The amount of time a person will be incapacitated after a hip replacement, is one of the first questions that both the patient, and the carer are going to be asking. Many people are worried about getting back to work, and not losing too much of their income.
I remember with my mom’s surgery, that Mom was very stoic about it all, while I was rather worried, due to my mom’s age (88 years old), and the fact that I could see myself having no free time for quite a while.
Well, this is going to vary a greatly, depending on the health, and age, of the person having the hip replacement, how much they prepared for the surgery, and the type of hip replacement surgery they have elected to undergo.
For posterior, or lateral, approach hip replacement, you will typically need help with many tasks for 2 to 4 weeks after surgery, and you will have to adhere to the numerous precautions post-surgery, for up to 10 to 12 weeks.
For an anterior approach hip replacement, you may typically need help for 7 to 10 days at home with some tasks, but you will be able to do most normal activities far more quickly. Any precautions you have to follow post-surgery will last up to 4 to 6 weeks.
CONTENTS - Overview & Quick Links
Hip replacement recovery week by week
- Posterior and lateral approach hip replacement recovery week by week
- Anterior approach hip replacement recovery week by week
Home care after a hip replacement
- Home care after posterior and lateral approach hip replacements
- Home care after anterior approach hip replacements
Caring for an elderly adult after a posterior approach hip replacement
Hip replacement recovery week by week
In the case of the posterior and lateral hip replacements, there are many precautions to be observed after surgery, due to the amount of soft tissue which has been cut to introduce the hip implant.
The surgeons, whose websites I have researched, seem to be, on the whole, advising the same lists of precautions to be observed, and for the same lengths of time.
Typically, there are precautions for –
- sitting
- low seats
- sitting down
- kneeling
- standing up
- twisting when standing
- turning when walking
- bending forwards
- leaning
- reaching
- crossing legs
- sleeping
- lying down
- bathing
- driving
- exercise
In the case of the anterior approach hip replacement, I found quite a difference in the number of precautions that a patient needs to observe, with some surgeons listing none, to others who listing quite a few – but it’s still nothing like the number of precautions to be observed after posterior and lateral approach hip replacements.
Typically, there are precautions for –
- bending backwards
- sleeping
- lying down
- driving
- exercise
The recovery rates for the different types of hip replacement are quite different, so I have once again divided this into two sections –
- posterior and lateral hip replacement recovery week by week
- anterior hip replacement recovery week by week
Posterior and lateral approach hip replacement recovery week by week
Different people will recover at different speeds, and start to do the different activities at different times, and timelines like this are just an average, and for the average person – this is not meant to be used by anyone to decide when to start and stop doing certain activities.
Elderly adults, and individuals who were in poor health, may take longer to recover if their bodies are not healing at a normal rate, and inversely, much younger adults in good health may recover a lot more quickly. I have included, towards the end of this piece, the timeline for my 88-year-old mom’s own recovery.
Here is a week by week timeline, that of where you can roughly expect to be, at different times, in your recovery.
I have divided the recovery timeline into 4 phases.
Remember, your surgeon is the only person who can tell you exactly when you are able to resume activities, and to drop precautions.
Phase 1 –
This phase is the first 1 – 1 1/2 weeks after surgery.
This initial phase involves the patient becoming accustomed to their new hip, and gaining in confidence.
- most patients do their first walk a few hours after surgery
- typically, a patient waits at least 48 hours before they can shower
- you will be informed of all the precautions you will need to observe
- the physical therapy team or nurses will show patients how to sit and stand, how to get in and out of bed, how to get on and off the toilet, how to transfer into a shower and bathe
- you may also be shown how to put on clothes using assistive devices
- pretty quickly, the physio team will show you your exercises and get those started
- by the end of this period you will typically be able to walk with one or two canes, a walker or crutches, with confidence
- a patient won’t leave the hospital, or rehab facility, until they are able to get in and out of bed, and walk with the walker or with canes
- in this first phase, the patient will be driven home at some point – the elderly will stay for the longest in hospital to make sure they are able to do the basics – my mom stayed a few days longer
- if needed you will be icing throughout this phase, a minimum of 3 to 4 times a day, 15 to 20 minutes at a time
Phase 2 –
This phase is from around 1 1/2 weeks to 6 weeks after surgery.
This phase is all about, walking more and more, doing the physio to strengthen the muscles, and getting back to some light activities in the home.
