Recovery day by day
After a hip replacement through the anterior approach most patients stand up on the day of surgery. Discharge usually happens within two days at most, and independent movement without walking aids comes on average within two weeks. This is the usual course and not a promise; the timings are individual.
The day of surgery
Within a few hours of the operation, once the anaesthetic has worn off and the condition is stable, the patient stands up together with a physiotherapist.
What you do
You sit on the edge of the bed, then stand up with a frame or crutches and take your first steps in the room.
What you feel
Pain around the wound, weakness and often a feeling of heaviness in the leg. The pain is managed with medication. Many patients note that the "old", deep pain in the joint is already gone.
What matters
Deep breathing, moving the ankle and drinking fluids. These three simple things reduce the risk of pneumonia and thrombosis.
Days one and two, discharge
Walking
The distance increases step by step. You move from the room out into the corridor. The physiotherapist teaches you how to go up and down stairs.
Pain management
You move from injected drugs to tablets. The aim is for pain to be at a level that does not get in the way of walking.
Discharge criteria
You stand and walk independently with a walking aid, you manage stairs, the pain is controlled with tablets and the wound is settled. These conditions are usually met by the second day.
What you get on discharge
Written instructions, a medication plan, a list of exercises, the date of your follow-up visit and my number for questions.
The first two weeks at home
This is the period when the most questions come up. The basic rule is simple: walk regularly and in short stretches, rest often, and do not sit still for long.
What you can do
Walking in the flat and the yard, stairs, sitting down and standing up, light household tasks, doing your exercises several times a day.
What you should avoid
Lifting heavy things, standing still for a long time, sitting in a low, soft armchair, lying down in a bath. Driving is not yet on the list at this stage.
Wound care
The wound should stay dry and clean. In standard cases daily dressing changes are not needed. You will get specific instructions about bathing on discharge.
Swelling
Swelling of the leg and ankle is normal in the first weeks. Elevating the leg while resting and compression stockings help. If the swelling suddenly increases or is one-sided and painful, call.
A significant share of patients move without walking aids by the end of the second week. This is an average, not a deadline you have to meet. Some people need more time and that is normal.
Six weeks: back to normal life
The most common questions about timings. Every figure describes the usual course.
| Question | Usually | What it depends on |
|---|---|---|
| When can I shower | Depending on the state of the wound, usually in the first days | Wound healing, the type of dressing |
| When can I drive | Around 4 to 6 weeks, later if the right leg was operated on | Reaction speed, painkillers being taken, the type of car |
| When can I return to work | Desk work in 4 to 6 weeks, physical work after 3 months | The nature of the work, how much travel it involves |
| When can I fly | Usually after 4 to 6 weeks, a short flight sooner | Thrombosis risk, the length of the flight |
| When can I start swimming | After the wound has healed completely, usually in 4 to 6 weeks | The state of the wound, pool hygiene |
| When can I resume sexual activity | Usually in 4 to 6 weeks | Comfort and pain. The question is normal, do not hesitate to ask it at the consultation |
Every timing is individual and is refined at the follow-up visit. None of them is a promise.
Three months and beyond
By three months most patients are back to their usual life. Pain is usually gone or minimal, the walking distance is restored and walking aids are no longer needed.
Recommended activities in the long term: walking, swimming, cycling, golf and exercises to maintain the muscles. These preserve the function of the joint and general health.
Activities we should discuss individually: running, tennis, skiing, jumping and contact sport. This is not an absolute ban. It is a conversation about the service life of the implant and about your priorities.
Follow-up visits are scheduled on a timetable. Their purpose is to notice a change in good time, including when nothing is troubling you.
Which signs mean you should call straight away
Discomfort during recovery is normal. But there are signs that are not worth waiting on. When they appear, call or go to emergency care.
A temperature above 38 degrees, especially together with chills.
Discharge from the wound, redness, heat or an unpleasant smell.
A sudden, sharp increase in pain that does not respond to medication.
One-sided, painful swelling or redness of the calf. This can be a sign of thrombosis.
Shortness of breath, chest pain or sudden weakness.
Being unable to bear weight on the leg, a sudden noticeable change in leg length, a noise from the joint together with pain.
A fall or an injury, even if the pain is not severe.
You get my number on discharge. Asking a question is always better than waiting. Never think you are calling at an "inconvenient" time.
Questions and answers
How long will I need crutches?
Usually for the first one to two weeks. Many patients use two crutches at first, then one, then a walking stick, and finally nothing. The transition is gradual and follows pain and stability, not the calendar.
Do I have to go to a rehabilitation centre?
In most cases no. After the anterior approach a large share of patients continue rehabilitation at home, with the exercises given on discharge. A specialised programme is considered individually, for example for an elderly patient living alone or where there are other illnesses.
Can I lie on the operated side?
Usually as soon as it becomes comfortable, often after the first two weeks. At the start many patients sleep on their back or on the healthy side with a pillow between the legs. This is a matter of comfort, not a prohibition.
Which exercises should I do?
On discharge you get a specific list for your case. The basic principle: short sessions several times a day rather than one long one. Exercise should not cause severe pain. Mild tension is normal, sharp pain is a signal to stop.
Why is my leg still swollen after a month?
Swelling is a normal reaction of the body to surgery and can continue for several weeks or even months, especially at the end of the day. Elevating the leg while resting and compression stockings help. If the swelling suddenly increases, is one-sided and painful, that is already a reason to call.
When is the first follow-up visit?
The first visit is usually two weeks after discharge, the next at six weeks, then at three months. The schedule after that is individual. You get the exact dates in writing on discharge.
Have a question about your own case?
At the consultation we look at your X-ray together and I tell you what stage the joint is at and what the next step is. Seeing a surgeon does not mean surgery.
Updated: · Author: Mikheil Mikeladze, MD