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Case Study: Total Hip Replacement

JC is a 49-year-old female who undertook bilateral hip replacement surgery with only an 8-week gap between surgeries. Ongoing hip problems had curtailed her sporting aspirations in rowing, running and windsurfing for the previous 18 years. This was due to a problem called hip dysplasia, causing subsequent labral tears and a developing picture of osteoarthritis. Unfortunately, by the time hip dysplasia was identified as the cause, the joint damage had reached a point of no return. Subsequently, osteotomy surgery was not a preferred option, and JC required total joint replacement for both hips.

Younger and fitter patients in this type of situation are increasingly being offered bilateral surgery, where both hips are replaced at the same time. This can save overall recovery time for the patient, avoiding two hospital stays and reduce operating theatre time. This was originally planned for JC, but due to some minor complications with the first right hip replacement her surgeon decided it would be best to operate on the left hip at a later date.

JC first attended Aqua-Physio 9 days after her right sided total hip replacement. The surgeon had used an anterior “minimally invasive” approach and her wound was healing well. She was mobile with x2 elbow crutches which were allowing her to normalise her walking pattern. Her right hip range of motion was reduced due to post-operative swelling, pain and weakness. Aquatic exercises focussed on regaining right hip active range of motion, normalising her walking without crutches and functional movements in the water.

JC competed 9 exercise appointments with us, using a mix of physiotherapist led and self-managed sessions. She then had her left hip replaced 8 weeks after the right side, by the same surgeon, who opted for an alternative posterior surgical approach this time. After then returning for a second time after this surgery JC was able to start gentle work on the left hip, just as she had done the right. We were also able to progressively load the right side a little more without affecting the more acute left side.

As time passed over the next 4-6 weeks JC’s hips became more equal in their range of motion and capability. At time of writing, she has begun more fitness training and dynamic movements such as running and jumping in our pool (see video link attached). This has been accompanied by an increase in her strength and conditioning work outside of the pool, led by a physiotherapist. A full recovery is expected for JC over the coming months, and with time she is hoping to return to rowing and windsurfing sports, which is all achievable.