Post- operative recovery following Total Hip Replacement

After surgery, you will be moved to the recovery room where you will remain for one to two hours while your recovery from anaesthesia is monitored. After your return to the ward, once your general condition permits, you will be mobilised around the bed. The same evening or next day, you will have a practice on stair climbing supervised by a physiotherapist. Once your general condition is satisfactory and mobilisation is adequate, you will be discharged home.

The overall speed of post-operative recovery is variable and in general, most patients can walk short distances unaided at about 2 weeks after surgery using the modern techniques such as Short Stay Joint Replacement and Minimally Invasive Approach, which Mr Kavarthapu routinely offers to his patients.

Post- operative recovery following hip arthroscopy:
  • Usually, you will feel some discomfort in your operated hip area and in addition, mild discomfort can be experienced in the lower back, buttock, knee and ankle regions. The discomfort can normally be reduced with the appropriate routine pain relief. In the majority, there will be some swelling in the groin, buttock and thigh. This is caused by the fluid used during the surgery. The swelling reduces within a few days.

  • You will be seen by a physiotherapist on the ward following surgery and will be given instructions regarding mobilising partial weight bearing using crutches. The duration of crutch weight bearing is usually for 2 weeks. However this can be variable depending on what is done during surgery and Mr Kavarthapu will explain to you after surgery regarding this.

  • Once the physiotherapist is happy with your progress, you will be discharged home the next day with home gentle exercise regime. However the duration of stay can be variable depending on what was done during surgery. You will usually be given a copy of the pictures taken during surgery and we request you bring these copies to Mr Kavarthapu clinic during review in 2 weeks.

What is expected after discharge?
  • The ward nurse would give instructions to remove the outer padded dressing after 2 days, but leaving the inner sticky dressings on the surgical wounds untouched. You are given instructions to observe the wound for any signs of infection (increasing pain, redness or swelling).

  • You should limit your activities to routine short distance walking using crutches. Please carry out the routine home exercises recommended by the physiotherapist.

  • You will usually receive a call from Mr Kavarthapuís secretary after about 2 days enquiring about your progress.

  • Please call Mr Kavarthapuís secretary and book a follow-up appointment at 2 weeks following surgery. At this appointment, your wound may be inspected and the sutures removed. A further explanation of the surgery undertaken can then be provided using the operative pictures. Your will usually be referred to physiotherapy at this point if the assessment reveals a satisfactory progress. Further appointment will be made after 6 weeks.

  • Your physiotherapist will develop an appropriate rehabilitation programme according to Mr Kavarthapuís protocol. Your physiotherapist will guide your return to sporting activities (running etc.) depending on your progress. This is extremely variable between individuals, depending on the surgical findings and the length of symptoms prior to surgery.

  • In the majority, by 8 weeks after surgery you should be walking relatively pain-free. Medium impact activities such as jogging can usually be commenced by this time and gradually progress to running if you make a satisfactory progress. Remember, however, that it may take 3 to 6 months (or more) to return to an elite level of competition/fitness. Any unexpected increase in pain can be treated with ice packs and anti-inflammatory medication. The broad strategy for rehabilitation is to regain early range of movement and stability, followed by strength and endurance. Return to work will depend on pain levels and the nature of your job.

There are some activities to avoid or take care with up to 8 weeks following surgery. These include the following
  • Prolonged standing / walking, especially on hard surfaces.

  • Heavy lifting

  • Squatting / crouching

  • Sleeping on your side. Try to sleep on your back. If you must sleep on your side, sleep on the unoperated side, with a pillow under your operated leg to hold that leg level with the body.

  • Clutch use in manual cars for left hips and break usage for right hips may flare up symptoms during the first month and is best avoided. One should do a trial with emergency stop break safely before commencing driving.

  • Sitting with the hips at 90 degrees- a more open seat angle is recommended i.e.; 120 degrees. Car seats should be tilted backwards slightly in order to open the hips out.
    Please note that these are only suggestions for minimising discomfort/pain

Potential risks and complications of hip arthroscopy

All surgery carries risks, although every effort is made to minimise them. The complications can be temporary or permanent. Reassuringly, permanent complications following hip arthroscopy are rare and the majority is temporary. There are, however, risks, which include the standard risks of undergoing general anaesthesia and specific risks associated with hip arthroscopy.

Complications have been reported to occur in up to 5% of patients and are most often related to temporary numbness/altered feeling in the groin and genitalia. This is due to a combination of distraction of the hip joint and pressure on the nerves in the groin at the time of surgery. This is uncommon and although there is a theoretical risk that this numbness could be permanent, in the majority the numbness recovers fully, usually within a few days. Other complications that were reported include, but are not limited to: pressure sores and blistering, infection, fracture, increased pain, impotence, bleeding, nerve palsies, abandoned procedure, deep-vein thrombosis, instrument breakage, avascular necrosis of femoral head, extravasation of irrigation fluid, delayed wound healing, exacerbation of symptoms. However, many of these complications are extremely rare. For example, the exact rate of infection following hip arthroscopy is unknown, but would certainly appear to be substantially less than 1 in 1000. Recently NICE produced guidelines on surgical management of hip impingement.

Post- operative recovery following Foot Surgery

  • The foot is wrapped in a bandage to control swelling and provide support.

  • It is necessary to elevate leg to reduce post-operative swelling.

  • Plaster immobilisation is not needed in most cases.

  • Most patients can commence immediate mobilisation.

  • A special hard-soled postoperative shoe is usually required for about 4-6 weeks.