The decision to get hip replacement surgery is never an easy one. But when constant pain is affecting your day-to-day life, and non-evasive solutions like pain medication and regular exercise haven’t brought any relief, surgery may be the next step.
While total hip replacement is considered major surgery, choosing to undergo surgery no longer has to be as debilitating or daunting as once thought.
“Rapid recovery has become a reality,” says Ritesh Shah, MD and orthopedic surgeon at the Illinois Bone and Joint Institute. “Over the last few years, we’ve seen hospital length of stays decrease, and the emergence of outpatient hip replacement surgery.”
If you’re considering hip replacement surgery, doing your research, knowing what to expect and working with your medical team on a pain and recovery plan can go a long way in alleviating your fears. Here are five tips for how to prepare, manage pain and recover well from hip surgery.
Step #1: Speak with Your Doctor and Do Your Research
Talk with your doctor about the benefits of surgery and if there are any other options to try first. Some non-evasive hip replacement alternatives include exercise programs, pain medications, and assistive walking devices. Your doctor may want to try some of these alternatives before opting for surgery. Once you’ve decided to go ahead with the surgery, you’ll want to research everything from your medical team to your insurance coverage, therapy aids and how much time you can take off work.
Do plenty of research on the surgeon who will be performing your procedure. Patient Erin Kaese underwent not one, but two total hip replacements at age 44. She knows a thing or two about how to prepare for this surgery, and she has one big piece of advice when it comes to choosing your surgeon and team. “Talk to someone who is similar to you in terms of age, medical situation and activity level and who has used the surgeon before,” says Kaese. She also recommends putting just as much research into your entire medical team.
While you’re learning more about the surgical team, don’t forget to research the hospital itself. Dr. Timothy Gibson is an orthopedic surgeon and medical director of the Memorial Care Joint Replacement Center at Orange Coast Memorial Medical Center in Fountain Valley, California. Dr. Gibson recommends looking for a hospital that has a total joint replacement team in place. “This provides pre-op education for patients and family members, as well as coordination of care from hospitalization to discharge,” says Dr. Gibson. “Patients who discharge to home do much better than those who discharge to a rehabilitation facility.”
And finally, you’ll also want to consider your long-term timeline, including how long to expect the effects of the surgery to last. According to the American Association of Hip and Knee Surgeons, a total hip replacement lasts an average of 15 to 20 years.
Step #2: Understand the Surgery
With total hip replacement, both the head of the femur and its socket are replaced. The surgeon first removes the damaged cartilage and bone from the hip joint. The damaged parts are then replaced with artificial parts, typically made of metal, alloy or ceramic. You may need total hip replacement if your hip has been damaged by arthritis, bone or cartilage disease or other injuries. In a partial hip replacement, only the head of the femur is replaced.
During your pre-operative appointments, your surgeon will most likely talk about the surgery’s approach. A posterior approach means they’ll access your hip joint from the back of the hip, while an anterior approach means the incision will be on the front of the hip. The approach generally comes down to your surgeon’s preference. “People get better just as quickly with both methods,” says orthopedic surgeon Dr. John Kronick with Muir Orthopeadic Specialists.
Also make sure you ask your surgeon how to best prepare for surgery. Dr. Gibson reminds us that the healthier you are before surgery, the better. Make sure your chronic conditions like diabetes are well-controlled prior to surgery and make a plan to quit smoking if you’re currently a smoker. Both smokers and diabetics typically have slower wound healing and are at higher risk for infection following surgery.
Step #3: Make a Pain Plan
Total hip replacement is a serious surgery, so pain management is a huge factor. According to Dr. Kronick, there are two key factors for controlling pain and helping you recover faster. First, how healthy you are before surgery and second, your attitude. Keeping a positive attitude is imperative to getting you through the initial recovery period.
Look into a pill box to keep track of all of your post-operative medications. You will most likely go home on medication for pain, nausea, and constipation. You may also need medication to help prevent blood clots. Make sure to take all of your medicines as prescribed, and don’t go too long between doses. It’s much easier to stay on top of your pain than to control it once it’s already excruciating. Total hip replacement is a big deal, so don’t try to tough it out on your own.
Step #4: Get Ready to Get Moving
If you thought you were going to spend your post-operative hospital stay resting, you may be surprised to learn this: While the time to recover from a hip replacement can vary, moving shortly after surgery helps speed up your recovery.
In fact, physical therapy usually starts the day after surgery. Orthopedic physical therapists are specially trained to help you feel better as soon as possible. You’ll also have access to pain medication to help you get through your recovery exercises. During your hospital stay, you’ll work with your physical therapist once or twice a day to regain full hip movement.
“Moving within hours of surgery has proven to result in excellent outcomes,” says Dr. Henry Finn, MD, medical director of the Chicago Center for Orthopedics, chairman of surgery at Weiss Memorial Hospital and professor of Orthopedic Surgery at the University of Chicago. “It also lowers the risk of blot clots post-surgery.”
Froedtert Hospital physical therapist and orthopedic certified specialist Tim Petrie shares what to expect when you start your physical therapy program: “You’ll work on restoring range of motion, improving strength, and returning to normal function,” he explains. “Depending on your type of hip replacement, your therapist will also help you maintain appropriate movement precautions.”
Step #5: Prepare Your Home
When it’s time to go home after surgery, ask a friend or family member to pick you up in a sedan. Climbing into a truck or SUV could be painful. You won’t be able to drive for about three to six weeks, so make plans ahead of time. Get pre-made meals delivered, stock up on frozen meals and premix some easy-to-grab snacks, such as nuts and fresh fruit.
Make sure your home is set up up properly so you can be comfortable continuing your recovery at home. Set up a home base for yourself. If you plan to camp out on your couch, make sure you have everything you need. Rearrange furniture so that your cane or walker can fit as you move around the house. Place your phone, remote, a book, and reading glasses within arm’s reach. If there are any tripping hazards, such as a throw rug, remove them for now. Make sure to prepare your bathroom. For adults with limited mobility invest in a shower chair or install hand rails.
When to Call the Doctor
According to the American Academy of Orthopedic Surgeons, the two big complications to watch out for are infection and blood clots. Common signs of infection include a fever, the chills, increased pain, and redness, swelling and drainage at your incision. These infections can spread quickly, so make sure to call your physician’s office if you suspect something may be wrong. Signs of blood clots include severe pain and swelling in your calf. If the blood clot travels to your lungs, you will experience chest pain, trouble breathing and a cough.
Remember Why You’re Doing It
Preparing for and recovering from total hip replacement can feel daunting, but remember that it’s also worth it. Now three months out from surgery, Erin Kaese is living a new life. “My range of motion is now better than before surgery and I have no pain. I walk better; I can finally kick a soccer ball; and do so many other things that had required modification or Advil,” she wrote in an article for the Athletic-Minded Traveler. “One of the best parts about being pain free is that I am not thinking about the pain and spending the time managing it. It is truly freeing.”
