What to Expect when Recovering from a Hip Replacement: The Role of Physiotherapy

 What is a Hip Replacement?

A hip replacement, also known as hip arthroplasty, is a surgical procedure in which a damaged or diseased hip joint is replaced with an artificial joint or implant. It is commonly performed to relieve pain and restore function for individuals with hip pain and deterioration typically caused by arthritis, fractures, or other conditions that result in severe pain and disability.

Reasons for Hip Replacement

• Osteoarthritis: Degenerative joint disease that causes cartilage breakdown.

• Rheumatoid Arthritis: An autoimmune condition causing inflammation of the synovial membrane.

• Osteonecrosis: Reduced blood flow to the femoral head, causing bone death and joint damage.

• Hip Fractures: Severe injuries that may not heal well with only pinning or internal fixation.

• Developmental Hip Dysplasia: Abnormally developed hip joint that becomes arthritic.

Types of Hip Replacement Surgeries

• Total Hip Replacement (THR): Both the acetabulum (hip socket) and the femoral head (ball of the hip joint) are replaced.

• Partial Hip Replacement: Only the femoral head is replaced, which is less common and usually related to hip fractures rather than arthritis.

In cases where the hip is fractured, a hip replacement may not be required. Alternatively a Dynamic Hip Screw, Intermedullary nail or internal fixation may be used. The type of surgery depends on the location of the fracture, bone quality, patient health and healing potential.

What to Expect Following Surgery: The Role of Physiotherapy

1.       You will likely stay in hospital for 1-2 nights, sometimes this is longer if there is a medical need or a care package at home is required.

2.       You will receive medication to manage pain and discomfort

3.       You will likely have swelling and pain, sometimes this worsens a few days following surgery and is perfectly normal

4.       In hospital a physiotherapist will show you how to use walking aids and help you start walking within 24 hours after surgery. They will show you how to get into and out of bed and explain any “do’s and don’ts”.

Physiotherapy once you return home

Physiotherapy after a hip replacement is crucial to ensure a successful recovery and to maximise the function of the hip joint. A personalised physiotherapy plan typically includes exercises and activities designed to improve mobility, strengthen the hip and leg muscles, reduce pain, and enhance overall fitness and coordination. Here's a general outline of what physiotherapy might involve after hip replacement surgery:

Early Postoperative Phase (1-3 Weeks)

1.   Initial Mobilisation: Often begins within the first day after surgery, with assistance to move and walk.

2.   Pain Management: Techniques and modalities to manage pain while starting physical activities.

3.   Gentle Joint Movement: To maintain a range of motion in the hip.

4.   Strengthening Exercises: May start with simple isometric exercises (tightening muscles without moving the joint).

5.   Education: On how to perform daily activities safely, such as how to sit, stand, and use the toilet. What pain is “normal” and what pain is a sign you need to slow it down.

Intermediate Phase (3-6 Weeks)

1.   Progressive Strengthening: Gradually increase the resistance and difficulty of exercises to build muscle strength around the hip.

2.   Gait Training: Improving walking patterns, potentially using aids like walkers or canes.

3.   Balance Exercises: To reduce the risk of falls and improve stability.

4.   Range of Motion Activities: To increase hip flexibility and prevent stiffness.

5.   On-going pain management: By progressing strengthening and weight bearing exercises, some hip pain may be expected. Your physiotherapist will guide you on what is expected and what is an indicator that you may be doing too much.

Advanced Phase (6 Weeks and Beyond)

1.   Advanced Strengthening: Including resistance equipment or weight machines as tolerated.

2.   Functional Training: Mimicking everyday movements and activities to return to normal life.

3.   Proprioception Activities: Advanced balance and coordination exercises.

4.   Endurance Training: Low-impact cardio activities, such as cycling, swimming, or using an elliptical machine, to improve overall fitness.

Long-term Maintenance

1.   Regular Exercise Routine: To maintain hip strength and mobility.

2.   Activity Modification: Learning ways to protect the new hip joint during more demanding activities or sports.

3.   Follow-up: Regular check-ups with the healthcare provider and physiotherapist to monitor hip health and function.

It's important to note that every individual's recovery and physiotherapy needs can differ, depending on factors like age, pre-surgery physical condition, and any complications that may arise after the operation. Therefore, at Home Physio Company we always ensure our assessments and physiotherapy plans are personalised. If we feel we necessary, we can also consult with your orthopaedic surgeon.

If you are having an elective hip surgery or you have recently had a hip surgery following a trauma contact us today for a free consultation on how we can help you.