At Home After Hip
Replacement Surgery
Understanding Your Hip Replacement and
Caring for Yourself at Home
Hip replacement surgery, also known as hip arthroplasty, involves replacing the damaged parts of the hip joint with artificial implants. This procedure is typically performed to alleviate pain and improve mobility, especially in cases of advanced arthritis or other conditions causing joint damage.
The goal of hip replacement surgery is to significantly increase your mobility. You can help ensure the best outcome by following your doctor’s instructions and engaging in your recovery plan.
What is hip replacement surgery?
During hip replacement surgery, the damaged ball and socket — also called the femoral head and acetabulum — of the hip joint are removed and replaced with new, artificial parts, also called prostheses. The prosthetic parts are typically made of metal, plastic, or ceramic.
Total hip replacement. In this procedure, both the ball and socket are replaced.
Hemiarthroplasty, or partial hip replacement. This surgery replaces only the ball (femoral head). This procedure is usually performed in the case of hip fractures.
Subchondroplasty. This is a minimally invasive surgical procedure that involves injecting a bone substitute, such as calcium phosphate, into the damaged area to stimulate bone regeneration and improve the joint's structure. Recovery from subchondroplasty is typically faster than from a hip replacement, with patients often able to return to normal activities within a few weeks.
During your recovery, follow your doctor’s instructions carefully and reach out to your care team if you have any questions or concerns. Engaging in your recovery plan will help ensure the best recovery outcome and reduce your risk of hospital readmission.
What to expect after hip replacement surgery
After hip replacement surgery, most people spend several days in the hospital. Once discharged, you will probably need a friend or family member to help you at home for at least several days, and up to several weeks.
Depending on your strength, you will generally be able to leave the hospital once you:
• Do not need intravenous pain medication
• Can urinate without complications
• Can eat and drink
• Can get in and out of bed
• Have stable vital signs
• Have no signs of infection
• Can walk with an assistive device
If you have difficulty meeting these goals, or do not have help at home, you may need to recover in a rehabilitation or skilled nursing facility. When deciding which recovery options are best for you, your surgeon will consider your overall health and whether you have help at home.
Managing hip surgery pain
The goal of pain control after surgery is not to take away your pain entirely, but to make it tolerable. Managing your pain supports your healing by lowering your stress response, decreasing swelling and inflammation, and helping you move sooner.
Opioid medication. Opioid pain medications are most often used for short-term relief when non-opioid options do not give enough relief. Be careful and don’t take more than prescribed. Let your surgeon know if the prescribed dose doesn’t help your pain; it may be a sign of a complication.
Non-Opioid medication. Over-the-counter pain medications such as aspirin, ibuprofen, and acetaminophen can reduce swelling and control mild to moderate pain.
Other pain control. Medication is not the only strategy to manage discomfort. You can also:
• Try different positions for comfort. Pay attention to any movement restrictions your surgeon has given you.
• Use ice for up to 20 minutes at a time to reduce swelling.
• Get regular activity to avoid stiffness, which can increase discomfort.
• Apply heat for 15 to 20 minutes before exercising to relax your muscles and improve mobility.
Taking Care of Your Incision
Always follow your surgeon’s instructions for taking care of your surgical incision. In general, to prevent infection in your healing wound:
Keep it clean. Keep your incision clean and dry. Ask your surgeon when you can remove the dressing. After hip surgery, surgeons often place dressings under sterile conditions. If so, the dressing should stay in place for 7 to 10 days.
Keep it dry. Your dressing may be waterproof and safe to shower with. Ask your surgeon when you can safely shower or bathe.
Keep an eye on it. Watch for signs of infection, like swelling, discharge, and changes in your skin color.
Infection: Warning Signs
Though it’s rare, it is possible to get an infection after hip surgery that can become life-threatening if left untreated. Get immediate medical attention if you experience:
• A fever over 100 degrees
• Chills
• Redness, swelling, and heat
• Increased pain at your surgical incision
• Drainage from your incision
Activities
Dislocation is a rare complication, but it is possible for your new hip to become dislocated from the joint. You can minimize your risk by following some simple precautions:
• If you sleep on your side, place a pillow between your knees.
• Do not cross your legs at the knee for six to eight weeks.
• Avoid extreme hip bending, such as lifting your knee higher than your hip or leaning forward as you sit.
• Keep your legs facing forward and avoid turning your feet to extremes inward or outward.
• Avoid sitting in low chairs.
Hip Rehabilitation
You will work with a physical therapist in the hospital to learn rehabilitative exercises. Continue these exeercises at home. You may also benefit from outpatient physical therapy sessions. Use an assistive device such as a cane, crutches, or a walker while you regain your strength and balance.
Early Recovery: The First 6 Weeks
The sooner you begin to move, the faster you will recover. To increase circulation, start with simple, supported exercises and progress gradually. As your surgeon recommends, progress through:
• Ankle pumps and rotations in bed
• More complex in-bed exercises, such as knee bends, buttock and thigh contractions, and straight leg raises
• Supported standing exercises, including knee raises; leg lifts to the back, called hip extensions; and leg lifts to the side, called hip abductions
• Short walks with the help of an assistive device. Soon, you will need less assistance and walk for five to ten minutes, three to four times a day
• Stair climbing one step at a time with support
• Using an exercise bike for 10 to 15 minutes, twice a day
• Exercising against resistance, such as with a band
Making Progress: Weeks 6-12
After six weeks, you will be able to do most light activities. Depending on your condition before surgery, you may be able to drive and walk without an assistive device.
Long Term Exercise
After 12 weeks, you will likely return to your usual activity level. Continue to get regular exercise. Take 20- to 30-minute walks, three to four times a week, to maintain your strength and promote the longevity of your new joint.
Deep Vein Thrombosis
After surgery, one of the most significant risks is developing a deep vein thrombosis (DVT), a blood clot that forms in a vein, usually in your leg. It can get dislodged and travel to your lungs, which is a medical emergency called a pulmonary embolism (PE).
Get emergency care if you have any of the following signs of DVT or PE:
• Pain in one calf and leg not related to your incision
• Redness, heat, or swelling in your leg
• Sudden difficulty breathing
• Chest pain when breathing
Resources:
Preventing Blood Clots After Surgery. American Academy of Orthopaedic Surgeons.
Total Hip Replacement Exercise Guide. American Academy of Orthopaedic Surgeons.
Activities After Total Hip Replacement. American Academy of Orthopaedic Surgeons.
Managing Pain With Medications After Orthopaedic Surgery. American Academy of Orthopaedic Surgeons.
Patient education: Total hip replacement (Beyond the Basics). UpToDate.
Key Elements of Enhanced Recovery after Total Joint Arthroplasty: A Reanalysis of the Enhanced Recovery after Surgery Guidelines. Orthopaedic Surgery.
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