Hello and welcome back to the ThreeSpires Physiotherapy blog where we take a look at all things physiotherapy and health related. In this physiotherapy blog post we will have a look at sometjing that our physiotherapists spend a lot of time helping patients with: the recovery from a hip replacement and use a recent hip replacement patient as an example of what to do, how best to approach things and some of the common difficulties that patients who have had a hip replacement face and how physiotherapy can be helpful.

What is a Hip Replacement?

Before assuming that everyone reading knows exactly what a hip replacement is and what it involves it is probably reasonable to actually look at what we mean by a hip replacement. So, the hip is a ball and socket joint formed between the femur (thigh bone) which forms the ball and the pelvis which forms the socket (technically called the acetabulum). A total hip replacement will involve replacing both the ball (femoral head) and the socket (acetabulum) with an artificial version but sometimes it is only necessary to replace the ball in which case this is called a half-hip replacement.

Why Do People Have a Hip Replacement?

There are two main reasons why people will have a hip replacement which can be categorised as either trauma or wear and tear. We will have a look at the process of wear and tear first. Surrounding the bones where they meet is cartilage which acts as a shock absorber and allows the ball of the femoral head to move in the socket of the actetabulum without lots of friction. Unfortunately, as we age this substance can get worn and the joint can become irritated and inflamed, this process is called arthritis and is the most common cause of having a hip replacement. The second cause of having a hip replacement is trauma involving a fall and a fracture of the neck of femur.

What Should I do After A Hip Replacement?

Well, there is a large body of evidence that shows that early access to regular physiotherapy will make a large difference to the quality and speed of recovery after having a hip replacement. So clearly getting access to physio and beginning an appropriate exercise and recovery regime after having a hip replacement is vital.

 

How Can Physiotherapy Help With a Hip Replacement?

Well as mentioned there is lots of evidence that shows that physio really does make a difference but possibly the easiest way to understand how physiotherapy can help with recovering form a hip replacement is to look at a case study.

As mentioned earlier, commonly hip replacements are done to replace the hip joint when it has become worn out due to osteoarthritis but sometimes they are done when a person falls over and breaks their hip. The case we will look at today involves a case of arthritis and pain in the hip.

Hip Replacement Case Study:

Hip replacements are an extremely common orthopaedic procedure and as home visit physiotherapists we see a lot of patients with joint replacements. In this case study our patient is a female Mrs S. (in her mid 70s) who was extremely fit and active but found that she had been getting more and more pain from her hip and had eventually decided to take the plunge and have it replaced.

Mrs S. had her hip replacement done via the NHS and spent approximately 2 weeks in hospital (this is a bit longer than usual and was due to a few complications post-surgery), she had some physiotherapy in hospital but on discharge home she felt that she wanted to supplement the NHS physiotherapy that was on offer and maximise her chances of recovery. So, she contacted us here at ThreeSpires Physiotherapy and we began a series of home visits to provide physiotherapy to optimise her chances of a good recovery. This is a common thing and I would always recommend to anyone that has had a joint replacement to consider supplementing the NHS physiotherapy available if they are worried that they are not getting enough. Sometimes patients are worried that there will be a conflict between NHS and private providers but this couldn't be further from the truth, as a private physiotherapy service we are able to offer appointments at times that are unavailable to the NHS and can fit in when there is a gap. Also most NHS physiotherapists are swamped with patients and are grateful for some assistance in getting patients better.

At the initial session Mrs S. was mobilising on a zimmer frame, had some basic exercises from the hospital physiotherapists and was waiting for an NHS physiotherapy appointment. The initial physiotherapy assessment showed that Mrs S. was generally physically fit and strong and was already capable of progressing off the zimmer frame and of doing more challenging exercises. So over the next 2 weeks whilst she waited for her NHS appointment we worked on an almost daily basis to progress her mobility, strength and develop a series of exercises that provided sufficient challenge to maximise her recovery. Again I would always recommend to patients after any form of joint replacement that they get early intervention by a physiotherapist and especially in the early part of recovery they have intensive and regular sessions in order to optimise their recovery. After all there isn't any point in having the best surgeon and operation if you don't invest in having the best rehabilitation and physio!

Over the next few months and combined with her NHS physiotherapy sessions Mrs S. made a fantastic recovery and is now currently walking long distances pain free and is virtually back to her normal self which is a fantastic achievement and really shows the benefits of our home visit physiotherapy service (and of course her own considerable hard work!!).

Key Points about Recovery From A Hip Replacement

Below are a couple of key points that are vital to think about if you want to maximise your recovery after a hip replacement:

1. Early Physiotherapy: Get physiotherapy as early as possible once you have been discharged home. It is essential that you know what you should and shouldn’t be doing and have a realistic programme of exercises to follow. This really will make a difference to your recovery.
2. Knowledge is Power: having an assessment with a physiotherapist early on in the process of recovering from a hip replacement will give you lots of information about timeframes, things to do, things to avoid, what to expect etc. Now, you may have been lucky and your orthopaedic surgeon will have gone through all of this with you in great detail but more than likely they will not have had the time. By booking an hour long initial assessment with a physio you will be able to arm yourself with the knowledge of how best to recover from your hip replacement.
3. The NHS is fantastic: but also overstretched. It is likely that it will take a while to get your NHS physio appt and also it is unlikely that they will be able to give you as many appointments as you need. Investing in supplementary private physio really does make sense.

Okay, I hope that you have found this article about how to recover from a hip replacement useful. If you or anyone you know needs help after having a hip replacement or you would simply like more information then please get in touch. For anyone reading this blog who hasn't come across our site before: we are a home visit physiotherapy service, based in Lichfield but serving anywhere within a 25 minute drive including areas such as Sutton Coldfield, Tamworth, Cannock, Burton and Rugeley. We offer a wide range of services including paediatric physiotherapy, post-operative rehabilitation, neurological physiotherapy and neck and back pain relief. If you need further information or would like to book an appointment we can be contacted on 0788 428 1623 or via enquiries@threespiresphysiotherapy.co.uk