Hip replacement recovery can be long and arduous, so let’s review what we know and what to expect. In addition, let’s also go over a hip replacement alternative. Let’s dig in.
Hip Replacement Basics
Hip replacement is the amputation of the arthritic hip joint and the insertion of a prosthetic hip replacement device. There is a total joint replacement where both the ball and socket joints are replaced, as well as a partial replacement which is usually replacing the worn-out ball part (femur). In addition, there’s also what’s called a “minimally invasive” hip replacement where a smaller incision is used. There’s also a “hip resurfacing” (aka Birmingham hip) which involves using a smaller prosthesis which is usually made of metal.
What Can I Expect after Hip Replacement Surgery? How Long Does it Take to Fully Recover from a Hip Replacement? How Painful Is Hip Replacement?
Hip replacement recovery begins in the hospital. Expect to spend 2-4 days in inpatient (9). About half of the patients will report moderate to severe hip pain the day after surgery which is most frequently described as aching, stabbing and sharp. Pain the first few nights after surgery is also common (10). Return to work is usually by 12 weeks (4.5-19.5 week range) (7). About 20% of patients worked fewer hours after surgery, while 80% worked the same hours. About 1/4 of patients who took narcotics before surgery still took them after surgery, but most were able to get off the meds. (8)
Is a Hip Replacement a Major Operation?
While hip replacement recovery is something to consider, you need to understand that this procedure is the amputation of a joint and insertion of a prosthesis. Hence, it’s by definition a big surgery. There are several serious side effects possible:
- Among patients 60 and up, hip replacement patients were 25.5 times more likely to experience a heart attack in the two weeks after surgery (13)
- Pseudotumors are surprisingly common many years after hip replacement (11)
- Persistent pain after hip replacement happens in about 2/3rds of patients (12)
Are There Hip Replacement Alternatives?
Yes, one way to avoid hip replacement recovery is to consider alternatives, but you need to make sure that you act when the hip arthritis is less severe. Why? Bone marrow concentrate, a stem cell rich injection made from your bone marrow has supportive research, but only for patients with mild to moderate hip arthritis (1-6). This precise injection is performed with both x-ray and ultrasound guidance. The doctor first performs a bone marrow aspirate and then uses a machine to concentrate the stem cell fraction of that bone marrow. That product, called bone marrow concentrate is then precisely injected into the hip joint, muscles, tendons, and possibly the bone using ultrasound and/or fluoroscopy guidance.
Watch my video below to learn more about reading your own hip MRI:
One Patient’s Experience
This is the story written by one of our hip arthritis patients who was treated 9 years ago:
“My hip pain started slowly, but the aching and movement restriction progressed rapidly over a six-month timeframe. I coped by taking Advil to mask the pain. Two osteopathic Doctors at major hospitals told me there was nothing they could do. I would likely need a hip replacement in a couple of years. Believing I was too young for such a drastic procedure, I began to research alternative treatments. By the time I arrived at Regenexx for my procedure, it was difficult for me to just walk across the parking lot and I sincerely hoped I was making the right decision. Approximately 2 weeks after my treatment I noticed a real improvement. I was ecstatic that I was no longer consumed by constant pain. I’m now 66 years old and remain very active with yoga, cycling, walking, and weightlifting. I’ll be forever grateful to the Regenexx doctors for giving me back a pain-free life! THANK YOU!”
The upshot? Hip replacement recovery can be tough, but doable. However, don’t fool yourself, this is a big surgery with risks. Hence, considering all hip replacement alternatives is a good idea.
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References:
(1) Centeno et al., Efficacy and Safety of Bone Marrow Concentrate for Osteoarthritis of the Hip; Treatment Registry Results for 196 Patients J Stem Cell Res Ther 2014, 4:10. DOI: 10.4172/2157-7633.1000242
(2) Rodriguez-Fontan F, Piuzzi NS, Kraeutler MJ, Pascual-Garrido C. Early Clinical Outcomes of Intra-Articular Injections of Bone Marrow Aspirate Concentrate for the Treatment of Early Osteoarthritis of the Hip and Knee: A Cohort Study. PM R. 2018 Dec;10(12):1353-1359. doi: 10.1016/j.pmrj.2018.05.016.
