Hip replacement recovery time

[tammienorrie]

My mother who is 78 is having a hip replaced later in the summer. The surgery is being done privately as she lives alone and it needed to be done at a time my brother and I were free to be with her afterwards.

operation is scheduled for a Monday, she will stay in hospital until the Wednesday morning then brother will take her home and stay until the Monday, when I take over until the following Monday. By that point we will be 2 weeks post op. I know every case is different, but by that point should she be able to dress herself, make simple meals, be left overnight? I am closer geographically than my brother but still an hour away, after the initial 2 weeks I will be going maybe twice a week to do grocery shopping, do the washing etc.

Are we being wildly ambitious?

My late father had his done at 69. He was in hospital one night, up on his feet the same day and came back home with crutches which he barely used. He slept downstairs for one night before (unbeknown to me) tackling the stairs to go to a comfy bed. I was astonished how quickly he was back to normal actually, but he did do all his physio exercises and was on painkillers for a few days after coming home.

Oh gosh. Reading this is more worrying than I thought. My mum will tell everyone in the hospital she is fine and will discharge herself. She is in a flat with 2 flights of stairs. She just believes she will be fine. She also has had sever mentla health episodes in the past and I had no idea about the delerium.

Hmm.

Mum is a stubborn old boot who does not wallow and is determined to put the effort in to her recovery which I am hoping pays dividends. She hates being dependent on anyone. I will report back on her progress!!

I had mine at 41 and was able to walk to school (5 mins) twice a day after a week. I was very tired though. Didn’t need painkillers - in fact the worst thing was the codeine induced constipation. If she’s on that, feed her prunes!!

with insight that this isn't anwering OPs questions, but offering a slightly different perspective re the medical stuff (from an anaesthetists pov)... a high incidence of post-op delirium/cognitive dysfunction after elective arthroplasty is not the experience in all units (delirium after a hip fracture is more common though). It's also not that common to see patients transferred from the local golden nugget back to the nash because of complications (if that happens frequently it suggests something's going awry).

Elective hips are a very different thing these days to historically (increasingly being done as a day case procedure now) and any statistics from more than about 5 yrs ago may not be so useful these days because there's been a lot of fine-tuning of techniques and prescribing. Hip outcomes are very very closely scrutinised and certainly NHS departments with an unusually high incidence of delirium or significant complications would expect some pretty uncomfortable attention (the same may not be quite so much the case in the private sector though).

There are some things that increase the risk of delirium/post-op cognitive dysfunction (for example, having a pre-existing cognitive impairment; a high burden of other (particularly cardiovascular) illnesses; male sex/ being very elderly; a fondness for the sherry!) and those should be highlighted in the pre-assessment period so that those risks can be anticipated/managed where possible. The main things a patient can do to help themselves are to a) be in as good condition as possible pre-op (engage with any prehabilitation suggested/offered, stop smoking etc), b) expect to have a spinal anaesthetic unless there's a medical contraindication and ideally avoid sedation intraoperatively, but certainly don't expect deep sedation, c) don't expect masses of opioid analgesia post-op (there will be some initially but that shouldn't be for long unless someone's already taking industrial doses pre-op). Mobilising (within sensible, safe limits) will reduce the risk of infections (which may increase the risk of delirium) and blood clots but it is important to take notice of what the physios are advising though, particularly wrt hip movement, and not just go nuts with the exercise. I'd have thought that in addition to individualised assessments and planning, most private hospitals would be running 'hip school' appointments where there's a group session that explains a lot of what to expect pre-op/whilst in hospital/post op back at home - deffo worth asking if that's not been offered.

Thanks so much for taking the time to write all that @Greybeardy . My dad actually had a hip fracture about 8 years ago and died a month later. He had dementia and went downhill so quickly in hospital. All the r it dh factors - male, fond of a sherry, underlying impairment. Mums situation is very different, she is having a spinal block rather than a general which is meant to aid with her mobilising more quickly. She is very nervous about the whole thing as has never had surgery in her adult life.

