One New Hip, One Year Later

Hip joint replacement is the most common bone surgery in the United States. About 170,000 hip replacements are done every year in the U.S. The most common reasons for having this surgery are hip pain and loss of function. These symptoms occur most often because of arthritis or hip fracture. Sometimes bone tumors or trauma cause joint damage that leads to a hip replacement.

Most patients with a hip joint replacement are treated after surgery by a physical therapist. Then they are sent home with an exercise program and self-care instructions. No further therapy is provided. Therapists wonder what happens to these patients. Do they have their full motion and strength a year later? Are the exercises given in the hospital enough for the entire recovery time?

A group of physical therapists have been studying these and other questions. They found that 12 months after a total hip replacement, most adults have gained back their full motion. Pain is not usually present, but feeling unsteady on the leg is a problem. This is called joint instability.

No one is quite sure what it takes to make a joint stable. It likely includes motion, strength, and a sense of joint position called proprioception. Even a small loss in hip muscle strength affects joint stability. Joint stability is needed to prevent falls and injury.

Exercise programs used after a hip joint replacement are not enough. These help patients regain motion and care for themselves, but they do not give joint stability when checked a year later. The first set of exercises should be followed four months after surgery. Then, a follow-up visit with the therapist is advised. Strength, motion, and stability will be measured. An updated and advanced set of exercises should be prescribed. It seems clear that full recovery from hip replacement requires a two-phase exercise program.