Total Hip Replacement

The following information has been written in line with the Physiotherapy and Surgical teams at the James Paget University Hospital. If you have had your operation at another hospital, you should refer to the information and advice you were given as it may differ from the information below.

What is a total hip replacement?

A total hip replacement is a major operation that involves replacing both the ball and socket parts of your hip joint with an artificial joint.

For differing reasons, some people may only have the ball part of their joint replaced (this is called a hemiarthroplasty). The information contained in this page is relevant to both types of surgery.

Why have I had a total hip replacement?

Every case is different, however, in a lot of cases people will choose to have their hip joint replaced because of osteoarthritis (for more information on osteoarthritis click here) that hasn’t improved with physiotherapy and/or has become increasingly difficult to live with. Some people have to have their hips replaced following a fracture (same as a break).

What should I expect after having a total hip replacement?

This is a really important question and it is useful for you to know what is normal after having your hip replaced. We’ve broken the answer down into things that are found most common:

Swelling after a total hip replacement is not normally something that causes too much of a problem. The swelling, which is normally around the scar but can travel down your leg, is part of the healing response and is supposed to be there. Interestingly, the swelling will often hang around for some time, maybe weeks into months. However, just because the swelling is still there, doesn’t mean there’s a problem, it is quite normal and to be expected.

A total hip replacement is a big operation and it is normal for it to be painful afterwards. The pain from your operation is linked to the scale of the surgery and is likely to be with you for some time, possibly into weeks or months, but this doesn’t mean anything is going wrong as it is normal and to be expected.

It is very normal to find that your hip doesn’t move fully after your operation. Often, because it will be sore (see previous), your hip may be difficult to move. This will be most obvious just after your operation but should improve with time.

Most people who have had a total hip replacement will have been told by the hospital that they are allowed to take as much weight as they can through their new hip. Alternatively, some people may have been told to limit how much weight they take through their new hip (see later for further details). It is very normal to find walking a bit of a challenge after having a hip replaced, and you may find that you need to use elbow crutches or a walking stick to help you in the early stages of your recovery.

What can I do to help my hip recover?

Reassuringly, there are lots of things that you can do to help get your hip going and start your rehabilitation.

Firstly, it is important to know what is normal. Therefore, if you haven’t already, please read the ‘What should I expect after having a total hip replacement?’ section.

If you have had your hip surgery at the James Paget University Hospital, unless specifically stated by the hospital, you will have NO RESTRICTIONS in what you can do with your new hip. If you have had your surgery elsewhere, it may be that the surgeon has told you that there are certain things you should avoid with your new hip. These may include:

Avoid bending your new hip beyond 90 degrees i.e. too far up towards your chest
Avoid crossing your legs
Avoid twisting on your new hip when standing
Use the shower instead of the bath
Do not put too much weight on your new hip

If you have been given any of the above restrictions, you should stick with these for the timeframe you were told, or unless otherwise stated by your physio or surgical team.

It is very normal to find that your hip doesn’t move fully after your operation. Often, because it will be sore (see previous) your hip may be difficult to move. This will be most obvious just after your operation but should improve with time.

I’ve been given a walking aid to help me walk, but I’m not sure how to use it!

No problem. Please click on the picture of the walking stick and you will be taken through to our Walking Aids page. Don’t forget to come back here for more useful information about your knee recovery.

A brown wooden walking stick with curved handle in an upright position.

Is there anything I should look out for?

After any operation, it is important for you to be aware of what is normal (see above) and perhaps, what is not. Below is a list of things that should be raised to your doctor, surgeon or practice nurse if you experience them after your surgery. If you have previously had a Deep Vein Thrombosis (DVT), you should familiarise yourself with the list and monitor yourself for any issues.

Generally feeling unwell and/or a temperature following surgery

Red, painful, swollen calf or calves

Entire leg considerably swollen

Painful groin or back of your thigh

Inability to move your foot with or without numbness below the knee

Sudden change in breathing i.e. finding yourself breathless; coughing up blood or a new pain in your chest – this could indicate a medical emergency and you should call 999 or go to A&E)

If your wound edge becomes red, oozy and/or painful please contact the ward that you were admitted to for your surgery. Please do not contact your GP. You will be asked to come into the hospital for a review by your Consultant or their team.

What does a good result look like after a total hip replacement?

As you would expect, everyone is very different, but after a total hip replacement it is hoped that the pain you felt before your operation would have improved and your ability to use the new hip would also have progressed i.e. being able to walk easier or get out of the chair with less effort.

There is often a large variation in how much movement comes back after a new hip, but if it is less painful and you can do more with it, it still means you’ve got yourself a good result.

How can get the best out of my new hip?

Use it and enjoy it! Recovery after a total hip replacement can sometimes be a bumpy journey and will take time. Often, you may not really get a good idea of just how good the result is until you are 12 months after the operation.

If you want to make sure you get the very best out of your new hip, getting or keeping yourself fit and strong will make sure that you, your body and your new hip are in the best shape to enjoy it. You will find a selection of strengthening exercises below that you may be interested in to really try to get your hip strong enough to do most of what you want it to do.

FAQ

Below are some of the common questions that are asked when talking about total hip replacements that haven’t been covered in the information above.

Q: Is there anything I shouldn’t do with my new hip?

A: As mentioned above, if you have been given a set of restrictions with what you should avoid after your hip surgery, you should stick with these until told otherwise. If you have not been given any specific instructions, it should mean that you are able to do what you like with your new hip, including lying on it, having a bath or going for a long walk. Sometimes running or jumping with your new hip is not advised. Do listen to your body when doing things after your hip replacement and gradually ease yourself back into normal life.

Q: My friend had a hip replacement and they were playing golf after a week. Why’s mine taking so long?

A: We are all different. It is often not useful to compare yourself to others, even if you’ve had the same operation. How difficult your hip was before the operation, your strength and how well your pain is controlled are just a few things that will vary from person to person. Recovery from a major operation takes time and it is best to think of this in terms of months rather than weeks.

Q: I’ve had my other hip replaced and it was much easier than this one, why’s that?

A: We are all different and so are your hips. Even though having a hip replaced is technically the same operation, given that it is done on a different hip means that it’s not exactly the same. Therefore it is unlikely the result will be exactly the same. Things like your age, strength, fitness and general health all change over time and will play a role in influencing how you get on after your operation, including if it’s your second one.

Q: When can I drive?

A: Driving is not normally advised before six weeks. However, it is each individual’s responsibility to ensure they are fit to drive. Generally it is recommended you can return to driving six weeks after a left total hip replacement or eight weeks after a right total hip replacement (due to the power required to brake). You should ensure you can confidently and without any hesitation, perform an emergency stop before even considering driving on public roads.

It is always recommended to contact your insurance company one month before you return to driving, to ensure your insurance is valid. Even if you drive an automatic car, we still recommend this timeframe before returning to driving.

Q: When am I going to be able to walk ‘normally’?

A: Firstly, there is no such thing as a normal walking pattern, only what is normal for you. It often takes some time to get the right amount of movement and confidence to walk as normally as you hope to. Make sure you don’t rush things and continue to use a stick (if you have been issued with one) or crutches to make sure your walking quality is good before discarding them. Quality beats quantity!

Q: My new hip clicks a bit. Is that normal?

A: Yes it is. Your new hip would have been put in place extremely firmly and it is incredibly rare for it to loosen. Occasional clicks and cracks are quite normal for joints, including newly replaced ones.