- icing will end a few days into this phase
- a patient may resume full weight-bearing 2 weeks after surgery
- the physio exercises should be done every day, and as much as has been advised
- you will probably need quite a lot of help with chores, and cooking
- you will start to walk unaided at 3 to 6 weeks
- those of you with desk jobs should be able to return to work after 4 weeks
- during this period you will hopefully return to light daily activities
- somewhere between 4 – 6 weeks, driving starts again – you can’t do this if you are still taking pain medication, but that should not be the case
Phase 3 –
This phase is from around 6 weeks to 12 weeks after surgery.
This phase is when you get to the point where your precautions are lifted – which means that your soft tissues that support the hip should now have healed and strengthened enough, that the precautions are no longer necessary
- your precautions will be lifted, so you can sit in chairs that you want to, reach down, bend over and pick things up – your surgeon will tell you when
- at 6 to 8 weeks you will be able to resume sexual intercourse, but avoid extreme positions at first
- you can start doing regular daily activities such as gardening and long walks, at 10 to 12 weeks
Phase 4 –
This phase is from 12 weeks and beyond
You should have had all the precautions lifted, and you can now get on with your life again.
- if your job involves some sitting, some standing, and light lifting, you should be able to return to work after 12 weeks
- you may be able to start doing low-impact sports like swimming, hiking, rowing, low-impact aerobics, bowling and bowling, at 3 to 6 months
- you may be allowed to kneel down, but typically with only one knee on the floor
- it may take up to 6 months to a year for a full recovery
Anterior approach hip replacement recovery week by week
The anterior approach hip replacement is far less invasive than the posterior and lateral approach hip replacements, and as a result the recovery to normal daily activities is a very rapid one, by comparison.
No muscles in the buttocks, or behind the hip, have been cut through, instead the incision is at the front (anterior) and only a small amount of soft tissue is actually cut, with the larger muscles being parted to allow the implant to be put in position.
It is for this reason that leaning forwards, bending down forwards, and sitting and standing do not pose the same risk of a hip dislocation, as a posterior or lateral approach hip replacement, and this makes the resumption of normal daily activities a far more rapid affair.
The precautions, as you will see when I come to those later, are more to do with bending and stretching backwards, where the pressure on the hip is at the front of the joint, but this movement is not one that is involved in too may of our daily activities, certainly not in the same way as bending to sit and stand, or to reach for objects are.
The timeline is again just an indicator of the typical speed of recovery of an average person, and may take a little longer for elderly adults.
For a more precise timeline, only your surgeon can tell you when you can, and cannot, start to do the different activities.
Phase 1 –
This phase is the 1st week
The patient gets used to their new hip, and starts walking in this first phase
1-2 days
- you will typically be walking on the first day with a walker, a few hours after surgery
- some surgeons give you a few basic exercises – but not all do this
- most clinics and surgeons do not recommend before the first 48 hrs
- depending on your stability, you will use a walker for a short period of time indoors
- outside in public areas, you will use a walker
5-7 days
- you may be having your first follow-up with your surgeon
- your pain medication will be assessed, and it will be decided what to do
- depending on whether it is a right, or left hip replacement, whether the car is a stick shift, or an automatic transmission, you may be allowed to start driving – right hip replacements will not be allowed to drive for 4 weeks
- most patients are still using the walker in public areas
Phase 2
This phase is week 2 to week 4
In this phase the activity levels build up, there is a resuming of normal life and a lot of people will go back to work.
10-14 days
- if you are still using the walker in public areas, you will be eased off it
- typically, you will begin to raise your activity levels – some can start putting or chipping, if they play golf
- not all surgeons recommend physical therapy, but if they do, at the two-week mark, you may start physical therapy
- those individuals who have desk jobs can return to work
3rd Week
- many patients will be walking very well without walkers or crutches
- return to driving, but it may take up to 6 weeks and cannot be done while you are still taking (narcotic/opioid pain medications)
- normal daily activities should have been resumed
- for golfers, you may start chipping and putting
Phase 3 –
This phase is week 4 to week 12
In this phase you should see the end of precautions, and a return to low impact exercise and sport, and driving.
