I'm having a replacement hip

RogerBill

Until this year I used to enjoy regular 8 mile walks, I’m 68, in generally good health and not overweight. I’ve had a diagnosis of “severe degenerative change in the left hip with complete loss of the superolateral joint space”. I’ve decided to pay for a private hip replacement operation because NHS waiting times are 12+ months. I’m having a Mako robot assisted hip replacement operation late September.

For 6 weeks after the operation I know you mustn’t bend more than 90°, twist or cross legs to minimise the risk of dislocation. I believe the ball and socket of the hip joint are just held together by the muscles. Therefore am I right in thinking it’s a good idea to exercise before the operation to build up muscle strength? A physiotherapist recommended some exercises using a resistance band around the ankles while side stepping and similar. I did these for a couple of months but stopped as my knees started to hurt, crack and pop. Mostly my hip is only painful when walking or standing so I’m more able to do exercises which don’t involve weight bearing. I’ve been doing a selection found on the internet but are there any particular exercises you’d recommend?

Any suggestions on this or other helpful hints and tips would be really great, many thanks.

anneb82

Hello @RogerBill

Welcome to the online community and thank you for sharing your story with us here. I hope that you will find this a safe space to continue sharing as well as helpful.

So you have been diagnosed with Osteoarthritis in your hip and have decided to go privately in order to have a hip replacement in late September. Before you're diagnosis you regularly walked a lot and have been advised by a physiotherapist to try certain exercises before the operation to build up more strength in your leg muscles. You are wondering if anyone has any other recommendations.

I know from personal experience that when I had my hip replaced through the nhs, they gave out certain exercises that I needed to do prior and after the operation to build up muscle strength. I am wondering whether or not they would be similar or the same as the ones you were recommended via the physiotherapist you saw.

Below are a couple of links to areas on our main Versus Arthritis website that I think may be of help to you. I am sure that there will be plenty of other people in the online community that can recommend things to you as well as any tips people have picked up along the way.

https://www.versusarthritis.org/about-arthritis/conditions/osteoarthritis-oa-of-the-hip/

https://www.versusarthritis.org/about-arthritis/treatments/surgery/hip-replacement-surgery/

https://www.versusarthritis.org/about-arthritis/exercising-with-arthritis/exercises-for-healthy-joints/exercises-for-the-hips/

I hope these are of some help to you.

Please do continue to get involved on the community. There is always some one around and we are always looking to make new friends.

Good luck with your operation and please do let us know how you are getting on.

Take care

Anne (Moderator)

RogerBill

Thanks Anne for your quick response. I'm doing those sort of exercises except for the External hip rotation which I find really painful. The other exercises I'm able to do easily and more intensively so I guess as far as exercise I'm doing OK.

Is there anything else you think I could do before the operation to help improve the probability of a good outcome?

Lilymary

Hi @RogerBill , I had THR in April, and yes, if you can do the exercises before you go in it will help. Eg, a friend who is a ski instructor and mountain guide had hers done about a year ago (between lockdowns) and made a really fast recovery. (We’re both early 60s). For me, the degeneration in my hip was so bad that I couldn’t exercise due to the intense pain when I did, although my job can be quite physical and kept me active, but walking, swimming, yoga, Pilates etc were far too painful and I had to give them up for over a year before surgery. I suspect this has contributed to my slow recovery (among a few other factors). My lateral hip abductor muscles felt like they’d switched off and I’ve had to teach them what to do again, almost re-learning to walk and stand. I had a few other pain inducing issues that slowed my recovery, but I do feel the fitter you are before you go in, the more likely you are to have a reasonably good recovery.

in addition to your hip abduction exercises, try cycling and swimming, and exercises that help your core strength (eg Pilates - I’m grateful that I retained some of that strength, as it has come in handy post op!). If it’s hurting, you’re probably doing too much, and it will result in inflammation and more pain, so ease off or find a different less painful routine.

RogerBill

Thanks Lily Mary, the above and your other posts I've seen are really helpful and I find it reassuring to hear of someone's recent experiences warts and all.

Another question if I may. For the first 6 weeks I understand you shouldn't bend more than 90°, twist or cross your legs. But is it OK to bend the other leg more than 90°, is it OK to twist and bend the back and is it OK to cross your good ankle under the operated leg to lift it into bed or the car? Hope that makes some kind of sense, it's far more difficult to describe in words than it would be to demonstrate😊

Lilymary

@RogerBill , I get what you’re saying, you can do pretty much what you like with the other leg, mine deserves a medal for all the extra work it’s had to do while the operated one’s out of commission. This included using it to lift my duff leg in and out of bed by hooking the good ankle under its partner and swinging them both around together, and flamingo impersonations for a whole range of tasks and exercises.

the six week rule is a general average, my own recovery is rather slow so I've had to be careful for somewhat longer, but the risk of dislocation doesn’t suddenly vanish after that date. I know of two who had multiple dislocations (4 each, one in front of me in pilates class). While these are allegedly rare, 3 months on I’m still being careful. I queried my surgeon on whether not crossing legs etc is a permanent thing. His comment was “most of my patients don’t take up jogging, but otherwise you can eventually do what you like”. That seemed a bit rash to me, but your new hip will, without doubt, tell you when you’ve pushed your luck too far.

do avoid twisting from the hip or turning suddenly, that’s a good way to induce a dislocation. Certainly did for one of my friends. She said all she did was turn round, but that was less dramatic than the time it went in the bath (getting in and out will be tricky for a while), which resulted in her lying stark naked in tepid water while four men tried to work out how to get her out! Luckily she has a well developed sense of the absurd and no shame,

RogerBill

@Lilymary That's good. Others have talked of using a leg strap or knotted dressing gown belt but that seems more trouble than simply hooking the good ankle underneath to lift the duff leg and which surely would hold the two legs together better.

A friend of a friend also had her hip dislocate when she was home alone so was lying on the floor out of reach of the phone for four hours in considerable pain until her husband got home. Certainly something I want avoid. The nearest thing I've suffered is putting my back out every year or so, usually caused by an innocuous twist. Also I'm apt to overdo exercises and things like DIY so I must learn to be more careful.

I'm not intending doing any jogging especially as my knees don't seem to be in great condition as they now crack and pop a lot. But I am encouraged by our postman who had his hip done a year or so ago and he now sprints around and is a keen golfer all seemingly without any problems. I've chosen to have the same surgeon in the hope that he'll do an equally good job for me.