(3) Darrow M, Shaw B, Darrow B, Wisz S. Short-Term Outcomes of Treatment of Hip Osteoarthritis With 4 Bone Marrow Concentrate Injections: A Case Series. Clin Med Insights Case Rep. 2018;11:1179547618791574. Published 2018 Aug 10. doi:10.1177/1179547618791574
(4) Mardones R, Jofré CM, Tobar L, Minguell JJ. Mesenchymal stem cell therapy in the treatment of hip osteoarthritis. J Hip Preserv Surg. 2017;4(2):159–163. Published 2017 Mar 19. doi:10.1093/jhps/hnx011
(5) Dall’Oca C, Breda S, Elena N, Valentini R, Samaila EM, Magnan B. Mesenchymal Stem Cells injection in hip osteoarthritis: preliminary results. Acta Biomed. 2019;90(1-S):75–80. Published 2019 Jan 10. doi:10.23750/abm.v90i1-S.8084
(6) Centeno CJ, Al-Sayegh H, Freeman MD, Smith J, Murrell WD, Bubnov R. A multi-center analysis of adverse events among two thousand, three hundred and seventy two adult patients undergoing adult autologous stem cell therapy for orthopaedic conditions. Int Orthop. 2016 Aug;40(8):1755-1765. doi: 10.1007/s00264-016-3162-y.
(7) Tilbury C, Leichtenberg CS, Tordoir RL, et al. Return to work after total hip and knee arthroplasty: results from a clinical study. Rheumatol Int. 2015;35(12):2059–2067. doi:10.1007/s00296-015-3311-4
(8) Chen EY, Lasky R, Dotterweich WA, Niu R, Tybor DJ, Smith EL. Chronic Prescription Opioid Use Before and After Total Hip and Knee Arthroplasty in Patients Younger Than 65 Years. J Arthroplasty. 2019 Oct;34(10):2319-2323. doi: 10.1016/j.arth.2019.05.050.
(9) Glassou E N, Pedersen A B, Hansen T B. Risk of re-admission, reoperation, and mortality within 90 days of total hip and knee arthroplasty in fast-track departments in Denmark from 2005 to 2011. Acta Orthop 2014; 85(5): 493–500. https://www.ncbi.nlm.nih.gov/pubmed/22826107
(10) Wylde V, Rooker J, Halliday L, Blom A. Acute postoperative pain at rest after hip and knee arthroplasty: severity, sensory qualities and impact on sleep. Orthop Traumatol Surg Res. 2011 Apr;97(2):139-44. doi: 10.1016/j.otsr.2010.12.003. https://www.ncbi.nlm.nih.gov/pubmed/21388906
(11) Hjorth, Mette Holm et al. Higher Prevalence of Mixed or Solid Pseudotumors in Metal-on-Polyethylene Total Hip Arthroplasty Compared With Metal-on-Metal Total Hip Arthroplasty and Resurfacing Hip Arthroplasty. The Journal of Arthroplasty, Volume 33, Issue 7, 2279 – 2286. https://doi.org/10.1016/j.arth.2018.02.011
(12) Pinto PR, McIntyre T, Ferrero R, Araújo-Soares V, Almeida A. Persistent pain after total knee or hip arthroplasty: differential study of prevalence, nature, and impact. J Pain Res. 2013;6:691–703. Published 2013 Sep 11. doi:10.2147/JPR.S45827
(13) Lalmohamed A, Vestergaard P, Klop C, Grove EL, de Boer A, Leufkens HG, van Staa TP, de Vries F. Timing of acute myocardial infarction in patients undergoing total hip or knee replacement: a nationwide cohort study. Arch Intern Med. 2012 Sep 10;172(16):1229-35. doi: 10.1001/archinternmed.2012.2713.