The first four weeks after minimally invasive hip replacement surgery: Ask Dr. Amy!

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- Dr. Amy Cannatta DC describes the first four weeks after minimally invasive hip replacement surgery.
You will be given a walker at the ambulatory surgery center. Use it as long as you like. Most patients ditch the walker at 2-3 days.
For the first four weeks after minimally invasive hip replacement surgery you should pretty much be a couch potato, but not a vegetable. That means getting up and walking around 8 minutes out of every 60 in an hour. Set an alarm to remind yourself t get up and move.
No specific exercises or therapy is needed in the first 4 weeks after minimally invasive hip replacement surgery. Light walking should suffice to reduce the risk of blood clots. Its also a good idea to pump your ankles while watching TV or resting.
There is no specific diet after hip replacement surgery, but a high protein, low carb diet high in natural whole foods is always best. Arginine is required for wound healing, and it can be found in most multi-vitamins. Taking a multivitamin every day before and after surgery is a reasonable practice to ensure your body has the necessary blocks to heal. Low proein levels are associated with poor wound healing. So, eating a high protein diet makes sense.
Out next edition of ask Dr. Amy will cover weeks 4-8 after hip replacement surgery. We will review specific exercises that will help you get the most out of your new hip.

[@nessfrancisco5746]

When you talk about hip replacement, you need to understand some people are worse off when they have it. I thought I had a pinch nerve in my back, so waiting for a back doctor appointment. I was on crutches for months before I found out it was my hip. When I had hip surgery I was behind most people. At 2 months I am ahead. I just want you to remember and tell people not everyone is the same. When you do this some might think there is something wrong with them.

[@63JKM]

I’m shocked no physical therapy the 1st 3 weeks. I was given exercises to start the next day and to start physical therapy day 6. For me physical therapy exercises, short walks and ice were the most important. I took my meds until I saw my Doctor. I continued to take them until they were out. I was walking unassisted day 8. I carried my cane with me just in case until the 2 week mark. Bottom line is don’t try anything until you speak to your doctor. Even if you feel like you can do more. Everyone is different. A therapy patient with me was still in a walker week 2. There’s no ribbon for early milestones.

[@terridemarest7880]

I am a very fit 56 year old that had anterior THR 4 weeks ago. No way without a walker 2 days later or 4 weeks later. Do not compare or expect this. I did have a bumpy first week due to low blood pressure and a blood transfusion. Still use walker for balance. Still sore but no meds.

[@heartscontent]

I agree with you. The hospital recommends a walker and later transitioning to a cane in stages. No way at day 3 or 4 do you ditch everything. I’m shocked.

[@anniejefferson7329]

I had my right hip done 8 days ago. Using walker for stability only. Stopped meds day 4. Dont like constipation., lol. Love physical therapy, i miss my gym workouts. Do your excercises peeps. ❤

[@BestPracticeHealth]

Hang in there and best results to you!

[@cindyhead8899]

Most doctors make you get up first day of hip replacement. And make you do physical therapy for up to six weeks

[@BestPracticeHealth]

Good point. Recovery depends so much on how the surgery was done. We advise anterior, direct superior or the superPATH minimally invasive approaches.

[@susanwickman3603]

Just over3 weeks after anterior hip replacement. I did everything the doctor told me and did all the exercises. Had my post op appointment day before my 3 week by one day and was released to drive. I walked w/o the walker very quickly, only when I walked outside. I have been driving for 3 days with no problem.

[@BestPracticeHealth]

Thanks for the update! I'm so happy for you. I hope you continue to recovery nicely and have a great result.

[@jimh527]

She's right.. And that was my surgeons instructions also. First 4 weeks concentrate on healing. Do the bed exercises if you want, but many people overdo it. After 3 or 4 weeks, the exercises become mandatory for the best results.

[@BestPracticeHealth]

Thanks for sharing that advice! Sounds like it worked for you. Glad to hear it.

[@artryan5330]

I definitely don’t agree with that couch potato. Same day I was walking with a walker now walking with a crutch. Post two weeks. My advice take your meds until you see your doctor. Helps you push to your therapy. Then ice.

[@sherrcon]

got to keep ahead of the pain by medication

[@casspeied]

Did you have the minimal invasive surgery?

