Rate of recovery will vary dependent on the patient’s age, the degree of any pre-operative weakness, stiffness and deformity as well as the complexity of surgery.
It is important that patients try and maintain muscle strength and power as well as mobility and flexibility even while the hip is arthritic and before surgery. Following a primary hip replacement, the patient will typically use crutches for the first few weeks as much as for balance, confidence and support rather than to protect the reconstruction. The patient should be in a position to put weight through the hip and, in fact, putting a little bit of weight through the hip is a good thing, encouraging the blood supply and loading the bone and soft tissues once again. The amount of weight that can be ‘put through’ the reconstruction will vary according to the technique used.
There are rules with regard to driving after hip surgery from the DVLA. Patients are not allowed to drive for six weeks.
During the first few weeks, patients should work to build up their range of movement putting increasing amounts of weight through the hip. Patients may start to mobilise using one crutch for support after three or four weeks as they feel confident and comfortable.
Typically the first review appointment would be six weeks from surgery. By that time, the patients should be able to start to walk without support and really start to push on with their exercises. Patients would then be able to start driving and typically will have a physiotherapy review appointment at that stage to ensure that all is progressing well both in terms of muscle strength and range of movement.
The next period of rehabilitation, between six and twelve weeks, is all about building up muscle, improving the range of movement and gradually getting back towards normal function.
Typically, I would expect patients to be walking quite freely without sticks within eight to ten weeks. Any residual limp should settle as the hip abductor muscles strengthen and I would expect patients to really be back towards normal function three months after primary hip surgery.
Swimming can be a good way to build up muscle strength around the hip and indeed working on an exercise bike, without resistance, can be helpful. Both of these activities can be started at around four to six weeks post-surgery. I would expect patients to be back to the golf driving range by eight to ten weeks and approaching ‘normal’ activities by twelve weeks.
© Andrew R J Manktelow – September 2011