- What You Need to Know About Hip Replacement and DVT
- Deep Vein Thrombosis After Hip Surgery
- DVT Symptoms to Watch For
- Take Steps to Prevent Blood Clots of DVT
- Prevention and Treatment of Blood Clots after Hip and Knee Replacement Surgery
- Joint replacement surgery increases risk of blood clot formation in certain patients, study finds
- Risk of Blood Clots After Surgery: It’s Possible
- Blood Clots in Orthopedic Surgery Fact Sheet
- DVT and PE Incidence and Impact
- NBCA DVT and PE Awareness Survey
- Key Survey Findings among THA/TKA Surgeons: General DVT/PE Prophylaxis Preferences
- Key Survey Findings Among THA/TKA Surgeons and Patients: Information Provision
- Key Survey Findings Among THA/TKA Patients: DVT and PE Awareness
- Key Survey Findings Among THA/TKA Patients: Information
- Key Survey Findings Among THA/TKA Patients: Prophylaxis
- Risk Factors for DVT and PE Include:
- Signs and Symptoms of DVT and PE Include:
- Device to Revolutionize Preventive Blood Clot Care After Joint Replacement Surgery
- What to Expect After Hip Replacement Surgery
- Exercises to help you recover from hip replacement surgery
- Driving after hip replacement surgery
- Preventing a blood clot after hip replacement surgery
- Going back to work after hip replacement surgery
- Learn More
What You Need to Know About Hip Replacement and DVT
Every year about 332,000 Americans have a hip replaced, according to the U.S. Centers for Disease Control and Prevention. The surgery puts each one of them at risk for a dangerous blood clot.
You can develop a blood clot, called a thrombosis, in the deep veins of your body after undergoing any surgery. Joint replacement surgery puts patients at slightly higher risk, says Alejandro González Della Valle, MD, an orthopedic surgeon at the Hospital for Special Surgery in New York City and a spokesman for the American Academy of Orthopaedic Surgeons (AAOS).
Deep Vein Thrombosis After Hip Surgery
The risk for deep vein thrombosis (DVT) after hip surgery is slightly higher because of a combination of factors, Dr. González Della Valle says. One is the way your surgeon must manipulate your bones to place the new joint. This “can force bone marrow into your venous system, which activates coagulation, and so you can form blood clots,” he says.
A second reason DVT risk is higher is that during and after surgery you are immobile for some time. Under anesthesia when your legs are still, the blood flow through your veins slows. When your blood doesn’t flow normally, the natural clot busters in your blood don’t work as well, according to the American Academy of Orthopaedic Surgeons (AAOS).
The academy also notes age is a risk factor for the blood clots of deep vein thrombosis, with older people at higher risk.
After hip surgery, clots may form in the veins in your thigh. These are of greater concern, according to the AAOS. Blood clots are more likely to occur in your calf after knee surgery.
“The higher you go into your leg, the bigger the veins are,” González Della Valle says, and bigger clots have a higher chance of leading to a pulmonary embolism (PE) — a blood clot in the lungs.
That’s what happens when a piece of a blood clot that’s formed in the legs breaks off, travels to the lungs, and lodges there. It happens in a small number of people, but a PE can be life-threatening. About one in every 100 people who develops a DVT dies of a pulmonary embolism, reports the Society of Interventional Radiology.
You are at greatest risk for developing a DVT from two to five days after your operation, according to the AAOS. Another peak period of concern is 10 days after surgery, when you’re likely to be at home or in rehab. However, the AAOS reports that you still can be at risk for at least three months after your surgery.
RELATED: 10 Questions to Ask Your Doctor About DVT
DVT Symptoms to Watch For
It’s important to know the symptoms of DVT. Tell your health care provider if you experience any of them after surgery.
Symptoms of DVT, according to Johns Hopkins Medicine, include:
- Painful or tender calves
- Swollen calves
- Redness or warmth in your leg
- Low-grade fever
- Faster-than-normal heartbeat
Take Steps to Prevent Blood Clots of DVT
Most people undergoing orthopedic surgery would develop a DVT without preventive steps, according to the AAOS. The Agency for Healthcare Research and Quality says that taking preventive steps can reduce your risk from 40 percent to 20 percent, or less.
