What To Expect After Surgery

Right after surgery

You will have intravenous (IV) antibiotics for about a day after surgery. You will also receive medicines to control pain and perhaps medicines to prevent blood clots (anticoagulants). It is not unusual to have an upset stomach or feel constipated after surgery. Talk with your doctor or nurse if you feel ill.

When you wake up from surgery, you may have a catheter, which is a small tube connected to your bladder, so you don't have to get out of bed to urinate. You may also have a compression pump or compression stocking on your leg, which squeezes your leg to keep the blood circulating and to help prevent blood clots. And you may have a cushion between your legs to keep your new hip in the correct position.

Your doctor may teach you to do simple breathing exercises to help prevent congestion in your lungs while your activity level is decreased. You may also learn to move your feet up and down to flex your muscles and keep your blood circulating. And you may begin to learn about how to keep your hip in the correct positions while you move in bed and get out of bed.

The first few days

You will probably still be taking some medicine. You will gradually take less and less pain medicine. You may continue anticoagulant medicines for several weeks after surgery.

Rehabilitation (rehab) after hip replacement surgery may vary depending on whether the surgeon used cement or cementless methods to attach the joint replacement surfaces. Whether your surgeon used cement also determines how much weight you can put on your leg. Your surgeon will let you and your rehab team know what limitations you have. Usually, you cannot put any weight on an uncemented hip for about 6 weeks. With a cemented or hybrid (one piece cemented and one piece uncemented) hip, you can usually put some weight on your leg right away. But you'll still need a walker, a cane, or crutches for several weeks.

In general, most people get out of bed with help on the day after surgery. Over the next few days, you will learn how to walk with a walker or crutches. Your physical therapist and sometimes an occupational therapist will teach you how to exercise, walk, and do activities such as dressing and cooking while you allow your hip to heal. Depending on the type of surgery you had and your doctor's instructions, you may learn the following precautions to keep your hip from dislocating:

• Avoid combinations of movement with your new hip. For example, do not sit with your legs crossed, because in that position you both bend your hip and bring your hip across your body.
• Your doctor may not want your hip to bend more than 90 degrees. If so, your therapist may suggest these ideas:
  • Do not sit on low chairs, beds, or toilets. You may want to get a special raiser for your toilet seat temporarily.
  • Do not raise your knee higher than your hip.
  • Do not lean forward while you are sitting down, or as you sit down or stand up.
  • Do not bend over more than 90 degrees. This means you can't bend down to tie your shoes for a while.
• For about 8 weeks, your doctor may not want your leg to cross the center of your body toward the other leg. If so, your therapist may suggest these ideas:
  • Do not cross your legs.
  • Be careful as you get in or out of bed or a car, so your leg does not cross that imaginary line in the middle of your body.
• Your doctor may not want your leg to rotate in or too far out. If so, your therapist may suggest that you keep your toes pointing forward or slightly out.

Most people go home within a few days to a week after surgery. Some people who need more extensive rehab or those who don't have someone who can help at home go to a specialized rehab center for more treatment.

Continued recovery

After you go home, monitor the surgery site and your general health. If you notice any redness or drainage from your wound, notify your surgeon. You may also be advised to take your temperature twice each day and to let your surgeon know if you have a fever over 100.5°F (38.1°C).

For a while, you may need to sit only in high chairs (not on low seats that flex your hip more than 90 degrees), use a toilet seat raiser, and sleep on your back.

You may need to use a walker or crutches for several weeks after surgery until you can bear your full weight, have less pain, and can safely move around without falling. How long you need to use crutches or a walker depends on the condition of your bones and what type of procedure your doctor used as well as his or her experience working with other people who had similar surgery.

Physical therapy typically continues after you go home from the hospital until you are able to function more independently. Total rehabilitation after surgery will take at least 6 months.

You will have an exercise program to follow when you go home, even if you are still having physical therapy. You should also take a short walk several times each day. If you notice any soreness, try a cold pack on your hip and perhaps decrease your activity a bit, but don't stop completely. Staying with your walking and exercise program will help speed your recovery.

For most people it is safe to have sex about 4 to 6 weeks after a hip replacement. Talk to your doctor about how and when it is safe. And ask your physical therapist or occupational therapist about positions that will not put your new hip joint at risk.

Living with a hip replacement

Your doctor will probably want to see you at least once every year to monitor your hip replacement. Gradually, you will return to most of your presurgery activities. If you drive a car, your doctor will probably allow you to start driving an automatic shift car in 6 to 8 weeks, as long as the seat is not too low and you are no longer taking pain medicine.

Because of the way the hip is structured, every added pound of body weight adds 3 pounds of stress to the hip. Controlling your weight will help your new hip joint last longer.

Stay active to help maintain strength, flexibility, and endurance. Your activities might include walking, swimming (after your wound is completely healed), dancing, golf (don't wear shoes with spikes, and do use a golf cart), and bicycling on a stationary bike or on level surfaces. More strenuous activities, such as jogging or tennis, are not advised after a hip replacement.

Your doctor may want you to take antibiotics before dental work or any invasive medical procedure for at least 2 years after your surgery. This is to help prevent infection around your hip replacement. After 2 years, your doctor and dentist will decide whether you still need to take antibiotics. Your general health and the state of your other health conditions will help them decide.