Following the surgical procedure of a total joint replacement, you will require therapy services both in the hospital setting and after discharge from the hospital. You will be most comfortable working with therapy if you are dressed comfortably. You should bring a pair of shoes with good support that can be loosened to accommodate mild swelling (such as sneakers), and a couple of sets of loose-fitting clothing such as sweat pants or shorts.
Occupational Therapist will work with you to teach you how to perform the functional activities that are a part of your daily life, such as transfers, dressing, bathing and kitchen skills.
Physical Therapist will work with you to obtain good motion, strengthen the muscles around your new joint, and teach you to walk on level surfaces and stairs.
Therapy Schedule While in the Hospital
Day of Surgery: Your orthopedic surgeon may order physical therapy to start on the day of surgery. On this day, we will start working on transfers out of bed and getting you up on your feet using a walker. We will walk with you to your tolerance on the orthopedic unit. You will be able to bear as much weight as you are comfortable with on your leg.
Post-op day 1 to 3: You will be seen by both Occupational Therapy and Physical Therapy. Physical Therapy is generally twice each day. Occupational Therapy is once daily.
- Walker - You will need to use a walker for one to two weeks. After that, you will progress to a straight cane.
- Straight Cane - You will need to use a straight cane until you get good strength and motion in your surgical joint, usually four to six weeks.
Some patients have difficulty performing skills at home. Though not everyone requires the use of special equipment, the following equipment may help you in your daily activities. (Many items are not reimbursed by insurance; please contact your individual carrier to check for coverage guidelines.)
- Raised toilet seat
- Shoe horn
- Long-handled sponge
- Reacher/ grabber
- Sock aide/ donner
- Tub bench
- Elastic shoelaces
Hip Replacement Precautions
Our orthopedic surgeons use the anterior approach for hip surgery. If your surgeon uses a different surgical approach, the therapist will teach you the appropriate precautions to follow. You should continue to follow your hip precautions until your surgeon tells you that they can be discontinued. The following hip precautions are for the anterior approach:
Anterior Approach Precautions
- Don’t stretch your hip back
- When walking, keep your operated hip in line with your body.
- When standing, do not perform any back-bend exercises.
- Don’t turn your foot out
- When lying down on your back, place a pillow next to the operated leg to keep it from rolling out.
- When standing, keep your toe pointed forward.
- When turning away from your operated hip, lift and turn your foot when you turn in.
You will need to exercise your new joint so that it will work at its optimal level. This takes commitment to the exercise program. While you are in the hospital setting, we will start with a set of core exercises.
Initially, the weight of your leg will give you the resistance you need to strengthen your leg. Over your recovery period, these exercises will progress to increase the number of repetitions that you perform, as well as to increase the amount of weight that you can lift.
You will need to be diligent at home and practice your exercises two to three times daily for up to three months. After this time, your strength will be sufficient to resume your pre-surgical activities.
Continuation of Therapy after Discharge
Following discharge, you will need to continue physical therapy services for four to six weeks. This can be accomplished in a home setting, an outpatient clinic or a rehabilitation center.
While you are in the hospital, you will work with your therapists and your physician to determine the best setting for you to continue those services.
- Before you go home you should be able to:
- Get in and out of bed by yourself
- Get on and off the toilet by yourself
- Walk down the hall with an assistive device
- Manage stairs at home
- Perform your exercises on your own
Home Safety Tips
- Remove all small rugs, such as scatter rugs.
- Use caution in areas where the floor may become wet, such as bathrooms and kitchens.
- Use small lights in any darkened area you may walk to during the night.
- Reinforce any loose support rails.
- Remove any areas of clutter in the spaces you will use so you can move easily around your home.
- Be alert to pets at home that may walk or run in your path.
- Use caution on icy or wet surfaces outside your home.
- Do not drive or operate a motor vehicle, regardless of which leg had surgery, until your orthopedic physician tells you that you can resume.