That makes it important, if you’re planning to have hip replacement surgery, to alert your surgeon to any risk factors for DVT that you might have.
Risk factors for DVT, according to Johns Hopkins Medicine, include:
- Being on hormone replacement therapy or oral contraceptives
- Having a personal or family history of DVT
- Having certain other diseases or conditions, including cancer, varicose veins, heart disease, and inflammatory bowel disease
To prevent a DVT after your surgery, ask your doctor whether these preventive steps would be appropriate for you:
- Wear compression stockings or a compression device. Researchers found that wearing a compression device could be as effective as taking blood thinners in stopping DVT in people having surgery to replace a lower extremity joint. Their findings were reported in the Journal of Bone & Joint Surgery in February 2014.
- Get up and move as soon after surgery as you can. The sooner you’re up and out of bed, the better, according to the AAOS. Your health care team should give you a list of exercises to do starting the day after your surgery. The exercises will help you regain your range of motion and balance and help avoid a DVT from immobility.
- Take anticoagulants (blood thinners). Johns Hopkins Medicine reports that your doctor may give you anticoagulants, or blood thinners, to use for six months or more after surgery to reduce the chances of a DVT forming. How long the drug should be taken varies from drug to drug and person to person. However, González Della Valle says surgeons today generally prescribe anticoagulants only for those who are at higher risk for developing a DVT and can safely take them. That’s because you are at risk of side effects like bleeding excessively when taking these prescription medications.
Prevention and Treatment of Blood Clots after Hip and Knee Replacement Surgery
Taking steps for the prevention and treatment of blood clots after hip and knee replacement surgery is an important part of your recovery. Joint replacement patients are at highest risk for developing a DVT two to 10 days after surgery, and remain at risk for approximately three months.
To prevent the occurrence of a blood clot, your doctor will likely prescribe a combination of treatment approaches for you, which may include:
- Exercise/physical therapy beginning the first day after surgery and continuing for several months
- Compression stockings
- Anti-clotting medicine to reduce the body’s ability to form blood clots
Exercise or Physical Therapy
You will likely work with a physical therapist to perform specific exercises that are designed to restore joint range of motion, strengthen your lower body, and improve circulation in your deep veins. For knee replacement, your doctor may recommend the use of a continuous passive motion (CPM) machine that slowly moves your knee.
Mechanical Prevention Therapies
Graduated compression stockings are graded (they are tight at the ankle and become looser higher up on the leg). There are also pneumatic, or mechanical, compression devices available. The compression action is thought to help circulation and reduce the risk of blood clots by preventing blood from pooling in the veins. Your doctor may prescribe compression stockings for you to wear or provide details about what to purchase over-the-counter. Your doctor may also prescribe pneumatic compression devices that use air pumps to massage blood out of the lower leg and back to the heart, similar to compression stockings. These devices are also thought to reduce the chances of a blood clot by keeping blood from pooling in the legs where a blood clot can form.
An anti-clotting medication may be prescribed to prevent blood clots and to treat them. This class of drug is referred to as an anticoagulant, or blood thinner.
Joint replacement patients typically begin to receive anti-clotting medicine the day after surgery, continuing throughout their hospital stay and into at-home rehabilitation. The length of your treatment with anti-clotting medicine and the type of medication you are prescribed will be determined by your physician and a variety of factors.
There are several types of drugs that fall into the anti-clotting medicine category:
- Heparin: Standard heparin and low molecular weight heparin are given by an injection under the skin. You may be able to give yourself the injections, or have a visiting nurse administer them.
- Warfarin: Your doctor may prescribe warfarin instead of heparin or low molecular weight heparin for blood clot prevention. Warfarin is taken orally in pill form once daily.
- Direct Oral Anticoagulants: These drugs are the newest type of anti-clotting medicines and are available in a pill form, which are also taken orally once or twice daily depending upon which medication you are prescribed by your doctor.
You and your doctor should review your treatment options together, along with their pros and cons and possible side effects. Some of the drugs require adherence to a schedule, careful management of your diet, and regular blood testing. All of this can be managed, but should be considered, along with your insurance coverage for the medication, when selecting a treatment options. Click here for more specifics about the use of each type of medicine.
