Hip replacement surgery has changed due to advances in surgical technique,
and many of our readers are aware of the fact that there have been advances.
Still the question of recovery remains an important one. We were fortunate
to be able to interview Dr. Steven L. Barnett, a specialist in joint replacement
and adult reconstructive surgery for arthritic conditions. Dr. Barnett
is a general partner of the Orthopaedic Specialty Institute in Orange
County. He has presented at numerous conferences nationally on arthritis
and new advances in joint replacement technique and is a recognized expert
on our question of recovery from hip replacement surgery.
HOI: Thank you Dr. Barnett for agreeing to this interview. Getting right
to the point, does hip replacement mean a long recovery process?
Dr. Barnett: This depends on how one defines "long recovery".
Because of advances in surgical technique as well as introduction of newer
pain management protocols, recovery from hip replacement surgery has been
significantly expedited over the last 5 years. Our goal is to mobilize
patients quickly which usually means up and walking on the afternoon of
surgery. Patients usually leave the hospital by the second day and can
return to work by 3-6 weeks.
HOI: When thinking about hip surgery, it seems that the length of time
in recovery would be one of the major concerns. Does recovery time depend
entirely upon the type of surgery?
Dr. Barnett: Yes and no. One important factor contributing to recovery
time is the shape the patient is in prior to surgery. At times we will
encourage patients who are severely limited in their weight bearing activities
because of the degree of their arthritis to get involved with physical
therapy prior to surgery so that their recovery will be easier post op.
New surgical approaches including the Direct Anterior approach and less
invasive Posterior Approaches have decreased the recovery time for patients
undergoing primary, elective total hip replacements. When considering
revision surgery (ie. Reoperating on a total hip that has failed), recovery
time tends to increase. This is related to more invasive surgery that
is necessitated by removing the hip that is worn out.
HOI: Do all types of hip surgery require a hospital stay?
Dr. Barnett: Usually hip replacement patients stay at least overnight whether
in an actual hospital or in a 23 hour stay surgery center. For the most
part this is to monitor vital signs as well as blood counts prior to discharge home.
HOI: Are there any ways a person can work to make the recovery time shorter?
Dr. Barnett: Making sure that patients are physically and medically optimized
prior to the surgical procedure. Most patients do not need to participate
with organized physical therapy prior to the procedure but we encourage
them to stay as active as possible without causing too much pain in the
affected hip joint. All patients need to see their family doctor prior
to surgery to make sure all medical issues are addressed.
HOI: How long does it usually take to fully recover from hip replacement surgery?
Dr. Barnett: With the newer techniques described most patients are transitioning
off of a cane by 2-4 weeks. Usually patients are ready to start back into
their leisure activities (Golf, Hiking, Tennis) at 6-8 weeks after surgery.
Despite the rapid recovery, hip replacement patients will have episodes
of mild soreness around the hip from time to time throughout the first
6-12 months. These are usually self limiting and resolve with rest after
a few days.
Hip Replacement surgery is one of the most successful medical interventions
that doctors can perform in the 21st century. Long term results show survivorship upwards of 95% at 20 years.
With the technology available to surgeons currently it would not be surprising
to see these kinds of survivorship rates extend out to 30 or 40 years
in the future!
Dr. Steven L. Barnett is a board certified orthopedic surgeon. He is an
attending physician at Hoag Orthopedic Institute in Irvine, CA. He is
actively involved in Orthopedic Residency and Fellowship training as well
as community and physician education. Dr. Barnett has published multiple
articles in the orthopedic literature. He is a general partner of Orthopaedic
Specialty Institute in Orange County.