Total Hip Replacement FAQs
What is the recovery time?
Everyone heals from their surgery at a different pace. In most cases, however, you will be restricted to using a walker or crutches for 2 to 3 weeks after your operation. You will then be allowed to advance to a cane outdoors and no support around the house for several weeks. You will gradually return to normal function without any assistive devices.
What is a dislocation of the hip?
A dislocation of the hip occurs when the femoral head (ball) comes out of the acetabulum (socket). While this risk is small, typically less than 2 percent, you are given dislocation precautions to help avoid this from happening.
What are the dislocation precautions for my hip (positions I should avoid)?
For a posterior approach you should avoid flexing (bending) at the hip more than 90 degrees. Avoid low chairs and other low furniture, because they require too much bending at the hip in order to get up. If you must reach to the floor when seated, always reach between your legs, not to the outside. Use an elevated toilet seat to avoid excess bending of the hip. If possible, use a chair that has arms. The arms provide leverage to push you up to the standing position. When sitting, position your legs so that you can see your inner thigh, calf, and foot (not the outside). Anterior approach total hip requires little to no hip precautions.
How long do I need to follow my dislocation precautions?
Follow your precautions very carefully for the first 8 weeks. For posterior approach total hip, you should avoid extreme positions of hip flexion (bending) forever if you have had a posterior total hip replacement procedure. This requirement is not needed for anterior approach total hip.
When can I discontinue using a raised toilet seat?
Between 6 and 8 weeks after your operation.
Can I sleep on my side?
You may sleep on your operative side whenever you feel comfortable. You may sleep on your non-operative side at 3-4 weeks with a pillow between your knees.
When can I shower (get incision wet)?
Three days after your operation, if no drainage is present at the incision.
Will the hip replacement set off metal detectors?
Most will. Modern scanning technology recognizes the implants and no cards or proof of surgery is needed at airport security.
How long will I be on pain medications?
You will likely require some form of pain medication for about 4 to 8 weeks. Initially, you will be on a strong oral medication (such as a narcotic). Most people are able to wean off their strong medication after one month and are able to switch over to an anti-inflammatory medicationsthe-counter pain medication (such as Tylenol or ibuprofen). If you are on Coumadin (warfarin), avoid taking any NSAIDs (e.g. aspirin, ibuprofen, Advil, Motrin, Aleve, Naprosyn) without first consulting your internist. If you take aspirin for medical reasons prescribed by your internist, continue to do so while on Coumadin.
I think my leg lengths are different. What should I do?
It is not uncommon to feel as though your leg lengths are different. At surgery, leg lengths are assessed very carefully, and an attempt is made to make them as equal as possible. Sometimes, the new hip has to be lengthened in order to obtain proper muscle tension (to help avoid hip dislocation). Wait three months before making any final judgments about your leg lengths. Your muscles and body take time to adjust to a new hip. A shoe lift may be prescribed for a true difference in leg lengths. In most cases, however, no treatment is necessary.
Can I use weights?
Generally, but not for the first two months. However, as everyone's strength varies, consult with your physical therapist before using weights. Use light weights to begin with, and gradually progress.
I am constipated. What should I do?
It is very common to have constipation postoperatively. This may be due to a variety of factors, but is especially common when taking a narcotic pain medication. A simple anti-inflammatory medicationsthe-counter stool softener (such as Colace) is the best prevention for this problem. In rare instances, you may require a suppository or an enema.
When can I drive?
If you had surgery on your right hip, you should not drive for at least a month. After one month, you may return to driving as you feel comfortable. If you had surgery on your left hip, you may return to driving as you feel comfortable, as long as you have an automatic transmission. Be careful when getting in and out of a car, and avoid crossing your operated leg over the other one.
DO NOT DRIVE IF TAKING NARCOTICS!
When can I return to work?
This depends on your profession. Typically, if your work is primarily sedentary, you may return after approximately 3 to 4 weeks. If your work is rigorous, you may require 2 to 3 months before you can return to full duty. In some cases, more time may be necessary.
When can I travel?
You may travel as soon as you feel comfortable. It is recommended that you get up to stretch or walk at least once an hour when taking long trips. This is important to help prevent blood clots.