Blood Clot Signs and Symptoms
While you are recovering from your joint replacement surgery, be on the lookout for possible blood clots and contact your physician immediately if you experience any of the signs or symptoms of a blood clot.
Symptoms of Deep Vein Thrombosis (DVT or blood clots in your leg or arm)
- Swelling, usually in one leg (or arm)
- Pain or tenderness not caused by an injury – it often feel like a leg cramp that will not go away
- Skin that is warm to the touch
- Redness in skin
If you experience any of these symptoms, call a doctor as soon as you can.
Symptoms of Pulmonary Embolism (PE or blood clots in your lungs)
- Difficulty breathing
- Chest or back pain that worsens with a deep breath
- Coughing, or coughing up blood
A PE can be fatal, if you experience any of these symptoms, call 9-1-1 or seek immediate medical attention.
NBCA’s Stop the Clot® THA/TKA Patient Toolkit was made possible by an educational grant provided by Janssen Pharmaceuticals, Inc.
Joint replacement surgery increases risk of blood clot formation in certain patients, study finds
Pulmonary emboli, or blood clots in the lungs, occur when a clot that forms within veins elsewhere in the body — often in the lower legs or other limbs — breaks free and travels to the lungs, where it can cause serious complications. Pulmonary emboli can occur in patients of any age and common factors associated with an increased risk of clot development include:
- oral contraceptive use;
- cardiovascular disease;
- prior clot formation;
- clotting disorders;
- family history of clots; or
- advanced age.
A new study focusing on the occurrence of clots in knee replacement patients and published in a recent issue of the Journal of Bone and Joint Surgery (JBJS) indicates that despite treatment with blood thinners prior to and immediately following joint replacement surgery, the risk of clot formation is still relatively high in certain patients.
“The rate of knee replacement has increased substantially worldwide, and continued increases are anticipated in the future,” said study author Alma Pedersen, MD, PhD. “The formation of clots, including pulmonary emboli, is a serious complication in patients undergoing knee arthroplasty. Prophylactic measures, such as the use of blood thinners around the time of surgery, are used to reduce the occurrence of clots, but their effectiveness in routine clinical practice following surgery is more uncertain.”
Study Details and Findings
The authors evaluated 37,223 knee replacement patients who had surgery between 1997 and 2007, looking for evidence of post-surgical embolism in the 90-day period following surgery.
The authors found 441 patients (1.2 percent) were hospitalized for blood clots during the 90-day period following knee surgery. An in-depth evaluation of these patient records revealed the following risk factors associated with clot development:
- advanced age (older than 80 years of age);
- history of cardiovascular disease;
- history of previous clot; or
- increased number of accompanying medical conditions.
The study also revealed the number of patients admitted to hospitals with clots following knee surgery has increased since 1997, which Dr. Pedersen noted is most likely due to advances in diagnosis which have enabled physicians to identify clots before they cause serious problems. The study also notes that individuals who have a knee replacement surgery due to rheumatoid arthritis have a lower risk of clots than those with other conditions. However, in all patients, the risk can be diminished slightly by replacing only one knee at a time, rather than both.
Although knee surgery is still a generally safe procedure, which enables thousands of men and women each year to regain mobility lost to injury or illness, patients should be aware of the risk of post-surgical clotting and talk with their physician about the possible use of blood thinners and follow-up evaluations that may help to identify clots which may be treated before they cause problems. Although blood thinners are typically prescribed only during hospitalization, the study suggested that physicians consider extending the duration of blood thinner therapy into the weeks following surgery.
“Despite the use of blood thinners, patients undergoing knee arthroplasty continue to remain susceptible for clot formation for several weeks following surgery,” Dr. Pedersen said. “Future studies should focus on the improvement of prophylaxis following hospital discharge, particularly among elderly patients and those with a history of cardiovascular diseases or previous clot formation.”
Risk of Blood Clots After Surgery: It’s Possible
Why there’s a risk of blood clots after surgery
- Your blood flows too slowly through your veins
When your blood flows freely, it mixes with naturally occurring anticoagulants in your blood that help keep it from clotting and keep it flowing smoothly. When you’re not moving around—like after surgery—your blood flow slows down and doesn’t mix with those anticoagulants. This makes blood clots more likely to form.
