Preparing for Hip Replacement

With an increasingly savvy and “baby-booming marketplace” ready for more implant surgeries than at anytime in history and everyone in the implantables supply chain –including patients– paying much closer attention to all the details, I thought a little primer from the patient’s perspective might be of interest.

Healthcare Matters welcomes Elizabeth Carrollton who writes about defective medical devices and dangerous drugs for Drugwatch.com. She penned the following guest post. Thanks Elizabeth!

Are you wondering what your life after hip replacement will be like? The answer to that question is that it’s largely up to you. Hip replacement is major surgery, so recovery will take some time and patience, and the process is different for everyone. However, there are some things you can do before your procedure to give yourself a good head start, and if you work hard at rehabilitating that hip after surgery, you’re quite likely be back on the golf course or tennis court within a few short months.

Preparing for Hip Replacement

Careful preparation before your replacement procedure can make your recovery move along quickly. The first step to take is physical therapy, since going into your procedure with the muscles that support the hip joint in great shape will minimize the impact of surgery on their strength and tone, making recovery faster and easier.

Secondly, use those weeks that you’re in therapy to do some research on hip implants and discuss them with your surgeon. Choosing your implant carefully can reduce your risk of complications, since hip replacement systems aren’t all created equal.

For example, metal-on-metal hip implants, which have been popular choices for the active patient over the last several years, have been problematic for a lot of people. Several implants have been recalled recently, including the DePuy ASR, Stryker Rejuvenate and Zimmer Durom Cup, and hundreds of hip lawsuits have been filed by injured patients.

The main issues that led to these recalls were high rates of early implant failures and complications, such as metallosis. A serious condition caused by an accumulation of metallic implant debris particles in the soft tissues surrounding the hip joint, metallosis leads to inflammation, pain and in some cases, tissue death and bone loss. The implant can become loose and unstable due to metallosis, making revision surgery necessary.

Rehabilitation After Hip Replacement

Aggressive rehabilitation therapy after your hip replacement is essential to a thorough and fast recovery. Patients who make rehabilitation therapy a priority regain a higher level of mobility, have less pain and have shorter recovery times than those who don’t.

Physical therapy usually begins within 24 hours after your procedure, since getting upright and active helps prevent post-operative complications like blood clots and respiratory infections. During your hospital stay, your therapist will assist you in walking with the support of crutches or a walker. You’ll be assisted through a variety of exercises to begin restoring strength and flexibility to hip muscles. Your therapist will also instruct you on post-operative restrictions and differences in range of motion and joint function that can be expected with your new hip.

After you’re discharged from the hospital, therapy should continue for at least six to eight weeks and can be done on an outpatient basis, either at home or in a clinic, or at an inpatient rehabilitation facility. An inpatient rehabilitation program can be the best option for people who are eager to get back to their lives as quickly as possible, since these facilities offer more intensive therapy and a wider range of rehabilitation equipment than most outpatient options can provide.

Thanks again to Elizabeth Carrollton of drugwatch.com.

—Tom Finn

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Comments

  • Donna:

    I had both my hips replaced (one at a time) during 2012. I disagree strongly that aggressive physical therapy is necessary after a hip replacement. In fact, I was injured in physical therapy while in the hospital after my second hip because the physical therapy program was aggressive. That was June and I am still suffering the consequences of PT’s pushing me so hard–I have chronic muscle pain, inflammation, and tendonitis in a hip adductor muscle that was torn while doing PT at the hospital post op.

    My first hip was done at a different hospital with a gentler approach to post op PT. I did well with this, went to an inpatient rehab for 5 days, and then home independently with friends stopping in sporadically during the first couple of weeks. I had 3 home PT visits and rehabbed the hip on my own after that–I didn’t even need outpatient physical therapy. I simply did my exercises every other day, pushing to the point where the last few reps were difficult, but never being aggressive about it. I walked as much as I could but never in an aggressive manner. I quickly gained strength and mobility without injury.

    Therefore, I strongly disagree that aggressive physical therapy after a hip replacement is needed. In fact, it had quite the opposite affect on me after the second hip and resulted in injury that still has me taking prescription pain medication, attending PT (trying to repair the mess the hospital PT created), and being unable to walk more than 1/2 mile 5 months after the hip replacement.

    Please don’t make people think they have to be aggressive with their hip replacement rehab. It’s just not true. A great deal of healing must take place before the more aggressive exercises are safe. I know that from personal experience and I never want anyone to suffer an injury as I did.

    • Tom:

      I think common sense plays a major, oft overlooked role here. When patient complaints about post-op pain are over the top, the idea that a PT would recommend aggressive rehab makes no sense at all, so I would agree with you.

      Just keep in mind that hip replacements yield a wide variety of outcomes. There are patients who will respond very favorably to aggressive rehab –and I would guess that they outnumber those who won’t.

      The PT and patient should be able to collaborate more creatively in cases where the outcome is not in line with expectations. And as is usually the case, the patient must become his/her own best advocate.

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