Total hip replacement (THR) is a surgical procedure where diseased bone and cartilage of the hip joint is replaced with prosthetic components.  Total hip replacement surgery can relieve joint pain caused by damage either from arthritis, fracture or other conditions and improves the quality of life for a large majority of patients who have undergone this operation.

After a THR surgery, it is important to be an active participant in the healing process to help to return to everyday activities quicker.  Upon discharge from the hospital or intermediate care facility, you will need to adopt certain changes in the way you perform your daily activities in order to safeguard your new hip and keep it healthy for a long time.  These are some of the changes you will be expected to include in your recovery process:

1. Weight on your new hip: Putting too much weight on your joint can make it loosen and move out of place.  Based on the type of surgery you have undergone, your healthcare provider will give you weight bearing guidelines which tells you how much weight the affected joint can handle.  This must be strictly followed at home.    The use of crutches, walkers or canes will help you move about easily.
2. Body Positioning: Do not bend the hips or knees further than 90 degrees and sit in chairs that have seats as high as your knees.  Use a raised toilet seat for proper bathroom safety.  Do not cross your legs and use a tool to pick objects from the floor. While sleeping use a pillow to help position your body and do not lie on the side of your body that had the surgery.  By following the guidelines given to you by your doctor you can protect your new hip from dislocation.
3. Modifications to your home: Ideally before your surgery, take steps to keep your home ready for when you return. This is very important to avoid potential falls.  Decide to use a room which is comfortable to reach to and which minimizes the use of stairs.  Rearrange furniture if required to make it easier to move around with a walker or crutches. Move aside items from the floor that can cause you to slip, such as mats, rugs and electrical cords.  Install proper bathroom safety equipment such as grab rails and shower chairs.  Place items that you frequently need within easy reach.  Assign yourself a proper chair that has a firm high seat rather than one which is low and requires you to bend down to sit. The use of a lift seat is ideal as it helps you to move in and out of your chair safely.
4. Physiotherapy: A physiotherapist will prioritize the hip replacement rehabilitation goals based on what you want to achieve. Be attentive at your physiotherapy appointments as the prescribed exercises provided will help you maintain strong hip muscles which support the artificial joint.
5. Daily activities: A physiotherapist or occupational therapist guide you with safe ways of performing daily activities such as:
   • Climbing stairs: Should be done one step at a time with the help of crutches or canes.
   • Dressing: Done by sitting on a chair and preferably using a dressing stick, long handed shoehorn or sock aids.  While putting on pants or skirts, remember to dress the operated leg first and undress the operated leg last.
   • Cooking: Avoid lifting of heavy utensils – slide them instead. Avoid bending and take short breaks from standing up.
   • Cleaning and laundry: Avoid bending and twisting your body while cleaning.  Wash smaller loads of clothes over the week rather than heavy loads.  Use long handled sponge and lightweight items for cleaning aids.
   • Bathroom use: Shower chairs can be adjusted to the correct height to avoid bending over.  Do not sit in a bathtub.  Make it a habit to use grab handles at all times.  A reacher can be used for proper cleaning and drying.
   • Shopping: As much as possible do smaller shopping to avoid heavy lifting of shopping bags. Divide the weight equally in two shopping bags.  Consider shopping online for groceries.
   • Driving: Before attempting to drive, a physiotherapist or nurse can show you the proper way to get in and out of a car without the risk of falling or dislocation, especially for car seats that are low to the ground. Once your reflexes and muscle strength get to normal, it would be safe to drive – some take 2 weeks while others can take as long as 8 weeks. You must not take any pain medication that can impair your driving skills as this can be fatal.
   • Sports: Once the wounds have been healed, your doctor will be able to let you know how soon you can return to sports.  This will largely depend on the type of hip replacement surgery, the prostheses and the sport.  Typically, swimming, cycling and golfing are safe, while jogging and basketball are likely to put a lot of pressure on the new hip.
   • Returning to work: Your doctor will recommend the appropriate time for you to return back to work.  For most people with sedentary jobs it is likely between 6 weeks to 3 months.  If your job involves bending, lifting, operating heavy machinery, it would not be recommended to return to work quickly.  Do not return to work without discussing it with your doctor.

6. Wound Care: During recovery at home, it is essential to keep the wound site clean and dry until staples are removed in order to prevent infection.  Any signs of redness, swelling, discharge or fever should immediately be brought to the attention of your doctor. Always wash your hands with soap and water before dressing the wound yourself.
7. Medication: Take all the medication as advised by your doctor. It will help with pain and fight infection. You may need to take blood thinners to lower your risk of forming blood clots. You may also be asked to wear special compressing stockings for up to 6 weeks to prevent swelling.
8. Diet: Follow a balanced diet to restore muscle health and promote proper tissue healing.  Drink plenty of fluids and cut back on caffeine.  Take supplements as advised by your dietician.  It is essential to maintain a healthy weight to avoid putting pressure on your hip.
9. Help at home: Consider the type of help you would need at home to assist you with errands. Find a family member or friend who can take some time off work to help you with the first few days when you are back from hospital.  Home Nursing services are now easily available and can cater to your specific needs after a hip replacement surgery.

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Sources:

Ortho Info

NHS UK

Medline plus

Drugs – Precaution after TJR surgery