Rehabilitation to Gain Long-lasting Strength and Mobility

Hip replacement surgery can significantly increase your mobility, but it is essential to build strength during recovery and avoid complications such as dislocation, blood clots, and infection.

What to Expect After Surgery

After hip replacement surgery, most people spend several days in the hospital. You will be able to go home 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

Depending on your strength, you may need to stay in a rehabilitation or skilled nursing facility.

Managing Pain

The goal of pain control after surgery is not to take away your pain entirely, but to make it tolerable. Managing pain supports 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-Opioids

Over-the-counter pain medications such as aspirin, ibuprofen, and acetaminophen can reduce swelling and control mild to moderate pain.

Non-Medication

Medication is not the only strategy to manage discomfort. You can also:

Try different positions for comfort. Pay attention to 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

In general, to prevent infection in your healing wound:

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.
Your dressing may be waterproof and safe to shower with. Ask your surgeon when you can safely shower or bathe.
Watch for signs of infection.

Always ask your surgeon what is right for you.

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

Your new hip can become dislocated from the joint. Dislocation is a rare complication, and 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 6 to 8 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 them 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 5 to10 minutes, 3 to 4 times a day
Stair climbing one step at a time with support
Using an exercise bike for 10 to 15 minutes, 2 times a day
Exercising against resistance, such as with a band

Making Progress: Weeks 6-12

After 6 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 3 to 4 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.

At Home After a Hip Replacement