4th – 6th Week
- after 4 weeks (once your incision has healed) you are allowed to get in a swimming pool, or hot tub
- anterior hip precautions will be lifted during this time
- your stiffness and swelling should begin to diminish
- you may be allowed to participate in exercises like regular gym exercise, doubles tennis, aerobics (low impact), hiking, rowing, biking, golf and weight lifting, after 6 weeks
- at 6 weeks, return to driving if you had the operation on the right hip
10th -12th Weeks
- except if your job involves heavy lifting or manual labor, you should be back at work by 10 weeks
- all your normal activities should have been resumed by now
- to keep strengthening the joint home exercise is recommended by most surgeons
Phase 4 –
This phase is from 12 weeks onwards
This phase is just living with your hip replacement, and knowing what you can, and cannot do, in the long term
- typically you are looking at 3 – 6 months before sports activities
- you may be able to return to heavy lifting and manual jobs, but a lot of surgeons do not advise manual as it can have an impact on the implant and in the long term it may damage
- equally, you will most likely be told that high impact sports such as jogging and basketball, football, are to be avoided, as they can damage the hip replacement
Home care after a hip replacement
After an anterior approach hip replacement, you will probably want some form of assistance for 7 to 10 days at home, and after a posterior, or lateral, approach hip replacement, you will require help with many activities for 2 to 4 weeks.
Posterior, or lateral, approach hip replacements, for a period of 6 to 10 weeks, require you not to bend your hip more than 90 degrees, so you may need help for a longer period if you are having a difficult time.
It can be quite a bit longer for the more elderly, and fragile, as their bodies don’t heal as fats, and they may not have been able to get into very good shape prior to surgery – by this I simply mean that they may not have been in a situation where it was possible for them to strengthen their legs and hips before surgery.
I will be giving an idea of how long that may be for a posterior hip replacement, in relation to my personal experience looking after my elderly mom, in the next section.
Home care for posterior and lateral approach hip replacements
Activities for which you may need assistance for up to 2 to 4 weeks after a posterior or lateral hip replacement –
– getting in and out of bed
– getting to the bathroom- going to the toilet
– your exercise program
– dressing
– bathing – getting in and out of the bath, or shower, as well as the actual washing
– driving
– cooking
– household chores
– laundry
– groceries
– follow-up appointments
My mom, who had her hip replacement aged 88, required my help for almost everything for more than 6 weeks – all the household chores, the cooking, the groceries etc. for a minimum of two months.
I have an article here – “How Long Do You Need A Caregiver After Hip Surgery ? A Guide With Recovery Times”, in which, as well as typical timelines of recovery, I outline what you will need a caregiver for, what is required in terms of preparation in the home, equipment you may need, and what you can do to prepare yourself for a hip replacement.
Home care for anterior approach hip replacements
As you will most likely be using a walker for the first 5 – 10 days, you may need help with –
cooking and housework.
And if your hip replacement is on the left side, and you drive an automatic transmission, you will need a driver –
for at least 2 weeks.
If you drive a stick shift, and it is your left hip which has had the surgery, you will typically need a driver –
for at least 4 weeks.
If you have had your right hip replaced, regardless of the type of transmission on your car, you will need a driver –
for 4 to 6 weeks.
Anterior hip replacement patients don’t typically have restrictions on bending, so you should be able to –
– dress on your own, with, or without, dressing aids – if it is painful to bend to do things it may be sensible to get a few aids.
– wash on your own, 48 hours after surgery you are typically allowed to shower, you may want to use a shower chair, so you don’t risk slipping and falling.
Caring for an elderly person after a posterior approach hip replacement
This section is both a timeline, and an outline of all the things I had to I help my mom with after her surgery, so you really can get an idea of what is required with an elderly adult after a hip replacement.
Recovery Period
11 Days – Mom was at the hospital for 11 days – the medical team wanted to make sure that she could walk well enough, and could get on and off the bed properly
Bathing for the first 4 weeks at home (weeks 2 1/2 -5 1/2) A lady, who came in from an outside agency, helped Mom with her with bathing – this was done seated on a bedside commode, in a room with lots of space around the commode.
I did the following for the first 2 weeks at home (starting 11 days after surgery)
- prior to my mom’s return from the hospital, I reorganized a lot of things in the house
- I set up a coffee and tea station with a kettle and some cookies, next to the chair in which Mom sat most of the time, if she wasn’t lying in bed. Elderly ladies do like their cookies…
- I had cooked and frozen quite a few meals to make life easier
- I put a bedside commode for the first week in Mom’s bedroom, which I tended to for her
- for the first week at home (days 11 to 18), I had to help my mom off the bed and over to the bedside commode
- after the first week, Mom was able to get off the bed by herself, and over to the bedside commode
- I shampooed Mom’s hair in a chair
- I assisted Mom with dressing
- I put Mom’s shoes on for her
- I helped Mom to get in and out of bed
- I cooked all meals – I had also cooked and frozen quite a few meals ahead
- I made all her drinks etc
- I served her breakfast, lunch and dinner
- I was present for standing up and sitting down
- I had all the groceries delivered, and I put them away with her favorites at an easy height to get to without bending or reaching
- I did her exercises with her
- I walked alongside her in the beginning when she changed rooms, or was doing it for exercise
- I had organized a coffee and tea station next to the chair where Mom sat, with a kettle and some cookies, and I kept that fully stocked ! Elderly ladies do like their cookies…
- I did all the laundries, vacuuming etc.
