If you follow along in this blog, you’ll already know that we used to work alongside surgeons. (If not, check out our blog!). One of these surgeons completed A LOT of joint replacement surgeries - almost entirely on the knee and hip. Therefore, we’ve treated our fair share of post-operative clients - especially post-hip replacement! As an FYI, a total hip arthroplasty (THA) is science speak for a total hip replacement (THR), so they are used interchangeably!
The purpose of this blog post is to try and clarify the ins and outs of having a hip replacement surgery. Knowledge is power! Be prepared, and things will go smoothly!
Aside: We will use the same headings in this post as we did in the other ‘Must Know Knowledge’ posts. We’ll try to stick with the same format so that it’s easier to navigate. Some things might look similar, as some advice is “surgery” related, and less specific to the type of surgery.
How do I know if I even need a total hip arthroplasty (replacement)?
Typically, to qualify for a hip replacement, many, or all, of the following statements are true:
Do I have to do pre-operative physiotherapy?
In short, yes, you should. It helps in the following ways:
What else should I do before I get a total hip arthroplasty (replacement)?
How is a total hip arthroplasty (replacement) performed?
Every surgeon has their individual preferences, and this section could get extremely lengthy if I’m not careful. That being said, I will provide a general surgical outline, and then describe briefly the most common methods of hip replacement surgery.
This is what your day will look like:
This animation on YouTube is an average example of what generally happens, but don’t watch it if you’re super squeamish. It’s an animation, but the drawings would be considered graphic to some people:
Note on the video: not every surgeon uses the posterior approach seen in this video.
More on the methods used:
Does method matter?
Before we get into the next part of this blog post, it is important to note that everything in this blog post is for information purposes only. This blog post is not intended to be strict medical advice. As previously mentioned, everyone is an individual, and therefore, individual variances do occur. It is important to consult your physiotherapist, surgeon, or doctor for the most applicable advice for you.
Hip Precautions - The post-operative RULES
Each surgeon will have a preference on these precautions, and for how long you should follow them (also, the method at which your surgeon uses may alter the need for these precautions!). That being said, following these precautions is EXTREMELY COMMON, and they usually apply for THREE MONTHS post-operatively.
After surgery, you should:
There are some great tips on how these precautions apply to dressing, sitting, bathing, etc., on the U.S. National Library of Medicine website here:
What does the typical rehabilitation process look like?
First, it’s important to reiterate that everyone is an individual, with individual circumstances, and therefore, the rehab process will be very individualized. That being said, in almost every case, it is safe to walk on your leg immediately after surgery, and you will typically spend 1-2 days in hospital post-operatively. In the hospital, you will learn how to walk with a walker, climb stairs safely, and be monitored for any post-surgical complications.
Once at home, you will often be allotted home physiotherapy appointments with a physiotherapist (for free), through the Community Care Access Centre (CCAC). That being said, the amount of appointments provided by the CCAC has been significantly reduced in the past couple years (down to 1-4 total appointments), which is not enough.
Due to the limitation in the number of CCAC-funded appointments, you will continue with further physiotherapy via one of two options: publically-funded (OHIP) physiotherapy, or privately funded (out of pocket/private benefits) physiotherapy. OHIP physiotherapy often has a limit to it as well, and many people require more than the “program of care” allows for. Therefore, it is important to consider the potential financial costs of ongoing physiotherapy when undergoing a total hip arthroplasty.
This next sentence is important: Complete rehabilitation after a total hip replacement will usually take 6-12 months. It’s likely that someone will tell you 3 months. 3 months of rehabilitation can get you back to work (depending on your job), or allow everyday life tasks to be more easily and comfortably completed. To get back to 100%, it will probably take longer. You may not be required to frequently attend physiotherapy appointments, but you should expect to be working on exercises, and self-management, for up to 1 year postoperatively.
Overall, post-operative care looks something like this:
How long does it take to heal after a total hip arthroplasty (replacement)?
In uncomplicated cases,
As with any surgery, here are some additional things to consider:
What exercises are safe to do right away after a total hip arthroplasty (replacement)?
In the hospital, or from the surgeon, you will likely be provided with a list of exercises to get started on. These usually include light range of motion, and muscle activation exercises. These are a great place to start. Remember that these will have to respect the RULES outlined above (the hip precautions)
Overall, you will progress in this order with rehab (roughly):
Lastly, it’s highly likely that you and your physiotherapist will work on other areas of your body (such as the back and knee/ankle) together. This should help to reduce any postoperative complications in your other joints, all while decreasing your pain, and improving your overall function!
How much function and how little pain can I expect at the end of my rehabilitation?
Alas, the loaded question. (We know we’ve started this section with that same sentence for each of the ‘Must Know Knowledge’ surgical blog posts… Sorry, but it’s always a loaded question).
Again, everyone is an individual, everyone heals differently, and therefore final pain and function are highly individualized. Further, if there are complications with surgery, it may alter the progress/end result of your recovery.
Here are some things we consider:
All that being said, the vast majority of individuals that we’ve treated post-total hip arthroplasty did very well overall, and outcomes are typically very favorable. Many have no pain at all, and they return to an active lifestyle. The caveat to this is that our experience is based on people who actively attended rehab! (We are physiotherapists after all!). Remember, the rehabilitation stage after surgery is VERY important to reach a full recovery!
What are the potential complications associated with a total hip arthroplasty (surgery)?
All steps will be taken to limit complications postoperatively, however, it’s important to understand the possibilities. Complications include:
There’s a lot of information in this blog post. But there’s also a lot to know. Be informed, ask questions (even the hard ones), and look out for yourself.
Let us know if you thought this blog post was helpful, and we will try to post new ones outlining the helpful points for other types of surgeries!
Are you planning to undergo (or have already undergone) a total hip replacement? At Strive Physiotherapy and Performance, we are committed to providing an in-depth assessment to ensure we can work together to find the best plan of action for each individual client. Call us at 519-895-2020, or use our online booking tool on www.strivept.ca to book an appointment with one of our knowledgeable physiotherapists, and they will be sure to help you understand your injury.
Physiotherapist at Strive Physiotherapy & Performance
Strive Physiotherapy & Performance
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