Hip replacement recovery, week by week

Hip precautions are movements to avoid while the tissues around the new joint heal. They depend on how the surgeon reached the joint. After the common posterior (back) approach, the usual precautions are: do not bend the hip past 90 degrees, do not cross your legs, and do not turn the operated leg inwards. After an anterior (front) approach, the limits are different and often fewer.

Many surgeons now relax precautions earlier than they used to, and some do not use them at all. Ask your surgeon exactly which movements to avoid and for how long. Everything below should be adjusted to those instructions.

Set the house up before the surgery. You will need a Western toilet with a raised seat or a commode chair, a firm chair with arms that is high enough that your knees are lower than your hips, and a bed of reasonable height. Clear loose rugs and wires from the path between bed, bathroom and kitchen.

Most Indian homes have low sofas, low beds and floor seating that are not safe in the first weeks. A plastic chair with arms, placed on a stable surface, is often the simplest fix.

Most people walk with a walker from the first or second day and can usually put full weight on the leg, unless the surgeon says otherwise. Short, frequent walks around the house are better than one long walk.

The goals are getting in and out of bed, a chair and the toilet safely, walking short distances, and keeping the circulation moving to lower the risk of clots. Take blood thinners and pain relief as prescribed.

Typical exercises: ankle pumps many times a day, buttock squeezes, thigh tightening, and heel slides within your precautions. Get in and out of bed on the side your physiotherapist recommends, keeping the knees apart.

Many people move from a walker to a single walking stick between weeks 2 and 6. Hold the stick in the hand opposite the operated hip. Stairs are done one step at a time: good leg up first, operated leg down first.

Strength work builds through bridges, sit to stand from a firm chair and standing exercises holding a kitchen counter. Side lying leg raises strengthen the muscles that stop a limp, but lying on your side may not be allowed early. Ask your surgeon when you can lie on the non-operated side with a pillow between your knees.

Keep walking every day and add a few minutes each week. Expect some swelling of the leg in the evenings.

Many surgeons review you around week 6 and may ease the precautions. Most people walk without a stick indoors around this time, and many outdoors by week 8 to 12. A persistent limp usually means weak hip muscles, and it responds to targeted exercise.

Driving is usually possible around week 6, once you can get in and out of the car safely and brake firmly, and are no longer taking strong pain relief. Desk work is often possible from week 4 to 6.

Exercises progress to heel raises, balance on each leg, step-ups and longer walks. Balance work matters because a fall in the first months is one of the main risks for the new hip.

By 3 months most people are walking normally, climbing stairs and doing daily activities without help. Strength and endurance keep improving for up to a year. Keep a strength routine going 2 to 3 times a week, as the muscles around the hip weaken quickly if you stop.

Walking, swimming, cycling, yoga with modifications and gardening are good long term activities. High impact running and jumping sports are usually discouraged. Ask your surgeon about your specific implant.

These need a specific conversation with your surgeon, because advice differs by surgeon, approach and implant. Many surgeons in India advise avoiding deep squatting and sitting cross-legged on the floor for good after a hip replacement, particularly after a posterior approach, because these positions combine deep bending and rotation.

Practical alternatives: a Western toilet or a commode over an Indian toilet, a low stool or chair for cooking and pooja instead of the floor, and a chair at family functions and temples. Many temples have chairs or benches if you ask.