Summit’s surgical protocols enhance the safety and comfort of hip replacement recovery.
The decision to have surgery is never made lightly. Patients want to know how long they’ll be off their feet and out of work. Some are nervous about going under anesthesia. Many are concerned about pain, and about the risks of overdoing opioid medications. Hip surgeon Dr. Dane Hansen addresses all of these concerns, explaining what hip replacement recovery is like for Summit patients. He also discusses the protocols Summit has developed to make the recovery process as safe and painless as possible.
The biggest advance in hip replacement recovery: Summit’s pain protocols
“If you compare today’s patient experience to the experience 15 years ago, the biggest change is our approach to anesthetic and postoperative pain protocols,” says Dr. Hansen. “For example, we now routinely use a spinal block. This single injection numbs the entire lower half of the body and lasts up to 24 hours, drastically improving pain control.”
A spinal anesthetic can sound scary to patients. “It sounds more intimidating than it is,” says Dr. Hansen. “This is a very safe procedure with significant benefits. Using a spinal avoids the need for heavy anesthetic and narcotic medications. As a result, patients wake up much more quickly. Because we can use lighter anesthetic, we minimize side effects like nausea and grogginess. Interestingly, studies show that using a spinal block results in less blood loss and less risk of infection. Our spinal protocol provides surgical benefits and decreases surgical risks.”
Patient pain control during and after surgery
“Pain control begins in the operating room with the spinal block,” explains Dr. Hansen. “We also use local numbing injections around the hip at the time of surgery and at the end of the procedure. Specifically, our surgery center uses Exparel, a long-acting numbing medicine designed to last 48 to 72 hours. Between the spinal block and these injections, patients get two to three days of pain relief without much need for other medication. Postsurgical pain is highest during those first 72 hours. Our protocols are designed to prevent pain when it is at its worst without much other medication—including narcotics—to augment the numbing injections.”
With good multimodal pain control for the first few days following surgery, many patients find they need less narcotics during recovery. “Once the numbing medications wear off, we use Tylenol and anti-inflammatories to control pain,” says Dr. Hansen. “The lowest grade of narcotic is a medication called tramadol. When patients do want additional pain control, most hip replacement patients don’t need more than tramadol. Our approach prioritizes patient comfort while significantly minimizing the need for narcotics.”
Use of blood thinners
“We minimize the strength of the blood thinners we use,” notes Dr. Hansen. “Typically, we’ll use aspirin unless the patient’s condition requires a more potent blood thinner. By minimizing blood thinner strength, we avoid hematomas, swelling around the surgical site, and other bleeding risks after surgery.”
Using compression socks during hip replacement recovery
“Compression socks are tight-fitting stockings to help prevent fluid from pooling in the legs,” says Dr. Hansen. “They aren’t very comfortable, and my patients don’t like them much. Still, it’s important to wear them for three to four weeks after surgery. In addition, we use sequential compression devices at our surgery center and send a portable pair home with patients. These inflatable cuffs squeeze the calves to help push fluid through the leg and prevent it from collecting in the lower leg.”
Physical therapy during hip replacement recovery
Physical therapy is a critical component of recovery after any joint surgery. “Most patients at our surgery center are on their feet and walking with a physical therapist within two hours of their surgery,” says Dr. Hansen. “Our goal immediately after surgery is to have patients walk 75 to 100 feet. The spinal can cause some muscle weakness, but with the use of our Secure Tracks system or a walker, patients can safely take those first important steps. We’ve learned that the faster patients get on their feet, the less muscle will atrophy. Immediate walking also decreases immobilization risks like blood clots.”
“Our therapists also help patients with what we call transferring,” explains Dr. Hansen. “Patients learn how to get safely in and out of bed and use a chair without putting their hip in a compromising position.”
Physical restrictions during hip replacement recovery
“There’s no restriction on how much weight can be placed on the hip following surgery,” explains Dr. Hansen. “Depending on the surgical approach, there are restrictions on extreme positions and on bending and twisting during the first few weeks after surgery. With a posterior approach, you can sit in a standard chair immediately following surgery, but it’s important to avoid bending past 90 degrees. You also want to avoid adducting, or bringing your knee across the middle of your body to cross your legs. Finally, we want you to avoid internal rotation, or twisting your foot outward. I have my patients observe these precautionary protocols for three weeks.”
Restrictions are in place because even minimally invasive hip replacement procedures disrupt tissues around the hip joint. “Movement restrictions are designed to keep hip tissues in position to heal well,” explains Dr. Hansen. “They also minimize the risks of possible instability or dislocation later on.”
A strong social structure supports recovery
“I encourage my patients to make sure they have a good support structure during their recuperation,” says Dr. Hansen. “Getting out of the house and socializing helps with recovery. A surgery like this can have mental and psychological as well as physical repercussions, especially when you are dealing with pain and decreased mobility. Healthy social interaction can really boost recovery.”
Full hip replacement recovery is evaluated periodically
Dr. Hansen schedules the first follow-up visit two to three weeks after surgery. “Within the first three months, I’ll see a patients two to three times,” he says. “After that, we schedule an evaluation at one year to make sure everything healed appropriately without issues. Then, I will see patients every few years just to keep an eye on things, or as often as they have questions or concerns.”
“Hip replacement is such an impressive surgery,” says Dr. Hansen. “Most patients with severe arthritis pain start feeling better the very day of surgery. They actually notice a difference the first time they walk on their new hip. Of course, recovery is progressive, but it takes less downtime than most patients expect. Generally, you no longer need a cane or walker after a week or two. Most people reclaim normal hip function in six to eight weeks. I tell people who do construction or physical labor that they can go back to work in six or eight weeks. That blows them away.”
When to seek treatment for your arthritis
Arthritis doesn’t have to spell the end of an active life. If you are experiencing worrisome symptoms or persistent pain, the renowned arthritis specialists at Summit Orthopedics can help. We work with you to confirm a diagnosis and develop an appropriate conservative treatment plan. If nonsurgical treatments fail to support your lifestyle goals, highly skilled orthopedic surgeons will consult with you and discuss appropriate surgical options. Summit is home to innovative joint replacement options. Our Vadnais Heights Surgery Center is one of only two surgery centers nationally to receive The Joint Commission’s Advanced Certification for Total Hip and Total Knee Replacement.
Start your journey to healthier joints. Find your arthritis expert, request an appointment online, or call us at (651) 968–5201 to schedule a consultation.
Summit has convenient locations across the Minneapolis-St. Paul metro area, serving Minnesota and western Wisconsin. We have state-of-the-art centers for comprehensive orthopedic care in Eagan, MN, Plymouth, MN, Vadnais Heights, MN, and Woodbury, MN, as well as additional community clinics throughout the metro and southern Minnesota.
More resources for you
- Meet Dane Hansen
- Read about why younger patients are getting hip replacements
- Ask Dr. Skendzel: Recovering from Hip Surgery Takes a Team
- Anterior Hip Replacement In The News