Preparing yourself for a total hip replacement

Why you need to have your hip replaced

The hip joint can be prone to osteoarthritis, which can reduce the cartilage at the end of your bones and affect the bones of the joint.

If you’ve experienced these changes in the hip joint, you’re likely experiencing pain and stiffness. You may no longer able to do sports or active hobbies, or even to move it normally. Initially you will have been recommended physiotherapy, but if this hasn’t enabled you to return to your normal life, you will be advised to have a total hip replacement.

What to get before your total hip replacement surgery

Before your operation, it’s well worth preparing yourself and your home for after the surgery, as the range of movement in your hip and your ability to walk may be slightly limited.

Equipment we advise you get before your hip replacement operation includes:

  1. A raised toilet seat so that you don’t have to bend at the hip as much when you use the toilet
  2. Crutches to help you get around (find out how to set up your crutches correctly)
  3. A long shoehorn to make it easy to get your shoes on and off
  4. A long-handled grabber to pick bits and pieces off the floor or in hard-to-reach places
  5. A sock aid, which is a nifty device to help you put your socks on

What to do before your hip operation

Your physiotherapist will ensure that you’re doing the right exercises in the lead up to the surgery. It’s important that you keep doing them to maintain range of movement and strength around the hip. This will help with your post-op recovery.

It might be worthwhile arranging an appointment with your physiotherapist at home, to ensure all your aids are fitted properly, and to practise using them too.

Also, have a look at our videos on walking with crutches and using stairs and steps with crutches:

How to use your crutches non, partial and full weight bearing

How to do stairs with crutches

How to perform steps with crutches

What happens during a total hip replacement

When you have a total hip replacement the acetabulum (the socket) is replaced with either a plastic or ceramic component, and the head of the femur (the ball) is replaced with a metal stem with either a metal or ceramic head.

What to expect after your hip surgery

Every one recovers differently, but you’ll usually start moving around and testing out your new hip under the supervision of a physiotherapist the day after your surgery.

Most people are discharged from hospital within 3 to 5 days after their hip replacement. But if you’re fit and strong you may be discharged sooner.

Most people can return to work, driving and light activities in about 6 weeks.

Follow-up appointments

Two weeks post surgery, you’ll have an appointment with the nurse at the hospital or clinic to remove your stitches or clips. If you have dissolvable stitches you won’t need this appointment.

At this point, you can start gently massaging the scar with a non-perfumed moisturiser such as Bio oil or E45. Your physiotherapist will be able to show you how to do this to help achieve a smooth scar.

You will have a follow-up appointment with your surgeon 6 weeks and 3 months post surgery to review your recovery.

You’ll need to continue with physiotherapy at home or in a clinic until you regain full range of movement in your hip, so that you can walk unaided with a normal gait pattern and return to all your normal activities.

How you’ll regain movement after your full hip replacement

Movements to avoid

The scar down the side of your leg may be slightly closer to your bottom or closer to the front of your hip. This will depend on how the surgeon chose to get around the muscles to your joint. Either way, there is a slight risk of dislocating your operated hip and you’ll be advised to avoid the following for at least 6 weeks after your hip replacement:

Either:
a) Lifting your knee more than 90 degrees to your chest
b) Rotating your leg towards your other leg
c) Crossing your legs

Or:
Not pushing your hip into any positions beyond stiffness sensation.

Walking

When you first start walking after the operation, the physiotherapist in the hospital will use a zimmer frame so you can get used to putting weight through your new hip. Most people can fully weight bear through their operated leg.

Once you can do this with good balance and confidence they will move you onto your crutches. They will initially start with a 2-point gait pattern which you can see in the video and then slowly move towards a normal gait pattern with crutches.

Your physiotherapist will advise you as you progress through your rehabilitation and help you practise walking with less support until you are walking unaided. They’ll make sure that you aren’t limping as you progress.

Stairs

You will practice stairs in the hospital with the physiotherapist, as demonstrated in our video, you’ll initially climb one step at a time, leading with your un-operated leg, then bringing the operated leg up onto the step next to it.

When you can walk with a single crutch or without crutches, your physiotherapist will help you to come up and down stairs with a reciprocal pattern (placing the opposite foot on each step).

Exercises

The physiotherapists in the hospital will demonstrate and get you to practice exercises in the bed and in standing. This will help with circulation, strengthening and regaining the range of movement in your hip.

Here are a few exercises that you will begin with:

Depending on the hospital, you may also have a course of hydrotherapy during your stay: this is exercising in water to help with walking and movement of the hip. Many patients find this beneficial as the buoyancy of the water assists and supports them. You may wish to continue this after being discharged, either at the hospital or at your physiotherapist’s clinic.

Here are exercises that you can perform in the water:

On discharge you will be advised to continue with the exercises you have been performing in hospital, and to arrange a follow up appointment with a physiotherapist either at home or in a clinic within a week of being discharged.

Here are a few exercises that you will progress onto:

Driving

Before being able to drive again, you’ll need to be able to do: Move around nearly pain free and without a walking aid Move the hip with nearly full range of movement Be able to perform an emergency stop with confidence

Your physiotherapist will be able to advise you when you might be able to drive again. We also advise you have a test drive with an experienced driver on a quiet road before heading out in your car.

Sports and hobbies

The time it take you to get back to your sports and activities depends on what they involve. Your physiotherapist will be able to advise when you’re ready to restart them.

You’ll usually be able to get back to walking, swimming and cycling within around 6 weeks.

More rigorous activities such as tennis and downhill skiing are normally delayed until at least 3 months post surgery.

We’d recommend you avoid sporting activities that have a high risk of falling after a total hip replacement if you didn’t participate in them before your hip replacement.

Helpful tips for when you get home

Travelling by car

While your hip has reduced range of movement, you will need to slightly change the way you get in and out of a car.

  • It will be easier to get in and out of the front passenger seat.
  • Make sure that the seat is pushed back as far as possible and that it’s slightly reclined.
  • Turn your back to the car and sit down onto the seat.
  • Then lift your legs as you swivel into the car.
  • Do it in reverse to get out of the car.

Washing and dressing

You’ll need to keep your wound dry for the first 2 weeks so that it heals correctly. To do this, either wash at the basin or shower with a waterproof dressing.

We advise you avoid bathing for 6-8 weeks after the operation, as getting in and out of the bath can be difficult with a stiff hip.

When dressing, the long-handled shoe horn, your grabber, and the sock aid will be helpful until you can bend forward far enough to reach your feet. We advise that you wear loose-fitting clothing such as skirts, shorts etc, as these are easier to get on and off.

We also recommend dressing your operated leg first, and undressing it last.