The thought of going under the knife is frightening to most people which usually leads to patient’s avoiding surgery and dealing with their circumstances. This is very common in people who are suffering with excruciating hip pain. According to the Agency for Healthcare Research and Quality, more than 300,000 hip replacements are done each year in the United States and only a small 1% of them fail and require a revision. Usually the patient’s who require a revision are ones who are noncompliant with their hip precautions, lack the knowledge of what tools to use during healing, or may have gotten an infection. Following your precautions and having access to adaptive equipment are simple ways to avoid further injury and promote healthy healing.

What Can Lead to a Hip Replacement?

A hip replacement may be needed after having a traumatic injury (i.e. car accident or a bad fall) however, the main culprit is usually arthritis.

Arthritis itself means inflammation in a joint and there are several different kinds of arthritis. The different types of arthritis that may lead to the need for joint replacement include:

Osteoporosis- is an ailment in which bones become very weak and break easily.
Rheumatoid Arthritis- is a chronic inflammatory disorder which effects many joints including ones in hands and feet.
Osteoarthritis- occurs when the stretchy tissues around the bones are worn down.

How Would You Know if You Need a Hip Replacement?

Usually your orthopedic doctor and/or surgeon would be the one to decipher whether or not a hip replacement is necessary or if another intervention would be more appropriate. Some signs that may indicate that it is time for a hip replacement include:

Hip pain while at rest, during, or after exercise
Stiffness in your hip
Pain medication aren’t providing you the relief you want
Hip pain prevents you from doing your everyday tasks
Hip pain keeps you from engaging in your leisure activities
You’re not as mobile as usual
You have been diagnosed with arthritis in your hip
X-Rays show damage to joint

What are the Hip Precautions?

Depending on what type of hip replacement your surgeon performs, posterior or anterior (other approaches may be used), you may a different set of rules to abide by.

Anterior Hip Precautions May Include:

Do not step backwards with surgical leg. No hip extension.
Do not allow surgical leg to externally rotate (turn outwards).
Do not cross your legs. Use a pillow between legs when rolling.
Sleep on your surgical side when side lying.

Posterior Hip Precautions May Include:

Don’t bend your hip past a 90 degree angle.
Don’t cross your legs.
Don’t twist your hip inwards- keep knees and toes pointed upwards.

Adaptive Equipment

Once you meet with your Occupational Therapy practitioner, she/he will introduce something called a “hip kit”. A hip kit includes are a set of tools that will help you achieve your maximal level of independence while adhering to your hip precautions. These tools will help make your life a whole lot easier and help you avoid another trip to the doctor. In fact, the study done by Bozorgi et al (2016) concluded that patients who received rehabilitation services post hip replacement showed improvement. However, patients who were in the experimental group (which had additional supervision) and were trained in use of adaptive devices, demonstrated physical function, strength, reduced disability, and pain intensity significantly more than the group who weren’t trained on adaptive devices.

Hip Kits May Include:

A dressing stick
A sock aid
A reacher
A shoe horn
A long handled sponge
A bathroom bottom buddy

References:

Spalević, M., Milenković, S., Kocić, M., Stanković, I., Dimitrijević, L., Vesna Živković, V., Čolović, H., Spalević, M. (2018). Total Hip Replacement Rehabilitation: Results and Dilemmas. Acta Medica Medianae, 57(1), 48-53. doi:10.5633/amm.2018.0108

Lee, G. R. H., Berstock, J.R., Whitehouse, M. R., & Blom, A. W. (2017). Recall and Patient Perceptions of Hip Precautions 6 Weeks After Total Hip Arthroplasty. Acta Orthopaedica, 88(5), 496–499

Bozorgi, A. A., Ghamkhar, L., Kahlaee, A. H., & Sabouri, H. (2016). The Effectiveness of Occupational Therapy Supervised Usage of Adaptive Devices on Functional Outcomes and Independence after Total Hip Replacement in Iranian Elderly: A Randomized Controlled Trial. Occupational Therapy International, 23(1), 143–153.