How to rehab after a Total Hip Replacement and what to expect after surgery

I have been a physical therapist for over 14 years and have probably rehabed over 1000 total hip replacements. I will give you general guidelines for after your Total Hip Replacement and what to expect after surgery.

Difficulty: Moderately Easy

Instructions

1. First of all, after your total hip surgery you will probably stay in the hospital for about 3 days. If you are unable to get up alone, walk alone or do other daily activities necessary for you to be at home you may have to go to a skilled nursing facility for a short time. The stay at the skilled nursing facility (or SNF) is usually anywhere from 1 to 2 weeks depending on how your rehab goes.

2. Let's back up just a bit. When your doc does the hip replacement he must dislocate the hip joint to be able to put in the new hip. Consequently the hip is very unstable with certain movements. You MUST avoid the movements that I will be telling you for about 2 months after the day of surgery OR YOUR HIP WILL DISLOCATE! Once the hip dislocates you are back from day one for the 2 months. And once it dislocates it is very prone to dislocate again. Something you want to avoid at all costs during the healing process.

3. OK, here are the movement you must NOT do. These are your hip precautions: 1. When sitting, you must not raise your knee above your waist 2. While sitting you must not bend over to the floor. 3. You must not cross your legs, you must not cross your ankles...this goes for in bed and sitting. 4. You must not turn your foot inward...if you are lying down and your knee is bent you must not let your knee drop inward. 5. When in bed, if you need to roll on your side you must place a pillow between your knees. I tell people to pretend you have a line that cuts your body in half right down the middle. Your leg on the operated side must not cross that line. You cannot sit on the floor during your 2 month recovery time.

4. Did you get all that? If not, don't worry, your therapist will drill this into your head so much that you won't forget, honest. So now your are asking "how the heck do I get my shoes and sock on?". Well, you need to get adaptive equipment to do those things while maintaining your hip precautions. You will need to get a raised toilet set...makes it really much easier to get up from the potty. Sock aid..a handy dandy little gadget that assists with getting your socks on (it's genius, really). A reacher...it will help you get your pants on and pick things up off the floor. A long handled sponge...you will be so glad that you will be able to wash your toes in the shower. You may need a shower chair..some folks can't stand for that long after surgery and just do better with a shower chair. That's the basic stuff that you will need to help you the 2 months that you are following your hip precautions.

5. You will have this big wedge shaped pillow strapped between your legs for about 2-3 days. This is to ensure that you do not cross your legs. Most folks are still under the influence of anesthesia and try to cross their legs and/or turn over without thinking. Usually by the 3rd or 4th day folks are clear enough that the wedge is taken away and you only need a pillow to place between your legs.

6. You will be gotten up the second day after surgery. This is extremely important so you don't develop pneumonia or blood clots from laying in one position. You will be given pain medicine and if you have a physical therapist that is on the ball they will put ice and estim on your surgical incision to also help with pain control.

7. You will also be starting exercises on that 2nd day. Usually ankle pumps, quad and glut sets, heel slides, hip abduction and adduction, LAQ on the edge of the bed, transfers and walking.

8. If you are over 65 generally the hip "prosthesis" (stem and ball and/or socket) is cemented in. If it's cemented you can usually weight bear as tolerated on the surgical side. You will most likely use a walker or crutches for a week or two and then progress to a cane then nothing. If you do not have a cemented hip, usually for the younger folks, then you will most likely be able to put just about half your body weight through the surgical limb. If you are partial weight bearing you must use a walker or crutches until your doctor clears you to be full weight bearing. That is usually in 4 to 6 weeks.

9. Some folks ask about sexual relations after a total hip replacement. I have had people dislocate during sex because their therapist did not tell them which positions were safe. Here is a few link that shows safe and unsafe positions for the man and women.
   
   http://www.healthsystem.virginia.edu/internet/orthopaedics/sexfunc.cfm
   
   or
   
   http://images.google.com/imgres?imgurl=http://orthochick.squarespace.com/storage/sxafterhipreplacement.gif&imgrefurl=http://orthochick.squarespace.com/sex-after-joint-replacement/&usg=__pvN8moZ425WQ6S2ruUno3pKYRDA=&h=537&w=440&sz=67&hl=en&start=3&um=1&tbnid=FWOOtaxJdzZBqM:&tbnh=132&tbnw=108&prev=/images%3Fq%3Dsexual%2Bpositions%2Btotal%2Bhip%2Breplacement%26hl%3Den%26safe%3Doff%26rls%3Dcom.microsoft:en-us%26sa%3DN%26um%3D1
   
   or
   
   http://images.google.com/imgres?imgurl=http://www.brookwoodorthopedic.com/images/avoidpos.gif&imgrefurl=http://www.brookwoodorthopedic.com/education/sexualconcerns.php&usg=__oW3na6H1P0iBI-sa5jhuQKQnZe8=&h=549&w=474&sz=122&hl=en&start=5&um=1&tbnid=qw4-boaqH6kNYM:&tbnh=133&tbnw=115&prev=/images%3Fq%3Dsexual%2Bpositions%2Btotal%2Bhip%2Breplacement%26hl%3Den%26safe%3Doff%26rls%3Dcom.microsoft:en-us%26sa%3DN%26um%3D1

10. If you have any questions regarding a total hip replacement you may email me at [e-mail]
    Good luck and a speedy recovery!!

Tips & Warnings

• This does not replace the expert advice from your doctor and I am in no way responsible for any harm you may incur from this article.