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From Surgery to Strength After Hemiarthroplasty
Introduction
When a hip fracture occurs, especially in older adults, it can dramatically change a person’s life in an instant. The road to recovery involves not just surgical repair but a carefully customised rehabilitation program. This article is a medium to share the recovery journey of a 76-year-old female. She came to Antara for rehabilitation after undergoing a right hip bipolar hemiarthroplasty for a hip fracture.
Understanding the Case
The Complete Rehabilitation Journey
The journey of our patient began on January 13, 2025. On this day, the patient underwent surgery for a right hip-side femur neck fracture. The patient was suffering from hypertension and hypothyroidism and a history of thyroidectomy and cholecystectomy. When she first presented for care, she experienced significant pain over her right hip and had difficulty walking. Her initial examination revealed muscle strength (MMT) of only 2/5 in her right lower limb, decreased range of motion, and pain during straight leg raise (SLR) testing.
The Surgical Procedure
The orthopaedic surgeons performed bipolar hemiarthroplasty to treat the right hip femur neck fracture of the patient.
During this procedure, the damaged femoral head is replaced with a prosthesis with two moving parts. Because of this new prosthesis, the patient can achieve more natural movement at the hip joint.
This surgery, though successful, was just the beginning of her recovery journey. The success of hip fracture rehab generally depends on both the surgical technique performed and the post-operative care that follows.
Rehabilitation Approach
Essential Post-operative Care for Hip Fracture Recovery
The post-operative care for hip fracture patients typically begins with pain management and gentle movements. Our care team initiated pain control immediately after the surgery, which enabled the patient to actively participate in physiotherapy sessions.
Her rehabilitation journey began on January 17, four days post-procedure. During the initial days, the Antara team focused on:
- Preventing infection at the surgical site
- Educating the patient on how to protect the joint during therapy
- Assisting with gentle passive movements to maintain joint mobility
Rehabilitation Goals
Early Phase Hip Joint Mobility Exercises
Rehabilitation exercises after hip fracture surgery began with simple movements that the patient could safely perform. During the early post-surgery phase (January 17–22), the therapist focused on providing gentle, personalized care. Our care home experts carefully selected hip joint mobility exercises based on the patient’s healing progress.
These initial exercises included:
- Ankle pumps to improve circulation
- Static quadriceps contractions to begin strengthening the thigh muscles
- Gluteal isometric exercises to activate the important hip stabilisers
These exercises might appear simple, but they are strategically chosen to begin rebuilding strength while protecting healing tissues. Pain management remains the most critical element of this phase, as it enables the patient’s active participation in the rehabilitation process.
The Continuous Part 2 Recovery
In the next phase of rehabilitation (January 23 – February 3), we upgraded the patient’s exercise program to align with her physical progress. Our team introduced gentle hip joint mobility exercises to prevent stiffness and maintain flexibility.
Over the following days, the patient was encouraged to perform more advanced hip joint mobility exercises, including assisted active range-of-motion (AROM) exercises.
This gradual progression is a hallmark of effective hip fracture rehabilitation. Advancing too quickly can result in complications or setbacks, while progressing too slowly can cause unnecessary deconditioning and prolonged recovery.
Communication Status
The Importance of Setting Realistic Expectations for Recovery
This case provides valuable insight into a typical recovery timeline for senior patients undergoing hemiarthroplasty. Every person’s recovery journey is different. But, with the help of understanding the general progression, we can set reasonable expectations:
- Initial Post-Operative Phase (Days 1–14): The primary focus during this period is on pain management, basic mobility, and prevention of post-surgical complications. Gentle movements and assisted exercises are introduced to support early recovery.
- Progressive Phase (Days 15–28): This phase emphasizes the gradual introduction of targeted strengthening exercises, particularly for the quadriceps, hamstrings, and gluteal muscles. The goal is to enhance stability and prepare the patient for functional activities.
- Advanced Phase (Beyond Day 28): The focus shifts toward regaining functional independence and resuming daily activities. Key components include gait training, gentle stretching of hip flexors and extensors, and bed mobility exercises to promote overall flexibility, balance, and confidence in movement.
For our 76-year-old patient, the progression of rehabilitation exercises after surgery was carefully monitored by experts. Our team made it clear that she recovered properly without overexerting her joints.
Conclusion
If you or your loved one experiences a hip fracture requiring surgery, below points can help you:
- Start your rehabilitation immediately after surgery; some exercises can be performed in bed.
- It should be the first focus in managing pain, as it helps in active participation in therapy.
- Recovery takes time but follows a predictable pattern.
- Our team at Antara will adjust exercises as your recovery progresses.
- Do not ignore the importance of education on joint protection and proper movement techniques.
We should all remember that hip fracture rehabilitation is not only about exercises—it includes:
- Pain management
- Improving mobility
- Better strength and function