- Surgery releases particles into your bloodstream
When you have surgery, it’s possible for small particles of matter like tissue, collagen, or fat to be released into your bloodstream. Your blood will then thicken around these foreign particles. If too many of them clump together, they can form a clot large enough to block blood flow.
- Your natural blood-clotting processes are more active after surgery
When your surgeon moves soft tissues like ligaments, muscles, or tendons in order to reach the joint being operated on, this sometimes triggers your body to release substances that promote blood clotting. A similar thing happens when a surgeon needs to work with your bones—like when they are preparing the area to receive your new, artificial joint.
Blood Clots in Orthopedic Surgery Fact Sheet
DVT and PE Incidence and Impact
Deep vein thrombosis (DVT or blood clots in the leg or arm) and pulmonary embolism (PE or blood clots in the lung) are often under-diagnosed and serious, but preventable medical conditions.
It is estimated that up to 600,000 people in the United States are affected by blood clots each year, and that up to 100,000 Americans die each year due to a blood clot in the lung.
10 to 30 percent of people affected by PE will die within one month of diagnosis.
In about 25 percent of people who experience a PE, the first symptom is sudden death.
Among people who have had a DVT, one-third will have long-term complications (post-thrombotic syndrome) such as swelling, pain, discoloration, and scaling in the affected limb.
One-third (about 33 percent) of people who are diagnosed with blood clots will have a recurrence within ten years.
In orthopedics, joint replacement surgery is becoming more common. Orthopedic surgeons performed about 520,000 hip replacements and about 581,000 knee replacements in 2006.
DVT is widely recognized as a major risk factor facing patients who undergo total hip arthroplasty (THA) and total knee arthroplasty (TKA).
Without prophylaxis (preventive treatment), up to 80 percent of orthopedic surgical patients will develop DVT, and 10 to 20 percent will develop PE.
Even when proper prevention measures are taken, it is estimated that 3 percent of orthopedic surgical patients will develop DVT, and 1.5 percent will develop PE.
DVT and PE remain the most common cause for emergency re-admission and death following joint replacement surgeries.
NBCA DVT and PE Awareness Survey
The NBCA DVT and PE Awareness Survey was conducted to:
- Document self-reported prophylaxis treatment among THA/TKA surgeons
- Measure THA/TKA surgeon perceptions about anticoagulant treatment barriers
- Benchmark DVT and PE awareness among THA/TKA patients
- Measure THA/TKA patient perceptions about anticoagulation barriers
The National Blood Clot Alliance conducted an online survey of 200 US orthopedic surgeons who perform hip and knee replacements. Mean procedure volume for these surgeons was 76 annually. For comparison, an online survey among 250 patients, over 20 years old (20 to 80 plus years old, the mean age being 54 years old; 55 percent female) who had undergone THA/TKA surgery within 12 months of sampling also was conducted.
The THA/TKA surgeon survey consisted of 67 questions along three different paths:
- General DVT prophylaxis preferences in THA/TKA
- Specific DVT prophylaxis practices/perceptions related to warfarin and low molecular weight heparin
- Information provision to THA/TKA patients/families
The THA/TKA patient survey consisted of 62 questions along four different paths:
- Awareness of DVT and PE
- Information received from healthcare professionals about DVT and PE
- Prophylaxis experiences related to DVT and PE
- Adherence to anticoagulation
Key Survey Findings among THA/TKA Surgeons: General DVT/PE Prophylaxis Preferences
99 percent of THA/TKA surgeons surveyed report routine use of DVT and PE prevention practices for most THA/TKA patients.
71 percent of surgeons surveyed prefer AAOS guidelines
Key Survey Findings Among THA/TKA Surgeons and Patients: Information Provision
97 percent of surgeons surveyed report they provide DVT risk information to THA/TKA patients all or most of the time.
THA/TKA patients say doctors and health care providers (HCPs) in orthopedics provide information about blood clot risk (80 percent) and consequences of blood clot formation (74 percent), but patient awareness is low.
Key Survey Findings Among THA/TKA Patients: DVT and PE Awareness
Among all THA/TKA patients surveyed, 71 percent and 79 percent had not heard of a condition called DVT or PE, respectively, when these specific terms were used.
