Total Hip replacement

Total Hip Replacement or THR is a surgical procedure whereby damaged and diseased cartilage and bone is of the hip joint is surgically removed and replaced with artificial material like stainless steel or titanium.

Symptoms that may tell you you need a THR:

  • Chronic pain in hip joint, often felt in the groin
  • Unable to walk
  • Unable to climb stairs
  • Unable to even sit or get up from sitting position
  • Problems with movement into ranges such as knee to chest
  • Possible onset of back pain as a consequence of changed walking patterns

What conditions get a THR?

  • Severe Arthritis
  • Osteoarthritis of hip joint
  • Death of hip bone (aseptic necrosis or avascular necrosis)
  • Unhealed fracture

Prior to surgery, a candidate would undergo rehab program under a physiotherapist to see if conservative management is enough to manage the pain. If this fails in reducing pain and improving activities of daily living then surgery is prescribed.

Complications of THR

THR are common and generally low risk, with great success rates with modern techniques. However there are always risks involved which can include:

  • Blood clots in legs that can travel around in the body
  • Pulmonary Embolism
  • Skin infection or joint infection
  • Difficulty in passing urine
  • Fracture of bone during and after the surgery
  • Limited range of movement
  • Risk of anesthesia: liver toxicity, irregular heart beat and pneumonia.

After a THR:

Once the patient is stable then rehabilitation can be started immediately in the hospital. Normally it starts on the same day or next day of the operation. Basic physiotherapy begin to avoid any complications, this includes breathing exercises,  proper coughing techniques, sitting out of bed, standing, and the first few steps with the new joint using a walking aid. Bed exercises start immeditely for the hip to strengthen the surrounding muscles and to maintain the strength in the rest of the body.

Precautions after THR

  • No heavy lifting
  • No driving until your approved by the surgeon
  • No crossing the legs while sitting
  • No bending down from the waist but instead bend down from knee
  • Use of ice for pain relief and control of swelling

Why Physiotherapy rehabilitation?

  • Prevents contractures or tightening of muscles
  • Improves patient education regarding movement and getting back to a normal life
  • Education about the movements to avoid (precautions) to prevent dislocation
  • Increased muscle strength
  • Maintaining full movement in the joint
  • Help patient with activity of daily living such as walking, sitting, climbing stairs etc

If you are going for this surgery, it is a fairly simple operation which is done is 2 or 4 hours time. If you do have any questions let your doctor or physiotherapist know.

Physiotherapy after this surgery is very important and should be taken seriously by the patient. The doctor and the therapist will usually educate the patient before the surgery to help ease the transition. Physio Savvy can offer you this rehabilitation once you are discharged from the hospital.

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Karishma Jhaveri

Karishma Jhaveri

Physiotherapist at Physio Savvy
Karishma completed her Bachelors in Physiotherapy from Manipal, India and has also completed Mulligan therapy certificaion. In Manipal Hospital, she worked for 3 years in clinical placement under several areas including diabetic clinic, pediatric wards, burns ICU and cardiac ICU. She then continued working in Mumbai under the President of Indian Association of physiotherapy Dr Ali Irani. Her work also includes health surveys in India for WHO in rural parts near Manipal, and she has taken a special interest in working with children.
Karishma Jhaveri

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Posted in Musculoskeletal Disorders.