Hey Doc, What can I Expect After a Total Hip Arthroplasty
Replacing a hip is a big undertaking. In essence, the operation amputates part of a limb and replaces it with an implant made of foreign substances. Before agreeing to this elective procedure, you’d better have a clear understanding of what to expect after you have your hip replaced.
Expectations after joint replacement surgery usually fall into three main categories: less pain, more function, and implant longevity. Of course, you want less pain after you have that severely arthritic joint replaced. Pain relief is a top priority closely followed by improved function. You want to be able to do more of what you need to do and want to do like walking, playing with grandchildren, and other activities that define your life. Furthermore, you want the new implant to last. Because humans are living longer than ever, you never want to have problems with your new joint again. All of these expectations are very reasonable goals to have in the first year after surgery.
In the first three months, you can expect less pain. Most people experience a 60% reduction in pain in the first three months. Because the hip joint feels better, most people are also able to walk further in the first three months. In fact, the more restricted walking tolerance you have before surgery, the more likely you will experience a big gain in your ability to walk.
But, improvements do not stop at three months after a total hip arthroplasty. You can also expect improvements for at least the first year. At one year after surgery, less people need to use a cane or a walker probably because they’re feeling steadier and are less apt to fall. You can also expect to walk even further distances as time goes on and you get stronger. Overall, you’ll likely be a feeling like a new person one year after a total hip arthroplasty.1,2
All of these expectations sound wonderful. Unfortunately, the harsh reality is that not everyone will obtain these goals. Progress after surgery can be limited for a variety of reasons by things like a person’s overall health or surgical complications. Some common complications after hip replacement surgery include nerve damage, hip dislocations, and infections. Nerve damage in particular is often overlooked as a possible cause of lingering pain and disability. The two specific nerves prone to damage during this surgery are the lateral femoral cutaneous nerve and the superior gluteal nerve. Damage to either one of these nerves can cause a delay in recovery. No one expects to have complications; but if you do have one, then expect for your progress after surgery to be limited.3, 4
Going into hip replacement surgery with clear expectations is very important. Everyone is very optimistic that the pain will be relieved completely, that you’ll be able to walk like you used to be able to, and that the implant will last the rest of your life. Most of the time, the best possible outcome does happen. But sometimes it does not. If you are not experiencing good progress after surgery on your hip, then work towards improving your health and discuss the possibility that you may be experiencing a complication with your doctor.
- Arch Phys Med Rehabil. 2013 Jul;94(7):1352-9
- J Biomech. 2011 Feb 3;44(3):372-8
- Clin Orthop Relat Res. 2010 Sep;468(9):2397-404
- Clin Orthop Relat Res. 2007 Feb;455:209-11
Christina Lasich, M.D., wrote about chronic pain and osteoarthritis for HealthCentral. She is physiatrist in Grass Valley, California. She specializes in pain management and spine rehabilitation.