Hip Replacement – Advice, Tips, & Frequent Questions

Looking to get a hip replacement or just had one done? The following is a guideline to help you through the first several weeks after. This is a general reference, and should note be used in place of your surgeons plan of care and standard protocol.

Types of THR and precautions:

Surgeons perform anterior or posterior hip replacements. Anterior procedures are becoming more common, largely because recovery time has shown to be shorter, less painful, and affects less of the major muscles surrounding the hip. Depending on what surgeon you use, this will determine what method they are more comfortable with. Anterior THR take more skill and therefore require more training to perform. Posterior THR tend to have more precautions. For either method of THR, please ask your surgeon for any precautions you will need to maintain following surgery.

For more information about THR visit: https://www.arthritis-health.com/surgery/hip-surgery/advantages-and-disadvantages-anterior-hip-replacement

Visually:

Anterior THR incisions are made towards the front of the hip. These incisions are usually straight. Posterior THR incisions are curved starting around your hip bone and arcing back and down from there. Either way, your incision should be kept dry and covered. These incisions are usually glued. Depending on the surgeon, you may be required to keep it bandaged for a certain time period. Please refer to your surgeon’s plan of care to care for your incision appropriately.

Pain:

Every person experiences pain differently. This means that there is no way to determine what level of pain you will be in following your THR. If your surgeon prescribed you pain medication, use as directed. The best thing to manage pain in the first few days is to use the pain medications (if applicable) as directed in combination with ice for 15-20 minutes every 1-2 hours. During the time you ice, it is most beneficial to elevate your leg off the ground to limit swelling and pain. Please note, if your leg is elevated and so is your upper body slightly, the swelling will pool around the hip joint, so the best idea is to lay flat with your legs elevated.

The first 2 weeks are typically the most painful following a THR. Each week should improve after that. A good piece of advice is to judge your progress week by week, instead of day by day. You will notice larger improvements weekly instead of daily and feel more confident that you are headed in the right direction.

Wound Care:

If your surgeon requires you to keep the wound covered for showering, you can find Tagaderm and non-adhesive gauze at any local pharmacy. You can use these to create your own, larger waterproof bandage. Following a shower, you will need to remove the waterproof bandages and replace with dry, breathable bandages if necessary, or leave open to air out. If the incision is glued this typically is done for 5-7 days, at which time the incision can usually be left alone. Again, this depends on the surgeon so be sure to ask what they prefer. In any case, your incision should never be left it moist bandages as this can increase your risk for infection.

Should I be walking?

During the first 2 weeks you should be getting up to walk frequently throughout the day. Walking helps to improve your quad strength, hip range of motion, and decrease your risk of getting a blood clot (DVT). Some general guidelines are to get up and walk 5-10 minutes every hour or 15-20 minutes every 2 hours. This should also be balanced with rest. Even though you need to walk, it is important to remember to allow your hip to heal. As you improve, you can increase your walking time as tolerated. It is common for you to feel really well one day, then have increased pain again the next. This is typically due to doing too much on days you feel better, so be cautious of how much you do on a daily basis!

Physical Therapy:

If you are receiving physical therapy, your Physical Therapist should be working closely with you and your surgeon to help guide you through the upcoming weeks. All other physical therapy exercises should be performed under the guidelines of a Physical Therapist. Not all surgeons require physical therapy following a THR, some prefer you progress your activity within the home weekly. Please refer to your surgeon to find out if they would like you to perform physical therapy or not. It can be beneficial to help you strengthen your leg and get rid of a limp following surgery if necessary.

Assistive Devices

Most commonly you will be on a walker, but sometimes they may have you use crutches. Prior to having the TKR, be sure you understand how to use whichever device you will receive if possible.

Please reference this site for how to use bilateral crutches:https://myhealth.alberta.ca/alberta/pages/use-crutches.aspx 

Please reference this site for how to use a walker: https://myhealth.alberta.ca/Alberta/Pages/use-a-walker.aspx

When to seek medical advice

If you experience any combination of increased warmth, redness, swelling, tenderness in your calf, fever, shortness of breath, or other abnormal symptoms seek attention immediately. Your biggest risk of a blood clot (DVT) is 2-10 days following surgery. For more information about DVT please reference here: https://orthoinfo.aaos.org/en/diseases–conditions/deep-vein-thrombosis

You should also contact your surgeon if you are having sudden increase in pain that is not alleviated by pain medication, rest and ice.

When will I return to normal?

This is different for everyone, so keep in mind the timeline may be faster or slower depending on your strength, activity level prior, and how well you adapt to your new hip. A general guideline given by many Physical Therapists is as follows:

• Performing normal, light activity within the home by 1 month.
• Able to get out and about, walking longer distances, going to the gym by 3 months.
• Normal activity level with occasional discomfort or notable differences by 6 months.
• It isn’t until roughly 1 year that you are expected to feel 100% back to normal.