The first week following hip replacement surgery marks a significant period in the recovery journey. This initial phase involves managing discomfort, beginning early movements, and understanding necessary care for the new joint. Familiarity with common expectations can help individuals navigate this time.
The First 24-48 Hours
Immediately after hip replacement surgery, individuals awaken in a recovery room, experiencing grogginess and discomfort from anesthesia. Medical staff closely monitor vital signs, circulation, and the surgical site. Patients may have intravenous lines for fluids or medication, and a drainage tube near the incision to collect excess fluid. The medical team assists with initial movements, such as wiggling toes and ankles to promote blood flow and prevent complications like blood clots. Within the first day or two, with assistance from nurses and physical therapists, individuals are helped to sit up and may take a few short steps with the aid of a walker or crutches.
Pain Management and Assistive Devices
Managing post-surgical pain is a primary focus during the first week. Healthcare providers prescribe a combination of pain medications, which may include oral medications, nerve blocks, or intravenous options. It is important to take these medications as directed to maintain comfort and facilitate participation in therapy. Non-pharmacological pain relief methods, such as applying ice packs to the surgical area, reduce swelling and discomfort.
Assistive devices are introduced early to support mobility and safety. Walkers or crutches help bear weight and maintain balance while walking. A raised toilet seat and grab bars in the bathroom aid in daily activities and prevent excessive hip flexion. Other tools like reachers and sock aids can help with dressing and picking up objects without bending too much.
Beginning Movement and Therapy
Early mobilization is a fundamental aspect of recovery, beginning shortly after surgery. Physical therapists guide individuals through a series of gentle exercises designed to restore mobility and strengthen the muscles around the new hip joint. These initial exercises include ankle pumps, heel slides, gluteal sets, and quadriceps sets, which can be performed while lying in bed. As strength improves, therapy progresses to sitting, standing, and walking short distances with an assistive device.
Physical therapists also educate patients on “hip precautions,” which are specific movements to avoid to prevent dislocation of the new joint. These precautions include avoiding bending the hip beyond 90 degrees, crossing the legs, or twisting the operated leg, depending on the surgical approach. Activity is gradually increased while adhering to these precautions.
Incision Care and Overall Health
Proper care of the surgical incision is important to prevent infection and promote healing. The incision site will be covered with a dressing, which needs to be kept clean and dry. Healthcare providers provide specific instructions on when and how to change the dressing, and what to look for regarding healing progress. Showering is permitted within a few days, but bathing or submerging the incision in water is avoided until it is fully healed, which can take several weeks.
General well-being also contributes to recovery. Maintaining adequate hydration by drinking plenty of fluids helps. A balanced diet, rich in fiber, can help manage constipation, a common side effect associated with pain medications and reduced activity. Resting when fatigued and gradually increasing activity levels are also important.
Recognizing Concerns
While some discomfort and swelling are expected, individuals should be aware of certain signs and symptoms that could indicate a complication and warrant immediate medical attention. Signs of infection include increasing redness, warmth, significant swelling, fever, chills, or pus draining from the incision site. Symptoms of a blood clot, such as new or worsening calf pain, tenderness, redness, or swelling in the leg, also require prompt evaluation. Sudden, severe pain, an inability to bear weight, or any unexpected changes in the hip’s stability should also be reported to the healthcare provider without delay.