Depending on the extent of problems in the hip and the type of surgical procedure you had, your recuperation times and return to functional activities may differ.
Dr. J. Pieter Hommen is a board-certified orthopedic surgeon who has been performing hip arthroscopy in Miami since 2005. He has served as a Master Instructor of hip arthroscopy to orthopedic surgeons and residents and is involved in academic research.
Patients often inquire about what they can expect after having undergone hip arthroscopic surgery. Here are a few tips Dr. Hommen has to help ensure a quick and successful recovery.
Same Day Procedure
Dr. Hommen performs over 90% of hip arthroscopies as an outpatient surgical procedure. This means that you are able to go home on the same day as your surgical procedure. The outpatient anesthesia team and nurses are skilled at minimizing unwanted anesthesia side-effects such as nausea, grogginess and pain after surgery, allowing you to be discharged within a few hours after the surgical procedure.
What Level of Pain Can I Expect After Hip Arthroscopy?
General anesthesia is used during the surgical procedure along with a specialized nerve block around the hip to anesthetize the hip joint. As soon as the procedure is over, you will awaken and your hip with remain under the anesthesia effects of the nerve block. This allows the majority of patients to use only acetaminophen (Tylenol) and an anti-inflammatory (Motrin) after surgery (if you are not allergic to these). Most patients do not require opioid medications after they have been discharged home. Dr. Hommen recommends that you continue to use acetaminophen and anti-inflammatory medications for 2 to 3 days after the procedure to minimize the inflammatory phase normally seen after surgery.
What To Arrange Prior to Surgery
Dr. Hommen recommends that you stock up with a week’s supply of groceries prior to your surgery to limit any unnecessary trips to the grocery store. Healthy foods that promote healing include: Fruits with antioxidants and vitamin C (blueberries, raspberries, strawberries, Goji berries, blackberries, grapes, pomegranates), vegetables with vitamin A and C (carrots, sweet bell peppers, broccoli, cabbage, brussels sprouts), fats (avocados, olive oil, nuts, seeds), dark leafy greens (kale, spinach, romaine lettuce), meats for iron and protein (poultry, seafood, eggs, beans, lentils, nuts), probiotics (yogurt, kimchi, kefir, sauerkraut), whole grains for energy and fiber (quinoa, wild rice, steel cut oats, whole-wheat or rice sourdough breads), and plenty of water.
It is normal to miss a few bowel movements in the first 2 or 3 days after surgery. Eating foods rich in fiber (prunes, vegetables, beans, lentils, whole-grain breads, cereals, wheat bran) and drinking plenty of water are helpful after surgery. Psyllium powder mixed in water can also be supportive if you are prone to constipation. The use of opioid pain medications after surgery is a frequent cause of constipation. Therefore, we recommend transitioning to nonopioid pain medications as soon as possible. Probiotic foods can help restore the normal gut bacterial flora after surgery.
It is also beneficial to stock up on any over-the-counter post-operative medications such as acetaminophen and anti-inflammatories as well as any prescription medications you normally take. Dr. Hommen will likely recommend the use of 325 mg strength acetylsalicylic acid (Aspirin or Ecotrin) for 4 weeks after surgery (if you are not allergic). Additionally, a few opioid pills may be prescribed after surgery which you will need to fill in a pharmacy after surgery.
Make your house crutch-friendly:
Be certain to move any throw rugs, cords, or other obstacles away from the paths you will take from the bed to the bathroom, living room to the kitchen etc. If your bedroom is on a second or third floor, or if you live in a walk-up, make arrangements to minimize the use of stairs after surgery. This may mean moving your bed to the first floor or temporarily living with a family member or friend for the first few days after surgery to minimize the risks of falls and limit any unnecessary activity after surgery. Scheduling a physical therapy session prior to surgery can help teach you the appropriate ways to use these devices and minimize the risks of falls and onset of aches and pains in other joints.
Ice packs in the form of gel packs are a convenient way to provide cold therapy to your hip after surgery. They can be used for 45 minutes every hour while awake during the first 72 hours after surgery to reduce the acute inflammatory phase after surgery.
You Will Need Some Help After Surgery
Having a family member or a friend available to help you for the first week after surgery may be very beneficial. They will drive you home after surgery as you will not be allowed to drive yourself home due to the effects of general anesthesia. They may also be helpful in assisting in household duties such as cooking and cleaning. If you are a student, let your school, college or university know that you may require some days off and inquire if you may have assistance in getting to class and with parking. The small keyhole incisions used at the time of arthroscopy will require careful monitoring after surgery to ensure there are no signs of infection. Given the location and small size of these incisions, having someone monitor the incisions may be helpful in the first few weeks after surgery.
Hip Brace and Crutches/Walker
Dr. Hommen may recommend a postsurgical hip brace to protect any repairs, reconstructions, or impingement resections for 2 to 3 weeks after surgery. It is recommended that you comply with the use of the brace in order to have a successful outcome. Weightbearing restrictions to the surgical extremity may also be recommended with lengths dependent on the type of procedure and extent of hip damage noted at the time of surgery, ranging from 1-3 week for labrum and impingement surgery and up to 6 weeks for hamstring repairs. The use of a walker or crutches is therefore paramount in order to allow the structures to heal successfully. Dr. Hommen recommends that you remain relatively active after surgery and to avoid prolonged periods of bed-rest during the day-time.
Hip Bandages and Dressings
The keyhole incision sites will be covered with absorptive gauze after surgery. It is advisable to keep these dressings clean, dry, and intact and that you sponge-bathe initially. Usually, these dressings are removed 72 hours after surgery by the patient or caretaker at which point you may resume showers. Avoid submerging the incision sites in a bath, pool, Jacuzzi, or sauna until 2 or more weeks after surgery. You may notice some normal swelling or bruising around the incision sites for the first week after surgery. For any postsurgical questions or concerns, instructions will be provided as to how to contact the office.
Importance of Physical Therapy After Surgery
Dr. Hommen will provide specific rehabilitation instructions for your physical therapist according to the surgical procedure performed and the hip findings noted at the time of surgery. A customized rehabilitation plan will be tailored to your presurgical injury, general health, as well as your goals for return to activities and sports. Your physical therapist is therefore vital in progressing you through the different phases of the recuperation protocol, from the initial reduction of acute post-surgical inflammation, to strengthening and flexibility, and a gradual return to activities. It is therefore important to keep your physical therapy appointments and to follow your home exercise instructions. Missing physical therapy appointments or overdoing your post-surgical therapy is not recommended and may be harmful. Dr. Hommen recommends that you start therapy within 48 hours from your surgery.
For more information about hip arthroscopy and what it can mean for you, schedule an appointment with Dr. Hommen today. Call the office (305-520-5625) or book your visit online.