Hip Replacement Recovery at Home: Precautions, Sleep, Toilets and Driving

A hip replacement rearranges your day for a few weeks, and what catches people out afterwards is rarely the pain. It is getting into bed, sitting down on a toilet that has suddenly become too low, putting on a sock, and knowing when it is safe to drive. This guide covers the practical side of hip replacement recovery at home - hip precautions, sleeping, toilets, dressing, shoes, stairs, driving and the equipment that helps - and what lifetime precautions after hip replacement really mean now.

One thing first, and we will keep saying it: your surgeon's instructions and your physiotherapist's programme override everything here. Practice varies legitimately between hospitals, approaches and patients, and the leaflet you were given was written for the operation you actually had. This is not an exercise guide.

What hip precautions are, and why yours may differ

Hip precautions are movement limits that reduce the small risk of the new joint dislocating while tissues heal. The classic set belongs to the posterior approach, where the surgeon works from behind the hip: do not bend the hip past 90 degrees, do not cross your legs, do not twist the operated leg inwards. They usually apply for six to twelve weeks.

After an anterior approach, from the front, the joint is vulnerable in a different direction and many surgeons give fewer restrictions or none. Some NHS trusts have relaxed routine precautions after posterior surgery too. So the honest answer to "what are my hip precautions" is whatever your own surgeon wrote down. If the leaflet is lost, ring the ward and ask again.

The same goes for hip replacement exercises to avoid. Your physiotherapist gives you a programme and says what is off the list for now. Do not add exercises from a video, and do not quietly drop the boring ones.

Sleeping after a hip replacement

For the first few weeks most people are told to sleep on their back with a pillow between the legs, so the operated leg cannot roll inwards or cross the midline while you are asleep. A firm ordinary pillow works.

Sleeping on your side after a hip replacement comes later. Many surgeons allow the non-operated side first, pillow still between the knees, and the operated side only once the wound and soft tissues have settled, often around six weeks. NHS trusts differ, so ask rather than experiment.

Trouble sleeping after a hip replacement is very common, and worth naming because people assume something has gone wrong. It improves. Move little and often during the day, keep the bedroom cool, put a pillow under the calf rather than under the knee, and take pain relief on the schedule you were given rather than waiting until you are awake and sore. Pain that is not controlled is a conversation with your GP.

Getting in and out of bed is technique, not strength. Sit on the edge near the pillows, take your weight back on your hands, lift the operated leg up first and swing the other after it, knees apart. Coming out, the operated leg leads. If the leg feels heavy, see our guide to leg lifters and bed levers.

Toilets, chairs and bed height: knees below hips

Almost every rule about sitting comes down to one idea. If your knees end up higher than your hips, the hip is bent past 90 degrees, and while precautions apply that is the position to avoid. British toilets are low and standard armchairs lower still.

• A raised toilet seat. Fits onto the pan and adds two to six inches, so you sit and stand without dropping into deep flexion. The most used item of the lot.
• A toilet frame. Arms either side to push up from, which matters when one leg is doing less work.
• Chair raisers or a firmer chair. Blocks under a sturdy armchair lift it to a workable height, and a high firm seat with arms beats a deep sofa. See choosing the right chair.
• Bed raisers. Raise the bed so your feet just touch the floor as you sit on the edge.

When you can use a regular toilet after a hip replacement depends on your precautions and your own height, and most people go back to a normal pan when restrictions lift at six to twelve weeks. Our post on toilet aids, raised seats and frames explains how they are supplied.

Washing, dressing and shoes

Dressing is where precautions bite hardest, because everything involving your feet asks you to bend. The rule is simple: sit down, and put the operated leg in first while the fabric is loose. Take it out last when you undress.

• A sock aid. A gutter that holds the sock open so the foot slides in and two tapes pull it on, with no bending.
• A long-handled shoe horn. Shoes go on seated, with your back straight. Pair it with elastic laces so nothing needs tying.
• A reacher. For pulling trousers over the foot and picking things off the floor.
• A long-handled sponge. For washing your feet without folding in half in a slippery shower.

