Activities After Hip Replacement

After undergoing hip replacement, you may expect your lifestyle after the surgery to be a lot like the way it was before, but without the pain. In many ways, you are right, but it will take time. You need to be a partner in the healing process to ensure a successful outcome.

You will be able to resume most activities; however, you may have to change how you do them. For example, you may have to learn new ways of bending down that keep your new hip safe. The suggestions you find here will help you enjoy your new hip while safely resuming your daily routines.

Activities in the Hospital

Hip replacement is a major surgery, and you may want to take it easy. However, it is important that you start some rehabilitation immediately after surgery to offset the effects of the anesthetic, avoid complications, and get off to the right foot. Your doctor and physical therapists can give you specific instructions on wound care, pain control, diet, and exercise.

Pain management is important in your early recovery. Although pain after surgery is quite variable and not entirely predictable, it can be controlled with various modalities. Your surgeon will inject medication in the hip joint at the time of surgery to help with some of the immediate pain. Multimodal medical therapy is the gold standard for post-operative pain control. This includes the use of anti-inflammatories, Tylenol/acetaminophen, nerve medications, and opioids. IV medication is rarely used.

Besides the pain medication, you will also get antibiotics before and after surgery, as well as a blood-thinner to help prevent blood clots from forming in the veins of your thigh and calf.

You may lose your appetite and feel nauseous or constipated for a couple of days. These are ordinary reactions. You may be given stool softeners or laxatives to ease constipation caused by the pain medication after surgery. You will be taught to do breathing exercises to keep your chest and lungs clear to prevent the lower lungs from filling with fluid and causing fever.

A physical therapist will visit you on the day of your surgery, and teach you how to use your new joint. It is essential that you get up and about as soon as possible after hip replacement surgery. Even in bed, you can pedal your feet and pump your ankles regularly to keep blood flowing in your legs. You may have to wear elastic stockings and/or a pneumatic sleeve to help keep blood flowing freely.

Discharge

Your hospital stay will vary, with most patients able to go home the same day or within 23 hours. Occasionally, a longer hospital course may be needed. In all patients, we will require you to perform certain skills of daily living prior to discharge. This includes walking with a walker, eating/drinking, and voiding or using the restroom.

The following tips can make your homecoming easier.

• In the kitchen (and in other rooms as well), place items you use frequently within reach so you do not have to reach up or bend down.
• Rearrange furniture so you can get about on a walker or crutches. You may want to change rooms (make the living room your bedroom, for example) to stay off the stairs.
• Get a good chair—one that is firm and has a higher-than-average seat. This type of chair is safer and more comfortable than a low, soft-cushioned chair.
• Remove any throw rugs or area rugs that could cause you to slip. Securely fasten electrical cords around the perimeter of the room.
• Install a shower chair, grab bar, and raised toilet in the bathroom.
• Use assistive devices such as a long-handled shoehorn, a long-handled sponge, and a grabbing tool or reacher to avoid bending too far over.

Activities at Home

• Keep the skin clean and dry. The dressing applied in the hospital should remain intact until your visit with physical therapy or your surgeon. If it becomes loose or soiled, ask for instructions on how to change the dressing if you are not sure.
• If you have stitches or staples that need to be removed, your surgeon will give you specific instructions when it is safe to shower or bathe.
• Notify your doctor if the wound appears red or begins to drain.
• Take your temperature as needed and notify your doctor if it exceeds 101F.
• Swelling is normal for the first 3 to 6 months after surgery. Elevate your leg slightly and apply an ice pack for 15 to 20 minutes at a time, a few times a day.
• Calf pain, chest pain, and shortness of breath are signs of a possible blood clot. Notify your doctor immediately if you notice any of these symptoms.

Medication

Take all medications as directed. You will probably be given a blood thinner to prevent life-threatening clots from forming in the veins of your calf and thigh. If a blood clot forms and then breaks free, it could travel to your lungs, resulting in a pulmonary embolism, a potentially fatal condition.

Because you have an artificial joint, it is especially important to prevent any bacterial infections from settling in your joint implant. Be sure to notify your dentist that you have a joint implant and let your doctor know if your dentist schedules an extraction, periodontal work, dental implant, or root canal procedure.

Diet

Wound healing requires an appropriate diet balanced with carbohydrates, protein, and healthy fats. Continue to drink plenty of fluids. It is also recommended to take a fiber supplement or consume foods rich in fiber while taking pain medications. Diabetic patients should be mindful of their blood glucose levels in the postoperative period.

Resuming Normal Activities

Once you get home, you should stay active. The key is not to overdo it! While you can expect some good days and some bad days, you should notice a gradual improvement over time. Generally, the following guidelines will apply:

Weight Bearing
Unless otherwise directed by your surgeon, you can put as much weight on the hip as tolerated. Most people are using a walker for the first few weeks, gradually putting more weight on the affected leg as tolerated.

Driving
You can begin driving an automatic shift car in 2-6 weeks. Please consult your surgeon. The physical therapist will show you how to slide in and out of the car safely. Placing a plastic bag on the seat can help.

Sex
Some forms of sexual relations can be safely resumed 4 to 6 weeks after surgery. Ask your doctor if you need more information.

Sitting/Sleeping Positions
Your surgeon, nursing staff, and physical therapist will tell you what precautionary measures to take to ensure your hip does not pop out of place. These are commonly known as “hip precautions.” Depending on the approach, or where the incision is located, will dictate what positions to avoid in the first few weeks after surgery. Be sure to ask your surgeon what precautions you have after surgery.

Climbing Stairs
Unnecessary stair climbing should be limited if possible until directed by your therapist as part of your rehab process. If you must go up stairs:

• The unaffected leg should step up first.
• Then, bring the affected leg up to the same step.
• Then bring your crutches or canes up.
  To go down stairs, reverse the process.
• Put your crutches or canes on the lower step.
• Next, bring the affected leg down to that step.
• Finally step down with the unaffected leg.

Return to Work
Depending on the type of activities you perform, return to work can be seen in as early as 2 weeks or as long as 3 months. Please speak to your doctor.

Other Activities

• Walk as much as you like once your doctor gives you the go-ahead, but remember that walking is no substitute for your prescribed exercises. Swimming is also recommended; you can begin as soon as the sutures have been removed and the wound is healed, approximately 4-6 weeks after surgery. Acceptable activities include dancing, golfing, and bicycling. Avoid activities that repetitive high impact on the hip. These activities can include: tennis, pickleball, contact sports (such as football, baseball), or racquetball, jumping, skiing, or jogging. These are not hard blocks, so consult your surgeon if you desire to perform these more stressful hobbies.