Why Is My Mother Still Using a Cane After Hip Replacement Surgery?

It has been a year and a half since the joint replacement, and I still need to use a cane to walk?

Doctor: Hello.
My mother, who is 75 years old, fell and fractured her thigh bone last January.
She had a steel rod inserted and then accidentally fell again while using the restroom in May.
Ultimately, she underwent a total hip replacement in June, and it has now been a year and a half.
She still needs to use a single-handed cane to walk (if she doesn't use the cane, she can only walk a few steps), and after walking for a while, her leg becomes uncomfortable and sometimes painful.
Why is this happening? She has been very healthy overall and has been walking for 30 minutes every day since the surgery.
She has two friends who also had hip replacements and were able to walk two months after their surgeries.

John, 70~79 year old female. Ask Date: 2000/11/16

Dr. Shi Guozheng reply Orthopedics

Typically, after joint replacement surgery, patients can walk without assistive devices within three to six months.
If normal walking is not achieved after six months, it is important to suspect poor integration of the artificial joint with the bone or inadequate bone cell growth, which may lead to insufficient stability.
Additionally, inflammation or infection should also be considered.
It is recommended that you consult a specialist to evaluate these conditions and pursue proactive treatment options.

Reply Date: 2000/11/16

More Info

After undergoing hip replacement surgery, it is not uncommon for patients, especially older adults, to experience prolonged recovery times and continued reliance on assistive devices like canes. In your mother's case, several factors could contribute to her ongoing need for a cane and the discomfort she experiences while walking.

1. Age and Recovery: At 75 years old, your mother’s body may not heal as quickly as younger individuals. Age-related factors such as decreased bone density, muscle mass, and overall physical resilience can significantly impact recovery. Older adults often have a slower healing process, which can lead to prolonged pain and difficulty in regaining strength and mobility.

2. Pre-existing Conditions: If your mother had any pre-existing conditions, such as arthritis or osteoporosis, these could complicate her recovery. Additionally, her previous falls and injuries may have led to muscle weakness or imbalances that affect her gait and stability.

3. Physical Therapy and Rehabilitation: While you mentioned that she walks for 30 minutes daily, the effectiveness of her rehabilitation program is crucial. Engaging in a structured physical therapy program tailored to her specific needs can help improve strength, balance, and flexibility. If she has not been participating in a comprehensive rehabilitation program, it may be beneficial to consult with a physical therapist who specializes in post-operative care for hip replacement patients.

4. Pain Management: Persistent pain can hinder mobility. If your mother experiences discomfort while walking, it may be due to various factors, including inflammation, muscle tightness, or even nerve-related issues. It’s essential to address her pain management with her healthcare provider to ensure she is receiving appropriate treatment, which may include medications, physical therapy, or alternative therapies.

5. Muscle Weakness and Atrophy: After surgery, especially if there were complications or a prolonged period of inactivity, muscle atrophy can occur. This weakening of the muscles surrounding the hip joint can lead to instability and difficulty in walking without assistance. Strengthening exercises, as recommended by a physical therapist, can help rebuild muscle strength and improve her ability to walk independently.

6. Psychological Factors: Sometimes, psychological factors such as fear of falling or anxiety about mobility can also play a significant role in a patient’s recovery. If your mother is apprehensive about walking without a cane, this could contribute to her continued use of it. Addressing these concerns through counseling or support groups may help her regain confidence in her mobility.

7. Comparison with Peers: It’s important to remember that recovery experiences can vary widely among individuals, even among those of similar age and health status. Factors such as the type of surgery performed, the extent of damage prior to surgery, and individual pain tolerance can all influence recovery times. While her friends may have had quicker recoveries, it does not necessarily indicate a problem with your mother’s recovery.

In conclusion, while it is concerning that your mother still relies on a cane after a year and a half post-surgery, it is essential to consider the multifaceted nature of recovery. A thorough evaluation by her orthopedic surgeon or a rehabilitation specialist may provide insights into her specific situation and help develop a tailored plan to improve her mobility and reduce her reliance on assistive devices. Encouraging her to engage in physical therapy, addressing pain management, and providing emotional support can all contribute to a more successful recovery.

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