Post operation advice

harry

I am due to have hip replacement surgery in mid November and am wondering what preparations I should make at home for the recovery period.

I know everyone is very different but some general tips would be very helpful. I am 63 and have been very active before being slowed down by the arthritis. I hope to get back to regular mountain walking and hopefully some road bike riding. I have read about getting a walking stick with a hooped handle, a raised toilet seat (?) and shoe horn.

What about stairs and general mobility of dressing etc?

I guess the hospital will provide some guidance but any shared experience or tips would be gratefully received.

Thanks

Harry

Anna

Hi @harry,

I’m sure other members may have exercise suggestions and as you say, the hospital physio will no doubt advise you, but while you’re waiting, you might like to look at the Versus Arthritis webpage on hip replacement surgery. If you scroll down the page you’ll see some suggested post op exercises:

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

Good luck, and do let us know how you get on,

Anna ( Mod)

Lilymary

Hi Harry, your assigned hospital should get in touch with you shortly before surgery to arrange for the aids you’re going to need. In my case, previously a fell walker like you, this included a raised toilet seat (essential), crutches (obviously), perching stool (really helpful in the bathroom), grabber, sock slider, long handled shoe horn, and trolley on wheels to help you move cups of tea etc round the house while on both crutches. Getting dressed with these implements is achievable (the hook on the end of the shoe horn, or using the grabber, will help you put on pants and trousers).

Get a lot of soft pillows in to sit and lie on, (specially in the car on the way home!) and a shoulder bag you can carry stuff round the house in. Also useful to have a plastic carrier bag on the car seat to help you swivel your legs in and out. It might be worth investing in some slip on shoes, as reaching down for zips and shoe laces is pretty much impossible for a while.

Once I was finally off crutches, I found a normal walking pole has been adequate (with wrist loop - but mostly to avoid aggravating old nerve damage in my wrist, which made crutches uncomfortable even if they were necessary). I still use it on uneven ground or longer walks, as I don’t trust my balance atm - I can’t move my operated leg fast enough to correct me, and the range of movement is still smaller. The physio will show you how to use the crutches correctly and make sure you can do stairs before you're discharged. I found having a spare third crutch at the top of the stairs (leaving one at the bottom, and vice versa) helped as it meant I didn’t need to carry one up and down the stairs when I needed both crutches indoors. Luckily a fellow “new hippie” passed her pair on to me so the hospital didn’t mind giving me a spare one.

Don’t be too hasty in getting back out in the hills, stick to lower, more level routes for a good while. A friend went back out there too fast, and ended up with multiple dislocations as she kept falling over. I have been keen to avoid that! I recently spent a week walking along those glorious endless wet sand beaches in Northumberland, and it did my hip no end of good. (I had surgery in April but my recovery has been uncommonly slow.) I still find hills much more challenging to my muscles and it aggravates surgical irritation to the psoas muscle in my groin, which is the one we use for knee lifts, so haven’t really been able to do hills yet.

While this surgery is now routine, don’t lose sight of the fact that it is major surgery and rather brutal on our bodies. Give your soft tissues and the bones time to heal before pushing them. You will need to be kind to yourself and to your body for a while. It’s not a race to ditch crutches, the emphasis must be on healing, and everyone heals at their own pace.

Coddfish

Hi @harry

I had a total hip replacement, right hip on 7th September. I had my operation privately and they very much leave you to decide what adaptations you might need. None of the home assessments others describe. When I went in for my pre-op assessment (around 2 weeks before surgery) they made a few suggestions of which the only one they really pushed was a raised toilet seat.

You might have a very short stay in hospital (mine was only 2 nights) but they mobilise you quickly, get you moving on elbow crutches, and have you go up and down a couple of steps before you leave. I have to say it was scary going upstairs the first night at home but it was a case of trusting the process.