After roughly 3 weeks at home (so around 30 days after surgery)
- I moved the bedside commode to over the toilet, so Mom could use it as a raised toilet seat
- I cooked any fresh meals
- I made her hot and cold drinks etc
- I was still making all the breakfasts, lunches and dinners
- I served her breakfast, lunch and dinner, as she couldn’t walk and carry items yet
- I still was doing all the laundries, vacuuming etc.
- I shampooed Mom’s hair in a chair
- Mom was dressing with assistive devices
- I put Mom’s shoes on for her
- I had all the groceries delivered, and I put them away with her favorites at an easy height to get to without bending or reaching
- I did her exercises with her
- Mom was doing longer and longer walks each day, but they were all indoors
- I did any tasks for my mom which would stop her from twisting or bending, such as dressing if needed
- I still was doing all the laundries, vacuuming etc.
After about 4 weeks at home (starting week 5) – (We no longer had the lady from the agency)
- I washed Mom’s legs and feet while she sat, and with the walker Mom would transfer to the shower to wash her upper half
- I was still shampooing her hair in a chair for her
- Mom started getting her own breakfast – I put out the items out for her the night before on a table beforehand
- Mom was now able to get her own hot and cold drinks if she wasn’t too hard
- I then organized the fridge so that there was no bending down low, as she started to get more things and do a little more for herself
- I did her exercises with her – this continued for about a year
- I did any tasks with my mom which would stop her from twisting or bending, such as dressing if needed
- I was still putting her shoes on for her
- I was still doing any heating up of food or cooking
- I still was doing all the laundries, vacuuming etc.
After about 7 weeks –
- Mom did not need much help with dressing, except her shoes, which I would help her put on for about 4 months
- Mom started to be able to do a full shower with the long handled sponge and handheld shower head – I no longer had to wash her feet and legs
- I still did all the chores and cooking at this point
My mom did not have any sports to return to, heavy lifting, or manual labor, so I can’t say anything with regard to that.
I was already doing all the household chores for my mom, and all the shopping online for her, but it would have taken her about 4 months at least to get back to that if she had been doing it.
I cannot say a lot about her walking as she has a dodgy right knee which started to flare up about 5 months after she had the hip surgery, as soon as she could walk a little, and she has not really done much about it, nor walked any more than is required around the house. COVID-19 has also put a stop to her going out very much.
I hope that gives you some idea of how much care is required for an elderly person, after a posterior, or lateral, approach hip replacement.
What not to do after a hip replacement surgery
Posterior and lateral approach hip replacements
Typically, the precautions for posterior and lateral hip replacements will last up to 3 months – don’t stop observing the different precautions until your surgeon says to do so.