My mum is 77 and had a hip replacement earlier this year. She stayed in hospital for one night and came home the next day. She lives alone and we didn’t need to stay with her overnight at all. She had got a stairlift in preparation for managing her very steep stairs and this was an absolute godsend as coming downstairs on crutches is super scary.
Between my siblings and I, we did help her out lots for a couple of weeks but by about week 6 or 7 she was doing everything for herself, including getting the bus and going to the shops.
She had very little pain. The wound pain was much less than the arthritic pain she’d had in her hip. She’s now looking forward to getting her other hip done, hopefully in the next few months.
Just wanted to add that my mum also had a spinal block instead of general anaesthetic and said she would definitely do that again next time. She was given meds to make her woozy enough not to really remember the op. All she remembers is listening to the songs from !es Mis which she had requested to be played during the surgery. As soon as the op was over she was putting on her mascara and eating a sandwich without any of the grogginess you’d get after a general.

My mum sounds exactly like yours. She wouldn’t allow us to stay with her overnight and was determined to get back to normal as soon as possible.

It actually is a lot quicker than you think it will be. The main thing after the first few days is changing the support stockings. But two weeks will be plenty for her to need someone with her.

I’m not sure about support stockings. We were told about the injections, can’t remember if they said stockings or not,

Maybe not, since she’s not having general anaesthetic.

My mum had a hip replacement last week aged 90 also privately due to family commitments. She’s usually very fit and well. She was out of theatres at 3pm and walked to the toilet with a frame at 6pm. Is actually doing incredibly well pain wise and mobility wise. Her hip was absolutely knackered and she was in so much pain pre op that I think her post op pain has been a breeze.
she needs help pulling her pants up and putting her slippers on. Don’t know if that helps. I will try to update if I remember next week. Hope all goes well with your DM

Forgot to say, mum mum had a spinal. Not a GA

Oh and she is on tablets for blood thinning not the injections. Said that’s what the hospital usually use (spire)

My MIl was in hospital for around 6 weeks then a hospital to home facility (basically a care home) for around 2 months.

She was early 80's and it was emergency surgery after a fall rather than preplanned so although it's unlikely to be that long for your Mum, it will be a good few weeks.

My MiL had an elective hip replacement in her late 80s, due to arthritis. She also has osteoporosis. She was doing OK after the op for three weeks or so but then they think developed a hairline fracture in her pelvis - the pain worsened suddenly and she was really set back to square one, although she did then go on recovering, but it delayed everything. The osteoporosis probably contributed to that.

We think she possibly bent more than was advised or possibly had overdone the moving about, though it may just have been bad luck.

However she managed independently with just daytime family visits to help with cleaning etc, all through that as well, after the first few nights.

Wow. The not driving was 6 weeks for me too, but managing stairs was a requirement for discharge - I could do it the next morning and was discharged 16 hours after surgery!

Other than that I agree that it was mostly minor adjustments like grabbers, a tool to help put on socks, and being cautious about not getting into certain positions or movements. I found a perching chair in the kitchen and a shower seat helped.

Lots of areas have reablement teams to provide support for up to 6 weeks which is ideal for this type of situation.

Check whether the private hospital will refer, if not you might have to ask your dm’s GP.

The physio team in the hospital have said they will not discharge until she can get to the loo by herself and in and out of bed. Stairs not really an issue.

Reporting back. We are a week post op. They had her up and standing with the support of a zimmer 5 hours after surgery. She is now home and managing on crutches, can wash and dress herself - isn’t wearing socks as it has been warm. No delirium at all. The worst thing has been trying to get comfy in bed, she usually sleeps on her side and is finding sleeping on her back very unnatural and not being able to roll over in the night is leading to disturbed sleep.

Sounds like she’s doing great! Thanks for the update

Thanks for the update, I'm glad she's doing well. Try a V shaped pillow for sleeping, I'm a side sleeper and was always worried about rolling over in my sleep, but the pillow stopped me worrying and l slept much better with it. Also, I didn't get the pillow immediately, and after a while my physio said that by then the risks of side sleeping were minimal and it was more important to get some decent sleep. He showed me how to arrange pillows to support my operated leg. A week is probably a bit soon but worth looking into a bit further down the line.