What is a total hip replacement?
A total hip replacement is a surgical procedure whereby the diseased cartilage and bone of the hip joint is surgically replaced with artificial materials. The normal hip joint is a ball and socket joint. The socket is a “cup-shaped” component of the pelvis called the acetabulum. The ball is the head of the thighbone (femur). Total hip joint replacement involves surgical removal of the diseased ball and socket and replacing them with a metal (or ceramic) ball and stem inserted into the femur bone and an artificial plastic (or ceramic) cup socket.
Why is total hip replacement necessary?
Total hip replacements are performed most commonly because of progressively worsening of severe arthritis in the hip joint. The most common type of arthritis leading to total hip replacement is degenerative arthritis (osteoarthritis) of the hip joint. This type of arthritis is generally seen with aging, congenital abnormality of the hip joint, or prior trauma to the hip joint. Other conditions leading to total hip replacement include bony fractures of the hip joint, rheumatoid arthritis, and death (aseptic necrosis, or avascular necrosis) of the hip bone. Hip bone necrosis can be caused by fracture of the hip, drugs (such as prednisone and prednisolone), alcoholism, and systemic diseases (such as systemic lupus erythematosus).
The progressively intense chronic pain together with impairment of daily function including walking, climbing stairs, and even arising from a sitting position, eventually become reasons to consider a total hip replacement. Because replaced hip joints can fail with time, whether and when to perform total hip replacement are not easy decisions, especially in younger patients. Replacement is generally considered after pain becomes so severe that it impedes normal function despite use of anti-inflammatory and/or pain medications.
Before and After Surgery?
Days before surgery, it’s appropriate for you to see your physical therapist to alley your concern about making sure your hip replacement surgery heals as intended. Many patients are afraid to be active and some do not want to move at all, fearing they will risk having the replacement disengaged. In actual fact, contrary to this fear, movement and exercises are very important to foster healing done in the most appropriate form as recommended by your physiotherapist.
Physical Rehabilitation after total hip joint replacement?
After total hip joint replacement surgery, patients often start physical therapy immediately! On the first day after surgery, it is common to begin some minor physical therapy while sitting in a chair. Eventually, rehabilitation incorporates stepping, walking, and climbing. Initially, supportive devices such as a walker or crutches are used. Pain is monitored while exercise takes place. Some degree of discomfort is normal. It is often very gratifying for the patient to notice, even early on, substantial relief from the preoperative pain for which the total hip replacement was performed.
Physical therapy is extremely important in the overall outcome of any joint replacement surgery. Our goals at Ageless Physiotherapy Clinic after your surgery are to prevent contractures, improve your education, and strengthen muscles around the hip joint through controlled exercises. Contractures that can cause limitation of joint motion result from scarring of the tissues around the joint and do not permit full range of motion therefore impede mobility of the replaced joint. Our patients are instructed not to strain the hip joint with heavy lifting or other unusual activities at home. Specific techniques of body posturing, sitting, and using an elevated toilet seat can be extremely helpful. Patients are instructed not to cross the operated lower extremity across the midline of the body (not crossing the leg over the other leg) because of the risk of dislocating the replaced joint. They are discouraged from bending at the waist and are instructed to use a pillow between the legs when lying on the non-operated side in order to prevent the operated lower extremity from crossing over the midline.
What Happens After Discharge From Surgery ?
It may come as a surprise to you that total joint replacement patients are encouraged to get up and start moving around as soon as possible after surgery.
When you are medically stable, our physical therapist will recommend certain exercises for the affected joint. The more quickly a joint replacement patient gets moving again, it is more likely that he or she will regain independence just as quickly. To ease the discomfort the activity will initially cause, pain medication is recommended prior to therapy. In addition, our physical therapist will discuss plans for rehabilitation following hospital discharge.
The success of your joint replacement will strongly depend on how well you follow your rehabilitation instructions. As time passes, you should experience a dramatic reduction in joint pain and a significant improvement in your ability to participate in daily activities. Our physical therapist will also go over exercises to help improve your mobility and to start exercising the thigh and hip muscles. Ankle movements help pump swelling out of the leg and prevent the possibility of a blood clot.
Physical Therapy Evaluation ?
On your first visit, our physiotherapist will want to gather some information about the history of your hip problem, your surgery, your lab tests and scans. You will be given a questionnaire that helps you tell us about the day to day activities prior to your problems and the problems you are having with your hip. The information you give will form part of an evaluation systems of measuring the progress you are making with your treatment when you start.
Once all these information have been gathered, your hip joint will be examined by following these parameters:
Range of Motion
Other Special Muscular Tests
Palpation of the Hip and muscles
Treatment Plans which will involve the physiotherapist formulating a highly specialized physical rehabilitation programs suitable for you and your complaints, taking into account your lifestyles, work you do, and health needs which may include:
Electrical Devices (e.g. TENS units)
Positioning in bed
Limiting exercises to short walk first day or week after surgery
Static Stabilizations Exercises
Dynamic Stabilization Exercises
Gait Therapy- assessment, analysis and Training
Muscle Strengthening Exercises
This check list will help you prepare for your physical rehabilitation after surgery. Check each item to avoid unnecessary delays.
. Arrival time varies so check with our front desk to allow sufficient preparation time to get you ready for your treatment.
. Medical Insurance Benefits or cards should be brought with you.
. Lab Tests and Scan Results are essential to accompany you on your first visit. Please bring along all results of the lab tests, scans, and x-rays during the process of surgery.
.Wear comfortable clothing that is appropriate for your examination and treatment when coming for consultation.
.We run escort services in case you need transportation from your home or the hospitals you are admitted or from the airport to our clinic and back.
.We can accept money transfer, cheque, cash and you can as well use our POS if you desire.
We arrange a seamless follow up visit for you when you are on admission in our facility to ensure you are healing well and making progress with your rehabilitation. We can also make progress report available for you and your surgeon whenever you need one to intimate you, your family members and your surgeons with the progress you are making with your rehabilitation.
#ImageCredit: Hopkins Medicine.