What activities are permitted following surgery?
You may return to most activities as tolerated, including walking, gardening, and golf. Some of the best activities to help with motion and strengthening are swimming and riding a stationary bicycle.
What activities should I avoid?
You should avoid impact activities such as running, downhill skiing on expert slopes, and vigorous racquet sports, such as single's tennis or squash. In addition, you should avoid any activity that may put your new hip at risk for dislocation.
Can I have sex?
You should wait several weeks postoperatively before resuming sexual intercourse. Follow your hip dislocation precautions. Having your legs apart is a safe position.
Can I drink alcohol?
If you are on Coumadin, avoid alcohol intake. Otherwise, use in moderation at your own discretion. You should also avoid alcohol, if you are taking narcotics or other medications.
Can I go up and down stairs?
Yes. Initially, you will lead with your non-operated leg when going up stairs, and lead with your operated leg when going down stairs. You can use the phrase, "Up with the good, down with the bad" to help you remember. As your leg gets stronger, you will able to perform stairs in a more regular pattern (about 1 month).
Can I kneel?
Yes, after 6 weeks. To kneel, touch down with your operated knee first. To arise from kneeling, use your non-operated knee first.
What should I expect for my range of motion (ROM) at 6 weeks? At 1 year?
Everyone's range of motion (ROM) varies and depends on individual factors. Your potential will be determined at the time of your surgery. In most cases, you will have enough motion to put on socks and tie your shoes. Clipping toenails may be difficult.
Do I need antibiotics before dental work or an invasive procedure?
Yes. You will be given a letter explaining this in detail at your first follow-up visit. Avoid any dental cleaning and non-urgent procedures for 6 weeks postoperatively.
I feel depressed. Is this normal?
It is not uncommon to have feelings of depression after your replacement. This may be due to a variety of factors, such as limited mobility, discomfort, increased dependency on others, and/or medication side effects. Feelings of depression will typically fade as you begin to return to your regular activities. If your feelings of depression persist, consult your internist.
I have insomnia. Is this normal? What can I do about it?
This is a common complaint following hip replacement surgery. Nonprescription remedies such as Benadryl or melatonin may be effective. If this continues to be a problem, medication may be prescribed for you.
How long will my total hip replacement last?
This varies from patient to patient. For each year following your hip replacement, you have a 1 percent chance of requiring additional surgery. For example, 10 years post-operatively, there is a 90 percent success rate.
When do I follow up with my surgeon?
Most patients are discharged from the hospital on the third or fourth postoperative day. Follow-up office visits are routinely advised for:
1. 1-2 weeks after surgery for staple removal.
2. 6 weeks after surgery for x-ray exam of your hip.
3. 1 year, 2 years, 5 years, 10 years and so on thereafter for x-ray and exam.
Please call our office appointment desk to schedule your appointments. 425-656-5060
I'm out of pain medication.
Refills for pain medicines may be obtained by contacting our office during business hours. It is the policy of our office that narcotic pain relievers will not be refilled or phoned in after hours or on the weekends. Prescription anti-inflammatory medications may be resumed 48 hours following the last Coumadin dose.
Normal things about your new hip:
Clicking noise with hip motion.
Skin numbness near or around your incision.
Swelling around the hip, knee, and/or lower leg.
Warmth around the hip.
"Pins and needles" feeling at or near your incision.
Dark or red incision line. This will gradually fade to lighter color.
Abnormal things about your new hip:
Call the office immediately, if you experience any of these.
Increased bruising on Coumadin.
Increasing redness, particularly spreading from the incision.
Increasing pain and swelling.
Fevers > 101 degrees F.
Persistent drainage from your wound.
Calf swelling or pain, particularly associated with ankle motion.
A sudden "giving way" of your hip with inability to bear weight.
Ankle swelling that does not decrease or resolve overnight.
Bleeding gums or blood in urine/stool.
Your new hip is the result of many years of research. But like any other device, its life span depends on how well you care for it. It is important that this care continues for the rest of your life.
Timothy B. Alton, M.D.
Hip & Knee Replacement
Trauma and Fracture Surgery
Fredrick S. Huang, M.D.
Hip & Knee Replacement