When you can wear jeans after a hip replacement is a fair question, and the answer is not a date. Denim is stiff and getting it over a swollen leg is a fight, so most people find soft elasticated trousers easier at first. Nothing bans jeans; the test is whether you can get them on sitting down, with a reacher, without bending past your limit. Our guide to dressing aids and easier ways to get dressed covers each of these.

The kitchen, the stairs and driving

In the kitchen, the enemy is standing still. A perching stool lets you sit at working height with your hips open, and it is the difference between making lunch and giving up on it. Move everyday things up to worktop height before you go into hospital, and use a trolley.

On the stairs: up with the good leg, down with the operated one, holding the banister, one step at a time. If the only toilet is upstairs and stairs are unsafe on day one, a downstairs bed and a commode for a fortnight is a plan, not a defeat.

How long after hip replacement you can drive is usually about six weeks, but the number matters less than the conditions attached to it. You must be off strong painkillers that affect concentration, able to make an emergency stop without hesitation, and able to get in and out of the car without breaking your precautions. Tell your insurer, and confirm with your surgeon that you are fit to drive.

Lifetime precautions after hip replacement: what that means now

The phrase worries people, and the honest answer is reassuring. For most modern total hip replacements there are no lifetime precautions in the old sense. Once healing is complete and your surgeon has discharged you, the usual advice is to avoid extremes of movement and repeated high-impact activity, and otherwise to get on with your life.

There are exceptions, which is why the answer has to come from your own surgeon. Somebody who has had a dislocation, a revision operation or unusual anatomy may be told to keep certain restrictions permanently. Ask at your follow-up, and write the answer down.

Speak to your GP or the surgical team promptly if the wound becomes red, hot, swollen or starts leaking, if you develop a fever, or if pain increases sharply after improving. Pain, swelling or heat in the calf, or breathlessness and chest pain, need urgent attention: a clot after joint surgery is uncommon but treatable.

Getting the equipment, and getting it in time

The best time to sort equipment is before the operation. Most hospitals run a pre-operative joint school or telephone assessment where an occupational therapist works out what you will need and issues it on loan, free, ready for discharge. Say yes to that appointment, and be honest about your home.

If you are already home and struggling, contact the hospital occupational therapy team or your council's adult social care service, who can issue equipment on loan through community equipment services. Buying privately is quick and usually modest: a raised toilet seat is roughly 20 to 40 pounds, a sock aid or long-handled shoe horn 10 to 20 pounds, a perching stool 40 to 80 pounds.

Frequently asked questions

When can I start sleeping on my side after a hip replacement?

Most people sleep on their back with a pillow between the legs at first, then onto the non-operated side with the pillow still in place, and onto the operated side later, often around six weeks. An NHS leaflet on sleeping on your side after a hip replacement applies to that trust's patients, so follow the one you were given.

When can you use a regular toilet after a hip replacement?

Usually when your precautions are lifted, commonly between six and twelve weeks, and sooner if you were given few restrictions or you are tall enough that a standard pan already keeps your knees below your hips. If in doubt, keep the raised seat longer.

How long after a hip replacement can I tie my shoes?

Reaching your own feet usually returns with the end of your precautions, so six to twelve weeks for most people, and it comes back gradually rather than on a fixed date. Until then a long-handled shoe horn, elastic laces or slip-on shoes with a firm heel do the job. Backless slippers are a genuine falls risk.

Are there hip replacement exercises to avoid?

Yes, but the list is your physiotherapist's to give and it depends on your surgery. The usual pattern is deep squats, sitting cross-legged, twisting the operated leg inwards and high-impact activity early on, most of which come back later. Say so if an exercise causes sharp or new pain.

Next steps

If you are preparing for a hip replacement, or already home and finding the house works against you, an occupational therapist can go through the bedroom, bathroom, stairs and kitchen and sort heights, equipment and technique in one visit. Find your local occupational therapist through our areas we cover page, or see our prices page.