I had a total hip replacement about 9 months ago. I had it in my head that I'd be back to normal after about six months. But that isn't the case at all. What went wrong?
Studies do show that the average patient makes rapid gains in recovery after a hip replacement in the first three to six months following the procedure. Patients are encouraged to keep up their exercise program after that for at least another six months (if not longer).
It appears that it takes some people as long as two years to fully regain strength, motion, and function. It's not entirely clear why there are such differences. Many factors may come into play. For example, the type of procedure performed has something to do with it. More invasive procedures that require the surgeon to cut through major hip muscles can delay restoration of normal movement patterns.
Implant placement is an important key. The implant must be put in place with the correct angle and rotation. If the center of rotation is off, the muscles can't function normally. Hip stability, load on the hip, and biomechanics are all affected in different ways by these variables. Sometimes the patient ends up with a leg length difference. The implant may sink down into the bone too much making the operated leg shorter than the other leg. In other cases, the component parts make the leg longer than the other side. Either of these situations can impact recovery.
There's also some question about how long the rehab program should extend. The standard time is two to three months. There's some evidence that this just isn't long enough. But it's not clear yet what the ideal time frame may be.
Some experts who study human movement and posture have also suggested that a different rehab protocol may be needed. It's clear that the hip abductor muscles are key here. These muscles move the leg away from the body. They also stabilize the hip when you stand on one leg. Both functions are equally important during standing and walking activities.
If you are not satisfied with your results, it may be time to check back with your orthopedic surgeon and your physical therapist. Together they can help find out what isn't going well for you and why. It could be something simple to get you back on track.
Julie Nantel, MSc, et al. Gait Patterns After Total Hip Arthroplasty and Surface Replacement Arthroplasty. In The Archives of Medicine and Rehabilitation. March 2009. Vol. 90. No. 3. Pp. 463-469.