People can maximize rest time and reduce the chance of falls by planning ahead. For example:. Read more about how to prepare the home for recovery from hip replacement surgery. A physical therapist can help a patient achieve certain rehabilitation goals. If a patient wants to swim freestyle, the physical therapist will teach exercises to prepare the hip for flutter kicking. Regardless of individual goals, physical therapy is essential to hip replacement rehabilitation.
Patients who attend their physical therapy appointments and do their prescribed exercises tend to recover more quickly and have better outcomes than those who do not.
Hip replacement patients are given a long list of things not to do—do not bend the hips or knees further than 90 degrees, do not cross the legs, do not lift the leg to put on socks, and much more. These movement restrictions protect the new hip from dislocation. After hip replacement surgery many patients are tempted to do too much at once, risking injury or dislocation. Alternatively, other people delay getting back into a regular routine longer than necessary.
Each patient must work with a doctor and physical therapist to find the right balance between activity and rest. That balance will change over time—for as long as a year—as hip function improves and stabilizes. Patients heal from surgery at different speeds. Then, you can use a cane outdoors and walk without any support when you are indoors.
You should not bend your hip beyond 60 to 90 degrees for the first six to 12 weeks after surgery. Do not cross your legs or ankles, either. As your muscles and ligaments get stronger, you can climb up and descend stairs normally after a month. If your surgery was on the right hip, stay away from driving for four weeks. Then, you may resume driving when you feel comfortable. Extreme impact activities allowed after 1 year.
No restrictions. Avoid extensive running. Implants based on metal-on-plastic bearings cannot tolerate long-term impact activities. They are smaller than the natural hip bearing and therefore not as stable as anatomic sized metal-on metal bearings.
Although modern plastics are now very wear resistant, especially in combination with ceramic heads, breakage of these modern thinner more brittle plastics is a concern in patients who are too active.
Therefore heavy labor and repetitive high impact activities should be avoided. Metal- on metal bearings only wear excessively when implanted incorrectly, but can tolerate high impact activities otherwise. Titanium stems of total hip replacements are more durable than plastic liners but may be subject to fatigue failure after long-term extreme impact activities.
Metal-on-metal bearings are biomechanically similar to the native hip bearing. They are extremely stable and therefore no motion restrictions are required after the initial 6 months.
Smaller plastic bearings are inherently biomechanically compromised. Therefore, some permanent restriction on extreme flexion activities is required. Total hip stems are more rigid than the surrounding bone.
It may become limiting when patients attempt impact activities. This does not occur with resurfacing. Cement is a weak link that breaks down over time. I only use uncemented fixation in the hip. There is no difference visible in the gait of patients with resurfacing or total hip replacement.
Two comparative Barrack, Noble survey studies have shown that a higher percentage of resurfacing patients are able to return to desired sporting activity than total hip patients. It appears that there is no functional difference between resurfacing and total hip for the vast majority of patients who have an arthritic hip. Large metal-on-metal bearings in total hips and resurfacing provide superior stability with a small risk of adverse wear failure if the acetabular component is malpositioned.
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