Ten years ago, I had a total hip replacement. Everything turned out fine but I still remember the agony of sleeping with that wedge between my legs and having to avoid certain motions to keep the hip from dislocating. Now that my other hip is giving out, I'm considering going with the new hip resurfacing procedure instead of a total hip. What kinds of activity restrictions are there for the joint resurfacing after the surgery?
After surgery, your hip will be covered with a padded dressing. Special boots or stockings are placed on your feet to help prevent blood clots from forming. A triangle-shaped cushion may be positioned between your legs to keep your legs from crossing or rolling in.
Physical therapy treatments are scheduled one to three times each day as long as you are in the hospital. Your first session is scheduled soon after you wake up from surgery. Your therapist will begin by helping you move from your hospital bed to a chair. By the end of the first day, you'll be up and walking using crutches. By the end of the second day, you'll cover longer distances with greater ease. Most patients are safe to put comfortable weight down when standing or walking. However, if your surgeon used an uncemented prosthesis, you may be instructed to limit the weight you bear on your foot when you are up and walking.
Your therapist will review exercises to begin toning and strengthening the thigh and hip muscles. Ankle and knee movements are used to help pump swelling out of the leg and to prevent the formation of blood clots.
This procedure requires the surgeon to open up the hip joint during surgery. This puts the hip at some risk for dislocation after surgery. To prevent dislocation, patients follow strict guidelines about which hip positions to avoid (called hip precautions). Your therapist will review these precautions with you during the preoperative visit and will drill you often to make sure you practice them at all times for at least six weeks.
Some surgeons give the OK to discontinue the precautions after six to 12 weeks because they feel the soft tissues have gained enough strength by this time to keep the joint from dislocating. On the basis of some preliminary data that suggests these precautions are not needed, some surgeons give their patients permission to be as active as they feel is tolerable. No restrictions are given even from day one.
You'll want to discuss this with your surgeon and find out what his or her protocol is for the procedure, especially given your age, general health status, and overall health and function.
Vincent A. Fowble, MD, et al. A Comparison of Total Hip Resurfacing and Total Hip Arthroplasty. In Bulletin of the NYU Hospital for Joint Diseases. June 2009. Vol. 67. No. 2. Pp. 108-112.
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