It is undeniable that hip joint problems are common in the elderly. It can be observed that many elderly people often fall from beds, chairs, or slip and fall frequently due to physical changes associated with aging. When problems lead to fractures or deformities, the best treatment is “hip replacement surgery” to correct the deformed joint.
Due to age and physical capacity after surgery not being as full as in youth, the body recovers slowly after surgery. The method that helps the body recover fully is “physical therapy.”
What do patients face after hip replacement surgery?
Although hip replacement surgery aims to allow patients to return to normal or near-normal daily life, on the other hand, recovery may be slow after surgery because patients are elderly and some may have underlying diseases, leading to complications such as surgical wound infections, urinary tract infections, respiratory infections, pressure ulcers, or hip dislocation. These factors negatively affect recovery after hip surgery, impacting both the physical and mental health of the patient.
Postoperative care is crucial for physical rehabilitation
In addition, inappropriate behavior due to lack of knowledge in self-care after surgery and lack of proper physical therapy rehabilitation may cause problems in using the prosthetic joint after surgery, such as weakness of the muscles around the hip, which mostly occurs before surgery. Movement is limited due to fear of pain, resulting in ineffective treatment. Therefore, physical therapy rehabilitation after hip replacement surgery is important to help patients live as close to normal as possible and gain confidence in movement and activities.
How to perform physical therapy after hip replacement surgery
After hip replacement surgery, patients will be trained in lung exercises through breathing and muscle strengthening exercises in various parts to prepare them to walk the next day using walking aids. If patients can sit, stand, or walk quickly, it helps reduce the risk of complications. Physical therapists will teach patients, relatives, and caregivers about exercises to strengthen the hip joint and encourage proper movement for daily activities, prevent hip dislocation, and improve blood circulation to prevent blood clots by ankle pumping exercises every time after waking up, provided the patient does not experience severe pain.
Proper movement helps strengthen muscles
In the early stages, doctors and physical therapists work together to organize activities for patients. When patients can exercise without fatigue, they will be encouraged to start sitting up, walking short distances, and gradually increasing walking distance (around the second week after surgery). Patients must diligently perform daily activities to help hip muscles regain strength and improve mobility, such as:
- Walking training with a walker and full foot weight-bearing
Patients can stand upright comfortably and maintain balance using a walker to help stabilize and prevent falls, then gradually walk short distances as much as possible without rushing. As muscles become stronger and more durable, a cane may be used to assist walking and increase walking distance.
- Training to walk up and down stairs
If there are no complications, when patients can walk steadily on flat surfaces and the hip and thigh muscles are flexible and strong (around the third week after surgery), physical therapists will start stair climbing training.
- Going up stairs, initially with assistance
- Going down stairs one step at a time or using handrails for support
Exercise to regain muscle strength
Recovery after hip replacement surgery may take several months, and it is necessary to work on rebuilding muscle strength completely. Exercise is essential to strengthen the muscles around the hip joint and thigh after surgery. Doctors and physical therapists will adjust muscle strengthening exercises to ensure patients can walk and perform activities safely.
Prepare the home environment to support the patient
When patients return home for recovery, the bed should be arranged on the lower floor, and belongings should be organized because patients still need walking aids such as walkers or canes for 2–3 months, depending on the surgical method and muscle strength. The bed should be about 40 centimeters high from the floor. Grab bars should be installed in the bathroom, and the toilet should be a sitting type to prevent the hip joint from being lower than the knee joint.
Precautions and self-care
- Do not bend the hip joint more than 90 degrees, as this may cause the implanted hip joint to dislocate.
- Do not cross legs while lying down, sitting, or standing, especially the operated leg.
- Avoid sitting on low chairs or squatting. Choose chairs that are high enough to prevent the hip from bending more than 90 degrees. Use cushions to raise the chair height if necessary.
- Avoid sitting on chairs without armrests, as armrests help when standing up or changing positions.
- Avoid running or jumping, as this may cause dislocation or fracture.
- Avoid lifting heavy objects, pushing items, and sudden twisting movements.
- Avoid bending forward while putting weight down, such as climbing steep hills or stairs.
- Prevent falls by using canes or walking aids until the hip joint is strong enough and movement is stable.
