Rehabilitation after hip surgery
Dr Negus strongly believes that rehabilitation is the key to your success after your surgery.
In the early stages (1-6 week) following any orthopaedic surgery, there is swelling and stiffness of the joint involved and there is a wound to take care of.
The second stage of the recovery which can begin from 2-6 weeks, involves a tailored increase in load and volume of exercise that is aimed at getting you back to the activities that you enjoy. This will be detailed for you by Dr Negus and his physiotherapy team alongside your own physiotherapist should you have one.
The third stage of your rehabilitation is to improve beyond the level you started at. Dr Negus and his team believe that there are gains to be made even beyond one year after your operation and if you want to get even stronger and fitter to keep up with the grandkids or maintain your place in your sports team, this stage is critical.
- Sleep on your back or on the unaffected side with a pillow between the legs
- When reaching down for anything, keep your knees apart and reach between your legs rather than down the outside of your legs
- Only sit in chairs that are at knee height or higher – no deep lounge chairs
- Preferably use chairs with arm rests to help you get up more easily
- Don’t bend over to pick up or lean forward to put on shoes and socks
- Your hip should not be flexed more than 90 degrees – see diagram
- Avoid lifting or carrying anything heavy
- Do not cross your legs when sitting down, standing up or lying down
The wound from hip replacement surgery requires little extra care.
- The skin sutures dissolve and do not need removing
- The dressing is waterproof allowing showers but should be changed if it peels or lifts up
- The wound should be kept dry, especially the groin wound from Direct Anterior Approach hips. If it becomes inflamed or oozing, please contact Dr Negus’ rooms or your GP immediately as you may require oral antibiotics for a short period of time.
- The wound needs a dressing until it is healed.
Patients can have hydrotherapy 4 weeks after surgery if the following criteria are met:
- Wound is clean and dry with no scabs, oozing or blisters
- Wound is reviewed by a rehabilitation physician prior to doing hydrotherapy
- If there are any concerns, please contact Dr Negus’ rooms
It is not required for all of Dr Negus’ patients to wear TED stockings routinely as guided by the latest evidence.
TED stockings are required for those with swelling or a history of DVT/ PE
Patients will ordinarily only need paracetamol based painkillers (Panadol or Panadeine) on discharge from hospital.
Dr Negus does not prescribe narcotics to patients as they leave hospital. If stronger painkillers are needed, Dr Negus will ask you to see your GP as they are in the best position to manage all your medications and their interactions with each other and your general health.
Dr Negus recommends that you limit your activities in the first 6 weeks to:
- Walking with support from a stick or crutches
- Gentle swimming in the shallow end (once the wound has been cleared)
Dr Negus advises against the following activities for at least 6 weeks:
- Social tennis
High impact sports such as road running should be discussed before the procedure as they will impact on the lifespan of the prosthesis.
Activities that put the hip in extreme positions such as yoga are not advised after hip replacement.
You can have sex whenever you feel ready. It is advisable to be the ‘passive’ partner for the first 6 weeks remembering that you must avoid any internal rotation of the hip or leg.
You are not allowed to drive in the first 6 weeks following total hip replacement as stated by the roads and traffic authority.
As you approach the 6-week time point, you must work out if you are safe to control the pedals such that you could perform an emergency stop if a pedestrian ran in front of your vehicle. If you feel that you couldn’t react quickly enough then wait a little longer.
It is usually safe to take a short flight a week after surgery as long as you do not have blood clots in the leg.
It is not advised to take a long-haul flight in the first 3 months after surgery as there is an increased risk of DVT.
If flights do need to be taken, it is advised that you wear TED stockings and mobilise during the flight as much as possible. Act on the advice of the airlines for in flight health including – Stay hydrated, limit alcohol, perform ankle exercises and elevate your legs as much as possible when seated.
Please discuss any travel plans this with Dr Negus prior to the surgery.
It is critical that once you have had a joint replacement, you are vigilant to any infections anywhere on the body, even years after the surgery.
Pay particular attention to tooth decay, dental abscesses and mouth infections.
Any infection can travel via the bloodstream to the hip joint and infect the metalwork resulting in further operations and high strength antibiotics in hospital.
Please tell your dentist you have had a hip replacement before any dental work and give them a copy of the current advice from the Arthroplasty Society of Australia which outlines recommendations for mouth care after joint replacement.