[@chiphister]

It has been 12 days since my total hip replacement surgery, and I am still not able to walk without a walker. I also had a large bone graft done for a golf-ball-sized bone cyst that had developed above the joint, which I am sure complicates things. I am 61 and - apart from the hip - very physically fit (I am one of the top swimmers in the country for my age group in Masters swimming). I followed the exercise regime suggested for hip replacement patients religiously both before and after surgery. I was, I must admit, very dismayed at learning from this video that MOST patients a) are walking within 2-3 days of surgery (I cannot even stand on my bad leg, let alone walk on it) , b) don't use the pain meds AT ALL (I took hydrocodone - 10 mg, 4 times a day for a week, then tapered off - now I take nothing). I was easily the youngest person on the floor getting hip replacement surgery that day, and the most physically fit. My mother had hip replacement surgery at 80 and was walking on her own in week. A friend's mother had hip replacement surgery at 75 and was grocery shopping BY HERSELF - no walker, no cane - in 3 days. It might be the bone graft, but it seems my results are pretty bad so far - bottom 1%? Not what I had expected or hoped, I must say. By the way, I had the minimally-invasive anterior hip replacement.

[@BestPracticeHealth]

The presence of a bone cyst and the need for a graft can indeed be a game-changer. Recovering from a bone graft procedure typically takes longer, often on the order of weeks to a few months, which can be challenging. But don't forget, there are some factors in your favor. Firstly, you're young, and equally important, you're a champion swimmer. As a master swimmer, you're likely in the top 1% when it comes to muscle mass, resilience, and certainly mental toughness. So, hang in there! It's crucial not to compare your progress to others who haven't undergone the same procedure because everyone's recovery is unique. I have no doubt that you'll get better soon, and all the effort and patience you're putting into your recovery will be well worth it.

[@chiphister]

@@BestPracticeHealth Thanks! That's helpful!

[@thecararenaprestige]

I had the same has you and I van tell you this is not a speedy recovery, am 52 very fit, but the operation I had the same has your is a long recovery

[@chiphister]

@@thecararenaprestige Hey there. Thanks for your reply - very much appreciated! It is now a month since my operation, and I can walk short distances with a cane. I cannot put my full weight on the affected leg as yet. When I directly asked about the impact of the bone graft on my recovery a few weeks ago, the physicians' assistant said, "No, that has no impact." Which, looking back, seems a very odd comment, as it clearly did and does. Looking back at my own post, I would say I was very overly optimistic about my recovery, based on the experiences every other person I personally knew who'd had the surgery. I think healing the graft, especially one as large as I had, is something akin to mending a broken bone, so something on the order of 4-6 weeks?, in keeping with the first comment above from @BestPracticeHealth.

[@deborahbarnett4954]

I would add that most people are definitely not walking 2-3 days after surgery without a walker. At 3-4, i was starting to use a cane but still relied on the walker primarily. It wasn't until day 5 that I could ditch the walker entirely. It's unfortunate that unrealistic expectation is in there. Also, pain management is critical so that you will get up and move, so if you need opioids for the first week, but it enables you to walk regularly, it's a worthy tradeoff. Last, I was surprised she mentioned taking ibuprofen. My surgeon had me take aspirin for 30 days as a blood thinner but no other NSAID. Instead, extra strength Tylenol as needed. I hope this helps anyone else with setting expectation. As a former competitive distance runner, I know the temptation to compare your progress :) Resist if possible! Cheers@@chiphister

[@CarolynStOnge]

I’m having my left hip done in about two weeks. My surgeon recommended that I use something called cold therapy. It’s a machine you rent for a couple of weeks and apparently it does amazing things for healing.

[@nancyberry4713]

I’m sorry there is no way I can go without a walker the first week

[@BestPracticeHealth]

That's OK! Everyone is different. That best thing is what works for you and keeps you safe.

[@lynnwilliams5432]

80 yrs fell had replacement Walker all this first week .

[@blakemoore666]

I’m on day 14 post anterior hip replacement, hip flexors still so tight can barely lift my leg, can’t imagine getting around without walker during this period

[@BestPracticeHealth]

Hmm. You may want to check in with your surgeon. Most people were done with the walker days earlier. Everyone is different, it may be fine for you, but check.

[@blakemoore666]

@@BestPracticeHealth I’ve seen him 3 times since surgery, he claims all normal, not sure I believe him at this point. I keep reading about similar issues as I’m having relating back to overhang of cup, leg too long, etc rubbing the iliopsoas tendon. Not sure a surgeon would admit this error though.