While THA/TKA patients have a very low awareness of DVT and PE, the survey showed that most patients (77 percent) do know what a blood clot is, and virtually all respondents (97 percent) recognize that blood clots can be life threatening.
Key Survey Findings Among THA/TKA Patients: Information
When asked how they acquire medical information, the top responses were: from their doctor (84 percent), from the Internet (71 percent), from nurses (38 percent) and from family members (22 percent) and health advocacy organizations (22 percent).
Nearly two-thirds (63 percent) of THA/TKA patients said they did not receive additional information or referral to additional information from doctors or HCPs about blood clot risks related to THA/TKA surgery. Among the 39 percent of THA/TKA patients who did receive educational material or were referred to educational materials, brochures were most common among the materials they received. When asked to rate such materials, more than 80 percent of these same respondents cited CDs, DVDs, and Web sites as “very useful.”
Key Survey Findings Among THA/TKA Patients: Prophylaxis
Patient-reported experiences with prophylaxis varied widely: 83 percent ambulation, 74 percent compression stockings, 57 percent mechanical compression, 58 percent anticoagulant pill, 46 percent anticoagulant injection, 42 percent aspirin.
Risk Factors for DVT and PE Include:
- Hospital Stay
- Major surgery, such as abdominal/pelvic surgery
- Knee or hip replacement
- Major trauma
- Nursing home living
- Leg paralysis
- Older than age 65
- Trips of more than four hours by plane, car, train or bus
- Active cancer, chemotherapy
- Bone fracture or cast
- Estrogen-based birth control pills, patch, or ring
- Hormone therapy
- Pregnancy or recently gave birth
- Prior blood clot or family history of a clot
- Heart failure
- Bed rest for more than three days
- Genetic/hereditary or acquired blood clotting disorder
Signs and Symptoms of DVT and PE Include:
Deep vein thrombosis (DVT or blood clot in the leg or arm)
- Swelling, usually in one leg
- Leg pain or tenderness
- Reddish or bluish skin discoloration
- Leg warm to touch
These symptoms of a blood clot may feel similar to a pulled muscle or a “Charlie horse,” but may differ in that the leg (or arm) may be swollen, slightly discolored, and warm.
Contact your doctor as soon as you can if you have these symptoms, because you may need treatment right away.
Pulmonary embolism (PE or blood clot in the lung)
- Sudden shortness of breath
- Chest pain-sharp, stabbing; may get worse with deep breath
- Rapid heart rate
- Unexplained cough, sometimes with bloody mucus
Call an ambulance or 911 immediately for treatment in the ER if you experience these PE symptoms.
Device to Revolutionize Preventive Blood Clot Care After Joint Replacement Surgery
New York City—March 29, 2010
A mobile compression device is as effective as medication at preventing the formation of blood clots after hip replacement surgery but provides greater patient safety, according to a study in the March issue of the Journal of Bone & Joint Surgery.
“This device is as useful as blood thinners for the reduction of blood clots after hip replacement and it’s superior in safety,” said Douglas E. Padgett, M.D., chief of Adult Reconstruction and Joint Replacement at Hospital for Special Surgery, one of the investigators and final author. “This has the potential to change the paradigm as to how we prevent blood clots after hip replacement. The efficacy is the same, the safety is markedly better and the cost is comparable. This essentially raises the specter of ‘can we use mechanical agents in lieu of the pharmacologic agents to prevent blood clots.’”
Roughly 30 percent to 50 percent of patients undergoing joint replacement surgery, either hip or knee replacement, will develop thromboembolic disease unless they receive preventive care. In people with this condition, blood clots form in veins; if a clot breaks away, it can travel to the lungs causing pulmonary embolism and death. For preventive care, doctors have the choice of using blood thinners or a compression device that wraps around the leg and pumps the leg to maintain normal blood flow.
“The College of Chest Physicians believes the best way to prevent blood clots is to use pharmacologic agents to thin the blood and make it difficult to clot,” Dr. Padgett said. “Orthopedic surgeons on the other hand have to balance the desire to reduce the risk of blood clots with the reality that many of these chemical modalities that thin the blood are in fact associated with bleeding and hemorrhagic complications.”
