can help ensure a smoother recovery process, improved rehab and a quicker return to daily activities.
Physiotherapy Preparation for Hip Replacement
Why You Might Need a Hip Replacement
The hip joint is susceptible to osteoarthritis, which can degrade the cartilage at the ends of the bones and affect the joint itself. Due to these changes, you’re most likely experiencing pain, stiffness or difficulty moving your hip.
While physiotherapy is often recommended initially, it might not always restore your ability to engage in sports or daily activities. In such cases, a total hip replacement may be advised.
What to do before your hip replacement surgery
Before your surgery, it’s beneficial to prepare both yourself and your home. Once you leave the hospital, it is extremely likely your hip and ability to walk will be limited initially.
The following equipment are things we would advise you to get prior to your operation:
• Raised Toilet Seat: This reduces the need to bend at the hip when using the toilet.
• Crutches: Essential for mobility post-surgery; ensure you know how to set them up correctly (if not provided by the hospital)
• Long Shoehorn: Helps with putting on and taking off shoes.
• Long-handled grabber: Useful for picking up items from the floor or hard-to-reach places.
Pre-Surgery Preparation
Your physiotherapist will guide you through specific exercises to maintain hip range of motion and strength before the surgery, which aids in post-operative recovery. A home physiotherapy visit would be beneficial to ensure all your aids are fitted appropriately and to ensure you are using safe techniques.
What Happens During a Total Hip Replacement
In a total hip replacement, the acetabulum (the hip socket) is replaced with a plastic or ceramic component, and the femoral head (the ball) is replaced with a metal stem with a metal or ceramic head.
Post-Surgery Expectations
Recovery times vary, but typically you’ll begin moving and testing your new hip with a physiotherapist’s help the day after surgery.
Most people are discharged from the hospital within 3 to 5 days, though healthier individuals might leave sooner.
Returning to work, driving, and light activities is usually possible within about 6 weeks.
Follow-Up Appointments
Two weeks after surgery, you’ll have a follow-up appointment to remove stitches or clips. If dissolvable stitches were used, this appointment won’t be necessary.
You will also have follow-up appointments with your surgeon at 6 weeks and 3 months to assess your recovery.
Continue with physiotherapy until you regain full range of motion, walk unaided, and resume your normal activities. This physiotherapy can be done at home or in a clinic.
Regaining Movement After Surgery
Movements to Avoid
To prevent dislocating your new hip, avoid:
• Lifting your knee more than 90 degrees
• Rotating your leg inward
• Crossing your legs
OR
• avoid pushing your hip into any positions that cause discomfort.
Walking
Initially after surgery, the inpatient physiotherapist will show you how to use walking equipment (such as a Zimmer frame) to get accustomed to bearing weight on your new hip.
Once balanced, you’ll transition to crutches, starting with a 2-point gait pattern and gradually progressing to a normal gait. The physiotherapist will help to avoid any limping.
Stairs
You’ll practice climbing stairs with your inpatient physiotherapist, initially leading with your non-operated leg and likely utilizing crutches
Exercises
Inpatient Physiotherapists will guide you through bed and standing exercises to improve circulation, strength, and range of motion. Continue these exercises post-discharge and arrange a follow-up appointment with a physiotherapist to continue to progress your rehabilitation.
Returning to Driving and Activities
To drive again, you must:
• Move nearly pain-free and without aids
• Have an almost full hip range of motion
• Perform an emergency stop confidently
Consult your physiotherapist for advice on resuming driving and consider a test drive on a quiet road.
Sports and Hobbies
You can usually resume walking, swimming, and cycling within about 6 weeks. More intense activities like tennis or skiing should wait until at least 3 months post-surgery. Avoid high-risk sports if you did not participate in them before your surgery.
Tips for Home
Car Travel
To get in and out of a car:
• Use the front passenger seat if possible.
• Push the seat back and recline it slightly.
• Turn your back to the seat, sit down, and then lift your legs into the car. Reverse this process to exit.
Washing & Dressing
Keep your wound dry for the first 2 weeks. Use a waterproof dressing for showers and avoid baths for 6-8 weeks. Utilize aids like a long-handled shoehorn and grabber and wear loose-fitting clothing for easier dressing.
Need Help?
Contact our friendly team for personalised care & assistance in advance or after your surgery.