Post-Bilateral Hip Replacement: Recovery Tips and Exercise Guidelines

Bilateral total hip replacement?

Hello, Doctor: I would like to inquire about issues related to bilateral total hip replacement: 1.
Is it still necessary to use a pillow between my legs for sleeping after more than six months? 2.
Can I ride a bike or drive? I have tried sitting on a motorcycle, but I can feel the prosthesis; I have not actually taken it on the road yet.
3.
I experience a clicking sensation when walking and going up and down stairs, my thigh muscles feel tight, and sometimes I walk with a waddle, feeling a bit unbalanced.
Since the surgery, my knees and lower back often feel sore, and my ankles frequently make popping sounds.
Currently, I am hesitant to run at home, but I occasionally practice squatting, walking, lifting my legs at 90 degrees, ankle exercises, and climbing stairs.
Most of the time, I only do rehabilitation exercises and sit with my legs elevated.
Are these strange sensations normal? 4.
My main question is whether I can use an ab roller (kneeling) to work on my core muscles and if I can engage in strength training exercises? Thank you for taking the time to read this—looking forward to your reply.

Nimingoooo, 30~39 year old female. Ask Date: 2020/07/17

Dr. Chen Yongxue reply Orthopedics

1.
Is it necessary to use a pillow for support after more than six months? ANS: In principle, it should not be necessary, but please let your attending physician decide.

2.
Can I ride a motorcycle or drive? I have tried sitting on a motorcycle, but I can feel the prosthesis; I have not actually been on the road yet.
ANS: Yes, you can.
3.
I feel a stiffness when walking and going up and down stairs, my thigh muscles are tight, and sometimes I walk like a penguin, feeling a bit unbalanced.
After the surgery, my knee and lower back often feel sore, and my ankle frequently makes popping sounds.
Currently, I am hesitant to run at home; occasionally, I practice squatting, walking, lifting my legs at 90 degrees, ankle support, and climbing stairs.
Most of the time, I only do supportive rehabilitation and sit with my legs elevated.
Is this strange feeling normal? ANS: You should strengthen your rehabilitation; in principle, you should be able to achieve a completely normal gait.
However, since you underwent bilateral total hip replacement at the age of 30, the diagnosis may be osteonecrosis of the femoral head or hip dysplasia leading to arthritis.
The prognosis for these two conditions may not be as favorable as that of typical degenerative hip arthritis.
4.
My main question is whether I can use an abdominal roller (kneeling) to train my core muscles and whether I can engage in strength training exercises? ANS: Because you are quite young to have undergone joint replacement, it is advisable to use wear-resistant joints.
If not, strength training is not recommended.

Reply Date: 2020/07/17

More Info

Post-bilateral hip replacement recovery can be a challenging yet rewarding journey. It is essential to follow a structured rehabilitation program to regain strength, mobility, and overall function. Here are some guidelines and tips for recovery, addressing your specific questions:
1. Sleeping with a Pillow: After six months post-surgery, many patients find they no longer need to sleep with a pillow between their legs. However, this can vary based on individual comfort and the advice of your orthopedic surgeon. If you still feel discomfort or instability while sleeping, it may be beneficial to continue using a pillow for support.

2. Cycling and Driving: Generally, patients can resume cycling and driving after bilateral hip replacement, provided they feel comfortable and have regained sufficient strength and coordination. It’s important to ensure that you can safely operate a vehicle without pain or restricted movement. If you feel the prosthetics while riding a motorcycle, it may be wise to consult your doctor before proceeding with that activity.

3. Walking and Stair Climbing: Experiencing a "clicking" sensation or tightness in the thigh muscles is not uncommon after surgery. This can be attributed to muscle stiffness and the adjustment period of your body to the new joints. If you feel unbalanced or experience pain in your knees or back, it’s crucial to engage in physical therapy to address these issues. Regular stretching and strengthening exercises can help alleviate tightness and improve your gait. If you feel like you are walking like a "penguin," it may indicate that your muscles are not yet fully adapted, and targeted rehabilitation exercises can help correct this.

4. Core Strengthening and Weight Training: Using an ab roller (kneeling version) can be a good way to strengthen your core, but it’s essential to ensure that you maintain proper form to avoid straining your hips. As for weight training, it is advisable to consult with a physical therapist or your orthopedic surgeon. They can provide personalized recommendations based on your recovery progress and overall health. Generally, low-impact exercises that do not place excessive strain on the hips are encouraged.

Additional Recovery Tips:
- Physical Therapy: Engaging in a structured physical therapy program is crucial. A physical therapist can provide tailored exercises that focus on strengthening the hip muscles, improving balance, and enhancing flexibility. They can also monitor your progress and make adjustments to your program as needed.

- Home Exercises: Incorporate gentle exercises at home, such as leg lifts, seated marches, and ankle pumps. These can help improve circulation and prevent stiffness. Gradually increase the intensity and duration of your exercises as tolerated.

- Hydration and Nutrition: Ensure you are consuming a balanced diet rich in protein, vitamins, and minerals to support healing. Staying hydrated is equally important for overall recovery.

- Pain Management: If you experience persistent pain, consult your healthcare provider. They may recommend pain management strategies or adjustments to your rehabilitation plan.

- Listen to Your Body: It’s essential to listen to your body during recovery. If you experience pain or discomfort during specific activities, stop and consult your healthcare provider. Pushing through pain can lead to setbacks.

- Avoid High-Impact Activities: While low-impact activities like walking, swimming, and cycling are generally safe, high-impact activities such as running, jumping, or contact sports should be avoided until cleared by your doctor.

In conclusion, recovery from bilateral hip replacement is a gradual process that requires patience and dedication. By following these guidelines and working closely with your healthcare team, you can optimize your recovery and return to the activities you enjoy. Always consult your orthopedic surgeon or physical therapist for personalized advice tailored to your specific situation.

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