Until now, the compression devices available were large, could only be used in hospitals and prevented walking. Recently, a company has manufactured a small, battery-operated compression device that people can wear that allows for its use outside of the hospital. The sleeve fits over a patient’s calves in a form fitting manner and is secured with Velcro. The mobile device is smart in that it applies intermittent, sequential pressure to the leg in correlation with the patient’s respiratory cycle, maximizing blood flow to reduce the risk of clot formation. The device is approved by the Food and Drug Administration.
“The other devices that are available are stationary. These are mobile,” said Dr. Padgett. “Back in the day, people used to stay in the hospital for upwards of 10 days, but we are in a whole new day and age now. Patients are leaving the hospital after 48 hours after hip replacement, but it is still the same operation.”
To test the effectiveness and safety of the mobile compression devices, investigators recruited 410 patients who were undergoing hip replacement from a number of hospitals, including Hospital for Special Surgery, Mayo Clinic, Scripps Clinic and the Cleveland Clinic. Patients were randomized to either the compression device, use of which started during surgery and then for 10 days after surgery, or low-molecular-weight heparin, a commonly used blood thinner, for ten days. At ten days, most patients are ambulatory and do not need the device. Of the patients who consented, 392 patients were evaluable in terms of safety and 386 patients were evaluable in terms of efficacy. Doctors could tell whether patients were actually wearing the device by checking the internal timer in the pump unit. The timer detects the amount of time that the device is properly functioning and is actually being worn by the patient.
To look for deep vein blood clots, doctors conducted ultrasounds on patients’ calves and thighs 10 to 12 days after surgery. The investigators found that in patients taking heparin, major bleeding occurred in 6 percent whereas no patients using the mobile device developed major bleeding. Major bleeding events are those that require transfusions or additional surgeries. Blood clots in deep veins below the knee formed in 3 percent of patients in both groups, but blood clots in deep veins above the knee formed in 2 percent of patients receiving heparin compared with 1 percent of patients using the mobile device. Clots that occur above the knee are more dangerous, in that these clots are more likely to break off and travel to the lung where they can result in death.
“This study allows us to take the next step which is to test the device in a larger study with an even larger recruitment of number of centers and number of patients to see if in fact we can quite frankly start to use this device for all elective hip replacements, and eventually knee replacements, and get rid of using chemical prophylaxis,” Dr. Padgett said. Hospital for Special Surgery will be using the device in the Rapid Recovery total hip replacement protocol for patients who are being discharged within 48 hours.
The mobile device, called the Continuous Enhanced Circulation Therapy plus Synchronized Flow Technology compression device, is manufactured by Medical Compression Systems, located in Or Akiva, Israel. Medical Compression Systems provided some funding for the study.
What to Expect After Hip Replacement Surgery
Hip replacement surgery is becoming increasingly common. Approximately 300,000 of these surgeries occur each year in the United States—a number anticipated to nearly double by 2030.1
Learn more: Total Hip Replacement for Hip Arthritis
Despite the ubiquity of hip replacements today, it is always helpful to know what to expect once surgery is over.
Hip replacement can restore mobility to a hip joint damaged by osteoarthritis. Watch: Hip Osteoarthritis Video
While your physician will provide specific instructions to fit your individual needs, there are several general guidelines to keep in mind following your operation.
Also, keep in mind that your recovery instructions and time frames may be different if you choose an alternative approach to hip replacement that involves smaller incisions or less muscle damage, such as anterior or minimally invasive hip replacement surgery.
See Postoperative Care for Hip Replacement
Exercises to help you recover from hip replacement surgery
Early activity is important following hip replacement surgery. In fact, some patients are walking short distances the same day as the procedure.
Physical therapy usually starts the day after surgery, and continues for about two months after the operation.2 Typically, a physical therapist will show you exercises to do at home while you are still in the hospital.
See Hip Replacement Surgery Rehabilitation Exercises
You may go to a rehabilitation facility for a period of time after you are discharged from the hospital; otherwise, you will go home. Either way, it’s important to stay active: walking and doing the exercises prescribed by your therapist or physician. Anticipate doing about 20 to 30 minutes’ worth of exercises several times each day, every day.
