Hip and Knee Questions and Answers.

Range of motion after hip replacement

Does hip replacement improve range of motion?

A hip replacement can sometimes improve range of motion.

In general, the two main symptoms from hip arthritis are pain and stiffness. Most of the time, hip replacement relieves both symptoms, although it is much more reliable at relieving pain than it is at restoring range of motion.

Hip motion after total hip replacement, though it usually improves, rarely returns completely to normal. This is not a terrible problem, because one of the feared complications of hip replacement -- where the ball comes out of the socket after surgery, called a dislocation -- often happens at the extremes of motion. So failure to regain every bit of normal motion is, from that standpoint, not so bad.

Even though most patients generally improve their range of motion after hip replacement -- which helps make typical daily activities, including intimacy, more comfortable -- this is not the case for every patient. Sometimes range of motion will not change after hip replacement or some range will be lost; interestingly, this usually is the case in patients with very good range of motion to start with. And rarely, a hip can become much stiffer -- or completely immobile -- after a hip replacement. This usually happens because some abnormal bone forms in the soft tissues (called heterotopic ossification) in response to the trauma of surgery itself. Significant, activity-limiting stiffness from that condition occurs in perhaps one or two percent of patients after hip surgery, and complete loss of motion is extremely rare.

Most of the time, motion stays about the same or improves a bit after total hip replacement. And many times, a good hip surgeon can predict -- by evaluating a patient for certain risk factors -- whether an individual is likely to form heterotopic ossification around the hip, and take measures to prevent post-operative stiffness from this condition.

As always, the most important thing to do is to find a surgeon with good experience in hip replacement surgery to help minimize the risks and optimize the benefits from a complex procedure like joint replacement.

Surgery for Hip and Knee at the University of Washington, Department of Orthopaedics and Sports Medicine, Seattle, Washington

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