In general, most individuals after hip surgery are discharged after 3 to 5 days providing there are no complications and particularly if there are family members to assist with daily activities. In some cases, the social service department at the hospital will find a temporary nursing home or intermediate stay facility until returning home is a viable option.
Once discharged from the hospital, a nurse, physical therapist and an occupational therapist will likely see the person for in home treatment. This is to ensure that the newly discharged individual is safe in and about his or her home. The number of home health care visits ranges from one to several. These are carried out for safety checks and reviews of the exercise program. In some cases, up to three visits home care visits before individuals can begin outpatient physical therapy. In other cases, the individual may be functioning adequately and may not require outpatient therapy.
The home exercise program for hip replacement is often similar to the regimen used in the hospital. It will progress with resistance and repetitions of strengthening exercises and increased distance and independence of ambulating. The individual continues to adhere closely to the weight bearing status assigned following surgery.
The occupational therapist involved in the home health care of the postoperative hip patient closely examines how safely and independently the patient is able to dress, bathe, and care for his or herself within the home environment. The occupational therapist can also determine the need for home medical devices such as elevated commodes and long arm instruments that help reach to the floor or apply socks.
Outpatient Physical Therapy
Once the postoperative hip patient is no longer homebound, most medical insurance plans will not cover home health care. If additional rehabilitation is needed, a new evaluation is generally conducted at an outpatient physical therapy facility.
In an outpatient physical therapy clinic the physical therapist may use the following methods of treatment to help reduce persistent swelling or pain and promote mobility:
- Thermotherapy or cryotherapy (use of heat or ice)
- Electrical stimulation
- Soft tissue mobilisation
- Joint mobilisation
Progression Of Ambulating And Exercise
Continued use of a walker or crutches is commonplace for the individual progressing to the outpatient setting. However, the goal is generally to progress each person with hip replacement to ambulating without an assistive device when possible.
Once initial hip precautions are no longer a concern, increasing the postoperative individual’s endurance can be addressed through walking, swimming, bicycling, and upper body exercises. The physical therapist will select a group of exercises that can be used to simulate day-to-day activities, like going up and down steps and raising up on the toes. Once the goals have been met in an outpatient setting regarding range of motion, strength, endurance, and ambulating, the person is ready for discharge with an independent program or possible exercising at a fitness center.