The benefits of early activity include:3
- Aiding in your recovery process
- Providing circulation to your legs and feet, helping to reduce the chance of developing a blood clot
- Increasing muscle strength and enhancing hip movement
Exercises will be mild at first, and can include gentle movements, such as knee bends, ankle rotations, and leg raises. Longer term, you will be able to resume an active lifestyle. Low-impact sports make great exercise choices: swimming, golfing, walking, and cycling, among others. But some activities may need modified or eliminated to prevent excessive wear and tear on your hip, like basketball and running.
See “When Can I…?” Answers for Hip Replacement Patients
Driving after hip replacement surgery
The time it takes to return to driving after hip replacement varies, generally from 2 to 8 weeks.
This time frame is dependent on several factors:
- You will need to have stopped taking narcotics for pain.
- You will need to have the stamina to drive, and have your reflexes back to normal.
- If you have surgery on your right hip, you may be advised to wait about one month before driving. This precaution is to make sure you have developed enough strength in your right leg to operate the car’s pedals. You may be able to drive in about two weeks if you have surgery on your left hip and have a car with automatic transmission.
Above all, it is best to listen to your body and doctor’s advice.
Exercises such as heel slides can help you regain strength and recover more quickly after a hip replacement. Learn more: Hip Replacement Surgery Rehabilitation Exercises
Preventing a blood clot after hip replacement surgery
Patients undergoing hip replacement surgery are at risk of developing a blood clot from deep vein thrombosis (DVT). Given this risk, your physician may advise you to:
- Take blood thinning medication
- Perform early movement and ankle exercises
- Wear compression stockings
- Elevate your feet
Two to ten days after orthopedic surgery is your highest risk of developing a blood clot, but you are still at risk for approximately three months following surgery.4
See Post-Surgical Hip Replacement Precautions and Tips
Additionally, your physician may advise you to wait 3 to 6 weeks after surgery before flying. This is because certain factors associated with flying—dehydration and prolonged sitting—can contribute to blood clots.
More broadly, whether you’re flying, driving, or taking the train, it is important to:
- Get up periodically and walk around
- Stay hydrated with fluids that will not dehydrate you, like alcohol and caffeinated coffee
Blood clots are potentially life-threatening: a blood clot in the leg could travel to the lung. A blood clot in the leg is typically characterized by swelling and pain. That said, you should seek medical help if a blood clot is suspected.
Going back to work after hip replacement surgery
Returning to work is dependent on your recovery rate. People with an office job usually return to work within 6 weeks; jobs requiring a lot of standing and manual labor take longer.5
Any surgery poses some risks and takes time to recover. But a hip replacement is one of the more successful orthopedic surgeries,6 so if you follow you doctor’s directions you stand a good chance for a successful recovery and a return to a more active life.
Choosing a Surgeon for Total Hip Replacement Surgery
Anterior vs. Posterior Hip Replacement Surgeries
- 1.Physical therapy after hip replacement: Can rehab happen at home? Harvard Health Publications Harvard Medical School website. http://bit.ly/27VwwGl Published May 2016. Accessed May 25, 2016.
- 2.Activities After Hip Replacement. American Academy of Orthopaedic Surgeons. http://orthoinfo.aaos.org/topic.cfm?topic=a00356 Last reviewed July 2014. Accessed May 25, 2016.
- 3.Total Hip Replacement Exercise Guide. American Academy of Orthopaedic Surgeons. http://orthoinfo.aaos.org/topic.cfm?topic=a00303 Last reviewed July 2007. Accessed May 19, 2016.
- 4.Deep Vein Thrombosis. American Academy of Orthopaedic Surgeons. http://orthoinfo.aaos.org/topic.cfm?topic=a00219 Last reviewed June 2015. Accessed May 25, 2016.
- 5.Fisher SJ. 100 Questions & Answers About Hip Replacement. Sudbury, MA: Jones and Bartlett Publishers; 2011.
- 6.Hip Replacement. National Institute of Arthritis and Musculoskeletal and Skin Diseases website. http://www.niams.nih.gov/health_info/hip_replacement July 2013. Accessed May 27, 2016.