[@MrJoeyelias]

I getting a lateral THR which is the common method in Canada and EU. No physio for 48 hrs I’m told

[@ShadowWolf3030]

Yea i dont see how after surgery you would not want pain killers, i had total hip replacement surgery 9 days ago and trust me the next day you will want them i would rather take them to help me rest rather then sit on a couch all day in agony, this isnt everybodys journey its a painful difficult one and my upper thigh is still numb and i cant walk without my crutches,

[@BestPracticeHealth]

Hang in there! Everyone is different, and that is especially true when it comes to surgery. However, the pain after surgery depends a lot on how the surgery was done. Some of the approaches are much less invasive than others. There’s a very high chance, regardless, that you were going to have a great result. Hang in there. Please let me know how it turns out.

[@ShadowWolf3030]

@@BestPracticeHealth thank you,, my surgery was in the front, this is my first ever surgery so i cant compaire it to anything, but if it gets better and i heal and can walk then it was all worth it,

[@chrismiles9044]

I am 8 weeks since my hip replacement and still have a num thigh in my non operating leg. Have you any idea what this could be please?

[@BestPracticeHealth]

first of all, I’m so sorry to be seeing this so late. I know this message was two months ago, and I hope the numbness is gone. But if it’s not, one thing to consider is an L3/4 disc herniation. I’ve seen this happen in conjunction with hip surgery. The L3 nerve root starts in the back, and curves around the thigh so that pain or numbness, often rap to the inner part of the knee. The last thing to consider is Malja paresthetica. Problems with the lateral femoral, cutaneous nerve can cause numbness in the thigh that has nothing to do with the hip or the back. The way to distinguish these conditions is to look at the pattern of the numbness. That should then be aligned with either a peripheral nerve, or a nerve root in the lower back. the Doctor Who handles these problems is typically a neurologist. Any neurologist is fit for this duty, and a sub specialist is usually not required.

[@chrismiles9044]

@@BestPracticeHealth Many thanks for reading my message, yes have now been diagnosed with Malig Paresthetica awaiting ultrasound to confirm its a compressed nerve. I never had a problem pre hip surgery.

[@casspeied]

I am having Mako assisted anterior surgery. Is this what you mean by minimally invasive? Also my doctor gave me arginine beforehand.

[@BestPracticeHealth]

Yes. The e3 minimally invasive approaches to total hip replacement are anterior, superPATH, and direct superior. Arginine is critical to wound healing, so that makes some sense. It's great to hear they are using a robotic assistant. The other 3 things to look for in your surgeon that would qualify them to be best practice certified are fellowship training, volume > 100 hips per year, board certified, and they use only registry proven implants. Best of luck! Please let me know how you do!

[@casspeied]

@BestPracticeHealth thank you for your reply. Yes Dr.Streumph does most of the hip replacements in NM. I looked up everything about him beforehand. I just want to make sure your couch potato and walking around the house applied to my surgery because it seems to make sense. I have not had a conversation with my PT yet.

[@luanndavis-jindela3223]

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[@larryfulk6875]

What do you think about using healing peptides, bpc 157 and TB500?

[@BestPracticeHealth]

Dr Lieberman answered your question today on our live show! Here is a timestamped link: kzbin.info/www/bejne/gHKxXpabo7Kqmqc

[@FamilyofFour30]

What does “minimally invasive” mean? Anterior approach?

[@BestPracticeHealth]

"Minimally invasive means less invasive than other ways it could be done. In hip replacement, it refers to the anterior, superPATH and direct superior apporaches, as opposed to the legacy 'posterior' approach which has a very slow to no recovery and permanent restrictions. Make sense?

[@BestPracticeHealth]

Hello! Your questions is being answered on Best Practice LIVE! Check it out HERE: kzbin.info/www/bejne/b4rMZ4F_f51psNE

[@BestPracticeHealth]

You can see Dr. Lieberman's full explanation HERE: kzbin.info/www/bejne/b4rMZ4F_f51psNE

[@paulettestarkey4464]

Do you need to wear those hose

[@lizstromsnesdolz629]

no medication? thats another lie

[@westmid69]

Rubbish folks !!! I've had minimum anterior total hip replacement left. I'm a 2h 23 marathon runner, now a very active golfer. I am surrounded with many hip replacement men andwomen. Listen ! Left hospital with 2 sticks, day 8 one stick. You can only walk unassisted when you are able to walk correctly with correct heel down off toe, no compensation. Personally I came off codeine day 5 now paracetamol when required. Exercises given by physio, bed and static Exercises are paramount. Walking free after 2 days bullshit.

[@lizstromsnesdolz629]

liar, you are not walking on your own after 2 days.

[@lizstromsnesdolz629]

she lies