Rehabilitation After a Total Hip Replacement
David Seymour, MD, specializes in physical medicine, rehabilitation and electrodiagnosis and is medical director of rehabilitation at Atrium Medical Center in Middletown.
Q. What’s the purpose of rehabilitation after total hip replacement? What happens and how does it help?
A. After total hip replacement surgery, many people are able to live active lives with much less pain. Each year, orthopedic surgeons perform total hip replacements for approximately 200,000 Americans, most often to treat osteoarthritis.
Before you can fully enjoy your new hip, however, you must complete rehabilitation to help you quickly return to daily activities while minimizing complications.
Your rehabilitation is provided by a team that includes your orthopedic surgeon, physiatrist (physician trained in Physical Medicine and Rehabilitation), nurses, physical therapists, occupational therapists and social workers.
Rehabilitation begins before surgery. Your care team coaches you on precautions to avoid hip dislocation, the fundamentals of relearning how to walk safely and efficiently, and an introduction to exercises you’ll do after surgery. You can also begin to prepare your home by identifying a chair you’ll use that’s firm and keeps your hips higher than your knees. Remove loose rugs and electrical cords. You can obtain a raised toilet seat and shower chair in advance, or do this just before you leave the hospital with the help of an occupational therapist and social worker.
After surgery, rehabilitation team members will create an individualized plan for you. They’ll take into account other health issues you may have, such as arthritic joints, heart disease or diabetes, that might affect your recovery.
Immediately after surgery, rehabilitation focuses on controlling pain and starting some gentle range of motion and strengthening exercises in bed. On the day of surgery, you’ll begin sitting bedside and standing, if you can. During the next two days, you’ll continue with therapeutic exercises. You’ll work on transferring yourself from bed to chair, using a walker with a physical therapist’s help, and self-care (dressing, bathing and toileting) with an occupational therapist.
Usually by the third day after surgery, patients are ready to leave the hospital to continue their rehabilitation in another setting. You may have several options:
- At home with home care
- A hospital inpatient rehabilitation unit with three hours of therapy daily
- A nursing home with a skilled care unit, typically offering less than three hours of therapy daily
Your rehabilitation team in all three settings will include your physician, a nurse, physical therapist and occupational therapist as necessary. A social worker also is available at the inpatient unit and nursing home. The option that’s right for you depends upon a number of factors, including your initial progress, exercise tolerance, level of assistance available at home, and insurance coverage.
If you go to a nursing home or inpatient rehabilitation unit, you’ll be ready to return home when you can transfer in and out of bed, stand up from a seated position, move on and off the toilet on your own, walk household distances and do your own self-care. You also may continue with outpatient, or in some instances, home therapy.
To help you stay safe at home, your rehabilitation team may recommend useful equipment: a long-handled reacher, a long-handled shoehorn, raised toilet seat with grab bars, and a walker. Your team’s social worker can help you obtain the needed equipment. The occupational therapist also may visit your home to identify safety concerns and recommend improvements.
After you’ve recovered from total hip replacement, you can participate in low-impact activities such as bicycling, swimming, dancing, golf and sometimes doubles tennis. High-impact sports such as jogging are not recommended. You can generally resume driving four to six weeks after surgery, based on your surgeon’s recommendations.
The goal of every member on your rehabilitation team is to help you return to your normal life with confidence — and much less pain — after total hip replacement. By partnering with your surgeon and rehabilitation team, you can look forward to participating in many of the activities you enjoy.
This information is for educational purposes only. Please talk to your physician for advice in all matters related to your health.