Hip Replacement

Physiotherapy following a hip replacement

A hip replacement is a surgical procedure in which a worn or damaged hip joint is replaced with an artificial joint.

The hip joint supports the weight of the body during both static and dynamic activities. It is a ball-and-socket joint, where the ball is the rounded head of the femur (thighbone), which fits into the socket, called the acetabulum, in the pelvis. The top of the femur just below the head is called the neck of the femur.

A total hip replacement involves replacing both the femoral head and the acetabulum. This may involve either:

  • Cemented hip replacement – the artificial joint is fixed to the bone using surgical cement.
  • Uncemented (press-fit) hip replacement – the implant is designed to allow bone to grow into it for natural fixation.
  • Hybrid hip replacement – a combination of cemented and uncemented components.
  • Resurfacing hip replacement – the femoral head is not removed but reshaped and capped with a metal prosthesis.

A hemiarthroplasty involves replacing the surface of the femoral head without altering the acetabulum (hip socket). This procedure is commonly performed following a fracture of the neck of the femur.

Total hip replacement surgery is a successful and effective procedure for diseased or damaged hip joints, but recovery can be a lengthy process. In some cases of advanced hip disease, resurfacing the femur and acetabulum with metal components may be considered, as it requires less prosthetic material and removes less bone.

Physiotherapy after a hip replacement helps to reduce joint pain, increase mobility, improve independence in everyday tasks, and enhance your quality of life.

Physiotherapy before a hip replacement

Before your surgery, it is important to stay as active as possible to support your recovery. Pre-operative physiotherapy will include daily exercises to strengthen the muscles around your hip joint. Activities such as walking and swimming are recommended in the weeks and months leading up to surgery to maintain joint flexibility and muscle strength. Your physiotherapist will also provide information and precautions regarding the surgical procedure and expected outcomes.

Symptoms after a hip replacement

After your operation, it is normal to experience pain and discomfort due to the major joint reconstruction. Your movement will be limited initially as the effects of anaesthesia wear off. A special pillow may be placed between your legs to maintain your hip in a safe position. A physiotherapist will visit you one or two days after surgery to assist with bed mobility, transfers, and sit-to-stand movements. Exercises may include ankle mobilisations and simple exercises for your quadriceps and glutes. Walking will also be encouraged, and you may be provided with a walking aid (such as crutches or a walker) and advised to partially weight bear during the early stages of recovery. You will typically remain in hospital for around 5 days, depending on your overall health and fitness.

Physiotherapy following your hip replacement

Physiotherapy is a crucial part of your recovery, so it is essential to continue exercises after leaving hospital. Physiotherapy at acephysiosports.com will help improve muscle strength and flexibility and support you in regaining mobility and function as quickly as possible.

Rehabilitation goals at acephysiosports.com will include:

  • Reduce pain and swelling in the hip joint.
  • Restore range of motion in the hip.
  • Strengthen muscles around the hip, including glutes, quadriceps, and hamstrings.
  • Improve balance and coordination to prevent falls.
  • Regain independence in daily activities such as walking, dressing, and climbing stairs.
  • Enhance overall mobility and endurance for daily tasks and leisure activities.
  • Educate on safe movements and hip precautions to protect the joint.

1-2 weeks

There are certain movements you should avoid during the first six weeks after surgery. For example, you should not cross your legs or twist your hip inward or outward. Your physiotherapist in hospital will provide further advice and tips to protect your hip during recovery.

During the first two weeks of your physiotherapy programme at acephysiosports.com, the main aims are to control pain and swelling and to passively improve range of motion and muscle strength. Treatment will also focus on improving ambulation and teaching you safe ways to mobilise around your home. Physiotherapy at this stage may include:

  • Passive and assisted range of motion exercises for the hip joint.
  • Gentle strengthening exercises for quadriceps, hamstrings, and gluteal muscles.
  • Ankle mobilisations to maintain circulation and prevent stiffness.
  • Bed mobility and transfer training (getting in/out of bed, chair, or toilet).
  • Gait training with a walking aid (walker or crutches) and partial weight-bearing practice.
  • Education on hip precautions to avoid movements that may compromise the new joint.

2-6 weeks

At this stage of your rehabilitation, your physiotherapy programme at acephysiosports.com will progress previous exercises to further increase range of motion, with the addition of resistance exercises. Exercises will also be functional, helping you regain independence in everyday activities. Treatment will include gait re-education (with less assistance) and proprioception (balance) training. Physiotherapy activities may include:

  • Resistance exercises for glutes, quadriceps, hamstrings, and hip stabilisers.
  • Functional exercises mimicking daily activities, e.g., sit-to-stand, step-ups, reaching.
  • Gait re-education to improve walking pattern and reduce reliance on walking aids.
  • Balance and proprioception training using exercises like single-leg stands or wobble boards.
  • Hip range of motion exercises to maintain and improve flexibility.
  • Core strengthening exercises to support overall stability and posture.

6-12 weeks

At this stage of your rehabilitation, your physiotherapist at acephysiosports.com will focus on restoring your functional ability so you can return to the activities you enjoyed previously. Your progress will be carefully monitored to ensure you are safe while performing activities. Your physiotherapist will guide and support you throughout your programme to achieve the best possible recovery. Physiotherapy treatment will involve progression of exercises to strengthen the muscles around your hips and legs while continuing to increase hip range of motion. Activities to improve fitness levels may also be included, such as walking, hydrotherapy, and gentle cycling.

12+ weeks

The success of your recovery and the time it takes to return to your previous level of function will depend on your commitment to your treatment programme. At this stage of rehabilitation, you will continue to progress with physiotherapy to reach your maximum potential. Recovery may take up to 6 months, but physiotherapy will help improve your quality of life and enhance your ability to perform both daily and sporting activities.

Summary

For more information, call acephysiosports.com now on +65 8153 5374, or to book an appointment, please contact us.

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