I am a similar age and had also been very active until a few months before the operation. Swimming, running, weights, gym classes etc. I had at least been able to hang onto swimming right up to surgery. Reading other people’s stories, I suspect my recovery is at the faster end of the spectrum. I needed 2 crutches for the first 3-4 weeks, and am currently using one for longer walks, none the rest of the time. It has been easy to get back to walking reasonable distances on the flat, but I still struggle with slopes and very rough ground. I have just restarted swimming today (the wound has to be well healed and scab free). I have done some gentle static cycling and am doing the parts of my normal gym routine that don’t involve taking weight through the hips. The physio wasn’t terribly helpful as it was far too basic, but I have been using my personal trainer to build a programme to help my specific needs. At about 4 weeks I worked out how to get up and down off the floor without breaching any of the movement guidelines. All of this is helping both physically and mentally.

When looking at this and at what others say, it’s worth remembering everyone is different and recovery depends on your general health, how much fitness you retained, the actual surgical technique involved, plus probably a whole host of other things. For me it’s now just about rebuilding stamina and fitness, plus the question of when it’s ok to start running again

Here is the set of equipment I arranged and what use I made of it.

• I got myself a comfortable reclining chair. This has been great and will continue to be a favourite after recovery
• I got a booster cushion for putting on dining chairs etc. In practice an ordinary cushion would have sufficed
• I got a raised toilet seat with handles. Essential. Initially my husband moved it upstairs and downstairs each day for me. It now sits in the downstairs loo and I just have a padded seat on the loo in our en-suite.
• Dressing aids. The hospital wanted me to use knee high compression stockings for the first few weeks (you will either be on these, or blood thinners, probably not both, depending on your surgeon’s preference). These need a partner to help, and ideally a tool. We got a ‘Rolly’ which is a continuous tube of ribbed silicone and it worked like a dream. I have also found a sock aid useful for giving me independence with ordinary socks. Also a long handled shoe horn with hooks on the other end. I didn’t find grabbers particularly helpful, not strong enough. I also got a long handled device to attach a razor to so I could shave my legs, I am guessing this is only a woman thing!
• I got a perching stool but haven’t found it necessary as I was quickly able to stand and cook, and didn’t find I needed anything like that in the shower. It’s been useful to use whilst volunteering at parkrun and to take as somewhere to perch when seeing my personal trainer though!
• I got a turning circle to help get in and out of the car.
• I made use of long loop elastic resistance bands to help my operated leg in and out of bed in the early days.
• I got a triangular shaped cushion to put between my knees to stop me rolling from my back to my side at night.
• I have been awfully grateful for our large walk in shower and that we have an SUV style car with high seats.

RogerBill

Hi @harry I agree with all the above advice. The only item I can think to add to the list is that I find a ruck sack is useful for carrying stuff from room to room especially when on two crutches. I posted a longer selection of tips in the "hello" section of this forum and I found other posts on here to be very useful.

There are videos on the internet which demonstrate how to get into a car and climb stairs after a hip replacement. For example do a Google search for Nuffield and stairs. If you practice a little before the op it will reduce the fear factor. Also my stairs climbing technique impressed the hospital physio on the second day after my op when I was still a little groggy from the general anaesthetic and all the pain killers. Others have a regional anaesthetic for the op and they might have a different experience.

harry

Many thanks all. I will start to collect the suggested items.

Coddfish

@harry Also think about trip hazards in the house (loose mats, rugs etc), unnecessary obstacles in walking routes (things you can move out of the way) and where things are stored (you won’t initially be able to get things easily out of low drawers, shelves etc). I didn’t think of any of this until I got home and saw the house through the lens of someone on crutches with limited range of movement….

And for the surgery itself, I would strongly recommend a spinal block plus sedative rather than a general anaesthetic. Lower risk, easier to recover from. You can have as much or as little sedative as you want. My choice was to remain conscious whilst having the edge taken off what was going on, but I think many prefer to have enough sedative to be asleep. Once the operation is complete, they stop the sedative and you are instantly alert. I was able to have a complex conversation with the surgeon about what he had found and what he had done before I left the operating theatre. It takes a few hours for feeling to fully return to your legs (in my case about 10 hours), but the benefit of that is an extended period of total pain relief. As I soon found out the hard way that I couldn’t tolerate opioids, I think that was probably a good thing!