Total Hip replacement: New Hip, New Limp

hip Aug 05, 2021
Total Hip replacement: New Hip, New Limp  
Tommy Conway - Chartered Physiotherapist and Director - OneHEALTH
Are you getting a total Hip replacement? Or have you just recently got it done? Have you been told that “you will need a new hip in the next 10 years?”. Are you just sitting there and waiting for your hip to get sorer and then get the operation? I am not going to tell you that you might not need a total hip replacement but I am going to tell you that if anyone says you don’t need physiotherapy after, they are wrong. For some reason you might hear along your travels “I don’t believe in physio” or “you won’t need physio after your operation”. This is not true! You most certainly will and lots of it. Why? Well, first off, do you know what actually happens in the operation? 

A total Hip replacement is needed when the surfaces of your Femur(Leg bone) and hip bone (See attached picture) are damaged and need to be replaced. This is done by: 

  1. Cutting through the glute(Buttock) muscles and pelvic ligaments to get access to the hip joint.

  2. The leg bone (Femur) is pulled away from the hip socket.

  3. The leg bone (Femur) head is cut off to prepare it for the new hip joint 

  4. The Hip socket is shaved down to make space for the new femur bone head. 

  5. Using cement to seal them to the bone

  6. Reattaching all the glute muscles and ligaments.

  7. Sewing up the initial incision. 

So here is why you might want to consider physiotherapy after: 

  1. Glute muscles are the biggest muscles in your body. They help you roll over, get up from sitting and standing and also keep you balanced when walking,you might need some work on that!

  2. Hip ligaments are some of the strongest in the human body, that’s why they need to cut through them. There is no way to pull the leg bone away from the hip without cutting through them. Post surgery they need to be put under load, as the only way to stretch them is in full weight bearing on that leg, might need some work on that.

  3. The hip bone: 17 muscles originate or attach to it, might need some work on that. 

  4. The Femur bone: 23 muscles originate or attach to it, might need some work on that.

  5. Scar tissue: It is very important to get the skin flexible after a surgery as this will restrict your ability to walk without limping. 

The surgery is always very successful. But the biggest problem is that most people don’t understand how complicated it is to use your hip properly again. I hear and see the same old story, Client goes into surgery with a limp. The client is six months post surgery and still has the same limp and doesn’t understand why. I get the same question on a weekly basis in my clinic “but sure I have a new hip, why am I limping?”

Every total hip replacement surgery I have rehabilitated has been successful, I have never seen a surgery go wrong but I have seen people go wrong. They think that all the sawing, hammering, screwing, cementing and sowing done in the surgery will take away their problems. It simply won’t, you have to work hard to get back your strength and flexibility, the easy part is the surgery because someone else is doing the work, the hard part is when you have to do the work yourself and my job is to make that work easier. My job is to restore the flexibility and strength in the muscles and ligaments that the surgeon cut through. Do you think they just go back to working normally after being cut open?. Not a hope, they lose everything, they start to waste at a drastic rate and most don’t do anything about it. Yes you are given exercises after you leave the hospital, but they are the first step on the ladder, you have another nine steps to get through, you need another set of more challenging exercises and treatments on a monthly basis. You have a choice, you can continue thinking that as soon as the anaesthetic hits, your problems are solved or you can make a plan with your physio to make sure you are not someone knocking on my door in six months saying “but sure I have a new hip, why am I limping?”

Again the choice is yours and I hope this helps. 



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