With regard to not flexing the hip at more than 90 degrees –
- don’t bend at your waist so that your hip is at an angle of more than 90 degrees
- don’t reach down in any position to pick up items – use a reacher
- if you are sitting, don’t lean forwards – use a reacher
- if you are in bed, don’t reach forwards to pull up the covers – use a reacher
- only sit in chairs where your hip will be higher than your knee once you are seated, i.e. the seat is higher than your knee when you stand next to it
- don’t sit on low seats, sofas, low recliners, soft seats or poofs
- don’t try to sit in the bottom of a bathtub until your surgeon says you can – 6 – 12 weeks typically
- don’t sit on a low toilet – get a raised toilet seat
- when seated, don’t stay in the same position for too long
- when you are sitting, never cross your legs
- don’t try and get down to kneel – if you are allowed to your surgeon will tell you, but it won’t be before 3 months, if at all
Sleeping –
- don’t lay, or sleep, on your stomach, as it will twist your legs as your feet will have to point outwards
- it is best to sleep on your back, but if you do, don’t put pillows under your knees to lift them up
- if you sleep on your back, put a pillow between your legs to stop your feet rolling and pointing inwards
- don’t cross your legs when lying down or sleeping
- you can sleep on your side, but don’t sleep on the side of the operation and put pillows between your legs
- if you do sleep on your side, don’t bend your knees, bringing your hip up to the 90 degree point
Walking –
- when walking, don’t pivot on your foot of the operative hip to turn, instead turn taking little steps
- as you walk, don’t look round by twisting your torso round, slowly turn around by taking small steps
Standing –
- don’t twist your upper body when you are standing or sitting, always facing forwards
- don’t point your feet inwards
- when walking, don’t pivot on your foot of the operative hip to turn, instead turn taking little steps
- don’t point your feet in outwards when you walk
Other precautions –
- don’t immerse your incision in water until your surgeon has told you that it is completely healed- usually 6 – 8 weeks
- don’t drive until you are given the okay by your surgeon – typically this will be 4 to 6 weeks after surgery
- wait to play sports or to do low impact exercise until your surgeon says you can – generally at least 3 months or longer
Anterior approach hip replacements
The less invasive nature of anterior hip replacements, when compared to the posterior and lateral replacements, results in far fewer precautions for patients to observe post surgery. There is a far lower risk of the hip dislocating after an anterior hip replacement.
You must remember that you should not stop observing precautions until your surgeon says it is okay to do so.
Backward extensions –
- you must not do hip extensions – bend backwards, pushing your hips forwards
- bridging exercises are not allowed
- sit-ups are not allowed
Standing –
- avoid turning your foot outwards, as it twists your hip replacement, including don’t point your toes outwards
Walking –
- when you walk don’t spin or pivot round on your foot, just take a few small steps
Sleeping –
- lying down, or sleeping, on your stomach, and is not allowed either – this will force you to point your feet outwards twisting the hip
- don’t sleep on your back with your knee pointing outward
- you may sleep on your side, but not on the operated side, you should sleep on the other side
- if you do sleep on your side, don’t do it without putting pillows between your legs to keep your hip in a neutral position
- don’t bend your knees and flex your hip in the 90 degree position or greater when you sleep on your side
- sleeping on our back is the best position, but do not put pillows under your knees
- when you sleep on your back, you need to put a pillow between your legs, length ways, to stop your legs from twisting
- if you sleep on your back do not point your feet outwards, they should be pointing upwards – a pillow between your legs will help with this
- you must not immerse your incision underwater until it is completely healed, and your surgeon will tell you when it is – typically 6 to 8 weeks
- avoid sleeping in recliners as this can cause the hip to become stiff
Other
- you can’t play any sports until your surgeon says it is okay to do so
- driving is not allowed until the surgeon has given you the okay
https://www.edwinsu.com/anterior-hip-replacement-post-op-instructions.html
https://www.newyorkhipknee.com/faqs/total-hip-replacement-faqs/
https://www.stefankreuzermd.com/anterior-hip-replacement.html
https://www.orthonewengland.com/wp-content/uploads/sites/156/2018/02/KENNON-DISCHARGE-INSTRUCTIONS-HIP-2016.pdf
https://www.nwh.org/classes-and-resources/patient-guides-and-forms/joint-replacement-surgery-patient-guide/joint-replacement-faqs
https://www.ozorthopaedics.com.au/blog/how-long-after-a-hip-replacement-can-i-tie-my-shoe-laces-23710.html
https://orthoinfo.aaos.org/en/recovery/activities-after-hip-replacement/
https://my.clevelandclinic.org/health/treatments/17102-hip-replacement
https://scottsdalejointcenter.com/patient-education/anterior-total-hip-replacement-precautions/
https://www.arthritis-health.com/surgery/hip-surgery/anterior-hip-replacement-dos-and-donts
https://ortho.duke.edu/sites/ortho.duke.edu/files/u18/Anterior%20Hip%20Precautions.pdf
https://www.sehat.com/sleeping-positions-after-anterior-hip-replacement
https://www.henrymayo.com/documents/CP-Anterior-Hip-Complete.pdf
https://orthospecialtyclinic.com/wp-content/uploads/2013/04/OSC-Gait-Instructions.pdf
https://rothmanortho.com/stories/blog/total-hip-replacement-recovery
https://greaterphoenixorthopedics.com/blog/what-to-expect-after-anterior-hip-replacement/
I’m Gareth, the author and owner of Looking After Mom and Dad.com
I have been a caregiver for over 10 yrs and share all my tips here.
