Total Hip Replacement

Welcome to the iMove Physiotherapy total hip replacement blog. Whether you’re here because you are exploring treatment options such as a hip replacement or just learning about your hip, the page is a great start! On this page, we’ll go through what a hip replacement is, some strategies for how to manage it, and some exercises for how to strengthen it. These tips are aimed at restoring your mobility and strength and getting you back to the things you love.

What is a hip replacement?

A hip replacement is a full or partial resurfacing of the bones in the hip joint. Normally the bones in our hip (the femur and pelvis) glide smoothly together. However, in cases such as advanced arthritis, the articular cartilage that provides a cushion between these bones can become worn down. Symptoms for this may include pain, discomfort, and reduced movement with everyday activities such as getting up from a chair or climbing stairs.

As can be seen in the picture below, the surgery aims to replace the areas where the articular cartilage in the hip joint (the natural cushion between the bones) has worn down. Without this cushion, it is harder for the bones to glide smoothly through movement (such as bending or straightening) and also with weight-bearing. A total hip replacement is also a treatment option for traumatic injuries (i.e. fractures) or other conditions.

What are the risks with surgery?

As with all surgeries, there is a degree of risk with such an invasive procedure such as a total hip replacement. Complications can include infection, blood clots, subluxation or dislocation, instability, and pain. Past medical history can also play a factor in the appropriateness of surgery. Careful consideration of all factors should be evaluated before surgery, included the risk vs benefit of the surgery.

See above the image on the left shows a healthy normal hip whilst the image on the right has very diminished bone space between the bones.

What can I do now?

Before undergoing a joint replacement, research has shown that strengthening the surrounding muscles can assist with recovery postoperatively. Here at iMove we specialize in pre-operative hip assessments and can assist you to begin your strength program.

Preparing your home environment and making sure you have adequate social support can also be vital post-operatively. You may find you will require assistance with everyday activities such as shopping, cooking, and laundry. If you live alone or have stairs it may be worth staying somewhere with support, especially if undergoing a bilateral hip replacement. Discharge planners and social workers may be able to assist with this. Equipment such as over toilet frames and bathroom rails may be additionally beneficial.

What are hip precautions?

Your surgeon may advise you that postoperatively you may have hip precautions. These may vary with the surgeon’s personal preferences and each specific case. However here are three common protocols we tend to see

Do not cross your legs (even if you’re lying in bed)
Do not bend your hip past a 90-degree angle (ie. Getting up from a low chair)
Do not twist your hip inwards (keep your knees and toes pointed forward).

These guidelines are generally only for a short amount of time (approximately 6 weeks) and are designed to reduce the risk of dislocation for the newly operated hip joints.

Strengthening Exercises include:

Static Quads
Inner range quadriceps
Clams

After surgery, it is advisable to see a physiotherapist for follow-up rehabilitation and a comprehensive strengthening program. At iMove Physiotherapy, we have experience with managing total knee replacements and would love to help you on your journey.