Hip revision precaution height: managing at home post-surgery

It’s two weeks now since I came home from hospital after my hip revision surgery (all due to my hip dysplasia).  In some ways time has flown, in others it has dragged.  It’s a bit like Groundhog Day; punctuated by exercises, napping, walking on crutches, eating, washing, a bit of TV, a para of the blog and then start again.

What marks out a hip revision surgery is the need to restrict certain movements until the hip socket sets in place securely.  So that the screws holding the socket into the filler in the pelvis set.  Big movements are a big no.  And I have a strict precaution height.

The restrictions are:

• No walking without crutches. To limit my movement and weight-bear sensibly
• No flexing the hip to 90 degrees plus.  So I can’t sit on a chair, bed, toilet lower than 47cm (18.5 ins) – my precaution height.
• No twisting or rotating in a way that could allow the ball to slip out of the socket. So no low chairs, no squatting and no stepping in and out of a bath. Flannel wash only for 6 weeks!
• No sleeping on my side even with a pillow between my knees. It is difficult to sleep in the same position all night, but I can only sleep on my back.
• No crossing my legs.
• No hip-bridging exercises. All the physio exercises have quite a small range.
• No driving and extreme caution getting into and out of a car to manage precaution height.  We have a mini so this has been fun!

All of the constant thinking, minding how I’m moving, is mentally tiring.  

What is a precaution height?

Put simply, the precaution height is the lowest furniture you can sit on.  It means you don’t end up flexing the hip too deep when sitting, or standing up from a seat, and so don’t risk the hip dislocating (painful) and then weakening the fixings.

It’s calculated based on the height of your knee to the floor when sitting in a chair (you make the measurement before surgery). 

Most dining chairs are about 40cm high. Sofas and toilets can bit lower.  I also need arms on anything I’m going to sit on, so I can take the weight on my arms and lower or raise myself up whilst protecting the hip and keeping the leg straight.

This led to me purchase things for home before surgery, like a high seat chair with arms, a raised toilet seat, and a second hand single bed that’s quite high from the ground. 

The hospital also sent me home with a loaned sit/perching stool for the bathroom so I can sit at the sink and wash, or at the kitchen counter to make a sandwich.  A Leg-Up leg lifter, so when I slide back onto the bed, I have a way of pulling my operated leg round.  A sock buddy (weird contraption to pull on socks, which so far has been usurped by boyfriend LOL!), and lots of grabbers to pick things up.

Pain and bruising

The first few days home I was still on power painkillers because I had breakthrough pain from the incisions, the nerve disturbance, and the internal bruising.  These also helped me sleep, especially when first in bed. But they do contribute to nausea and dizziness and I don’t need more of that post-surgery!

After three days I’ve been only on paracetamol and ibuprofen, and I would describe it as mild pain and discomfort.  Doing my exercises was sore until the bruising and swelling reduced – this subsided after about a week, so 10 days post-surgery.

And I’m on blood thinners, to ensure I don’t develop clots, until the end of July.  Which means being super careful not to cut myself or develop any new deep bruises.

Sitting in a chair or perching on the stool was difficult for the first week.  Then each day the swelling reduced – it was like an extra bit of my sensation returned.  Right now I can can still only sit for about an hour before I have to move due to discomfort.  When I first got home this was 15 mins.

The incision/wound

I had the wound checked yesterday by the local GP nurse. It’s all looking clean and healing well (they went in using the same anterior scar from my hip replacement 22 years ago). Thankfully no staples to remove like I had with the knee, just self-dissolving sutures.

What’s worse – hip or knee surgery?

The pain from the knee replacement was 10x that of the hip revision.  Those first three weeks of throbbing pain and the lack of sleep for 3 weeks I hope never to repeat.  By comparison this hip surgery has been child’s play – pain-wise.  

Howvever, the movement restrictions from the hip revision are more limiting right now.  I could do more (pain aside), more quickly, with my knee.  I didn’t have this 6 weeks of restrictions. So the hip revision is going to take longer to recover from.

Physio exercises

By far the exercising is walking.  Weight bearing (with crutches) to build strength and encourage new bone to develop is part of the PT routine.

For the first two weeks I had a few exercises, each with limited range;

• laying: ankle holds, quad holds (pushing my knees back into the bed), hip bends (sliding the heel up to bed bending the knee), buttock squeezes – definitely sore for the first week!  Plus straight leg hip abduction which I have never been able to do easily without help.
• standing: hip abduction, hip bend (lifting the knee a bit), hip extension (leg back), and heel raises up to tip toe.
• sitting: seated knee extensions for both legs, strengthening the quads

I’ve been doing these religiously 3x a day.  And it’s amazing how much easier they get once my body (and brain) is trained to do them.  A marker of progress.  Little victories.

Always followed by an ice pack to relieve the pain/soreness from doing them.

Friends on rota – thank you!

After one week home my partner had to return to work (for a rest, LOL) and I’m grateful for the friends who came in on rota that first long weekend, to break up the day and help me.  I express just how lovely it was to see you folks; for the lunches, the cuppas, the hair washes, the washing hang-outs, the plant watering, the cat feeding and basically just letting me live vicariously by hearing about things other than my regular Groundhog Day existence.

Of course the biggest thanks go to my loving and patient partner and my emotional support cat.  I can’t imagine the last two weeks without them.

And to all of you out there reading these posts, and sending good wishes, thank you and love to you all.  Until next time… xx

Jill Pringle was born with bilateral hip dysplasia 53 years ago. She writes this blog to share her experiences of living and walking with this condition, and about her adult and childhood orthopaedic surgeries. Jill is also a proud differently-abled supporter of Steps Charity, who help children and adults who can’t take walking for granted.