The hip functions as a ball and socket joint. The top of the femur (thigh bone) fits into the acetabulum (part of the pelvis) to form this “ball and socket” that can move in many different planes of motion. Common signs and symptoms of the need for a total hip replacement or arthroplasty (THR or THA) are severe, limiting pain in the front of the hip or groin area or on the side of the hip, deep aching or throbbing with increased activity, pain that radiates down the side or front of the leg, weakness of the leg causing tripping or falling, walking with a limp, no relief of symptoms with conservative measures such as physical therapy for pain management and strengthening or anti-inflammatory injections and/or medications. These signs and symptoms can be as a result of joint deterioration from osteoarthritis or other issues such as trauma or avascular necrosis (loss of blood flow to the femur or “ball” of the joint).
Total hip replacements can be performed posteriorly (from the back) or anteriorly (from the front) and depending on which your surgeon chooses for you, you will have different precautions to follow after surgery.
Posterior Hip Precautions: No bending past 90 degrees at the hips, no turning or rotating your leg inward toward the mid-line of your body, and no crossing your legs or moving your surgery leg across the mid-line of your body.
Anterior Hip Precautions: No turning or rotating your leg outward or away from the mid-line of your body and no extending your leg backward past neutral (in other words, no donkey kicks :)).
The most important thing you can do following a THR is to follow the hip precautions! Being strict with hip precautions will greatly decrease the likelihood of dislocations and complications.
Rehabilitation will generally start as soon as the same day as the surgery in the hospital and it will last up to 14 weeks, but everyone is different, so don’t be concerned if yours takes longer or doesn’t take that long. Rehabilitation will initially focus on getting your normal gait back while using an assistive device such as a walker, re-gaining muscle strength lost by surgery, pain control, range of motion improvement within your restrictions, flexibility and care of your surgical incision. Gradually we will progress to walking without an assistive device, more advanced and functional strengthening, balance training and aerobic conditioning to allow you to return back to your old self (maybe even better!)
The initial period after any joint replacement can seem daunting because progress never occurs at the rate we all prefer which is yesterday. It happens subtly, gradually, over time. When you do finally look back at the you before the surgery, you’ll be glad that the new joint is there and the old joint isn’t holding you back anymore. Wishing everyone a healthy or rehabilitated hip! – Kelly
