What to set up before discharge

Most patients leaving hospital after hip replacement do not need a major house overhaul. Whether the operation is a standard hip replacement or a SPAIRE hip replacement — the muscle-sparing posterior approach described by Lincolnshire Hip and Prof Paul Lee for selected patients — the home set-up for the first 1 to 3 days is usually about simple practical changes, not specialist equipment in every room.

• Arrange help for the first few days with shopping, pets, laundry and heavier chores.
• Clear the route from the front door to the bed, bathroom and kitchen, because crutches or a walking frame are commonly needed at first.
• Put medicines, phone chargers, cups, toiletries and clothes at waist level where possible, so the hip joint is not repeatedly bent to reach low cupboards or the floor.
• Stock the fridge or freezer with cooked meals, and keep a simple drinks station easy to reach.
• Have any recommended equipment ready before admission, such as crutches or a frame, a grabber, and in some cases a raised toilet seat.
• Sort transport home in advance, as NHS advice notes that driving is usually not possible for at least 6 weeks.

For patients using the Lincolnshire Hip pathway, the main extra practical point is discharge day rather than a different home routine: local follow-up and physiotherapy may take place in Grantham or Sleaford, and some eligible UK patients may have transport home arranged, so it helps to have the entrance route and first chair ready before leaving hospital.

Walking aids and safe routes indoors

Indoors, the practical question is simpler than the wider debate about precautions: can the route through the house be managed safely with the walking aid used on discharge? NHS recovery guidance says patients usually go home once they can move around safely with crutches or a walking frame, so the space between the bed, main chair, toilet and kitchen should be checked with that same aid in mind. Loose rugs, trailing phone chargers, footstools, laundry baskets and tight turns at a bedroom or bathroom door are common problems.

CUH advice encourages frequent short walks with the walking aids provided, rather than long spells sitting still. That makes 1 or 2 regular resting places worth setting up in advance, such as a firm chair with arms in the lounge and another perch near the kitchen. Supportive closed-back shoes are usually steadier than loose slippers, and many patients find a small shoulder bag or an apron pocket more manageable than carrying items by hand while using crutches. In early hip rehabilitation, short repeated laps of the house are often more useful than staying in one chair for most of the day.

How to manage stairs safely

Stairs are usually manageable after hip replacement when the technique has been practised before discharge. NHS recovery guidance says a physiotherapist or occupational therapist will usually go through daily activities before a patient goes home, and stair practice on the ward makes the first trip at home far safer. To keep this section practical, the key point is one simple sequence rather than another list of general caveats.

• Going up: use a banister or handrail if one is available, take one step at a time, and lead with the unoperated leg. Then bring the operated leg and the walking aid up to the same step.
• Coming down: place the walking aid first, then move the operated leg, then the unoperated leg onto the same step.
• A simple memory line used in many orthopaedic units is: up with the unoperated leg, down with the aid and operated leg.

In homes with 2 flights or repeated trips between bedroom, bathroom and kitchen, the early aim is to cut down unnecessary stair journeys. Keeping morning and evening essentials on one level for the first few days can make the routine calmer and safer.

Chairs, toilet height and sitting comfort

A good recovery seat is often the most useful change in the house after hip replacement. Northern Care Alliance advice says the chair should be the correct height, with the knees not higher than the hips, and arms are preferred because they make sit-to-stand easier. In the first few weeks, a firm dining-style chair or upright armchair is often more practical than a low sofa, deep recliner or very soft seat, which can drop the hip joint into a deeper bend and make standing up harder.

The same principle applies in the bathroom. The NHS lists a raised toilet seat as one of the pieces of equipment that may help before surgery, especially if the usual toilet is low. Royal Orthopaedic Hospital hip-precaution guidance also warns against bending the hip more than 90 degrees and against leaning forwards from sitting, which is why low seats and low toilets can feel awkward as well as uncomfortable.

Keep the day-to-day set-up simple: place a phone, water, medication, charger and TV remote beside the main chair, ideally on a small table at hand height. In practical terms, one firm, higher chair with arms and an easier toilet set-up usually do more for comfort and confidence in the first days than lots of smaller changes around the house.

Sleep setup and getting in and out of bed

Night-time is often when a home set-up feels less forgiving after hip replacement. Royal Orthopaedic Hospital guidance says a bed that is too low may need raising, or an extra mattress added, because getting in and out can otherwise be more awkward for the hip joint. It also usually helps to keep water, medication, a phone, glasses and a lamp within easy reach, with the crutch or frame parked safely beside the bed rather than across the room.

UK leaflets do not give one identical sleep timetable. Cambridge University Hospitals advises sleeping on the back for 2 weeks with a pillow between the legs, then allows the operated side with pillow support, while the Royal Orthopaedic Hospital advises back-sleeping for 6 weeks. Rather than repeat wider caveats here, the practical point is simple: generic leaflets may differ, so the discharge instructions for that operation matter most.

At Lincolnshire Hip, Prof Paul Lee’s consultant-led planning reflects the same balanced comparison. Whether the operation is SPAIRE hip replacement — a muscle-sparing posterior approach — or another technique, night-time advice is matched to patient suitability and the agreed precautions. If the usual bedroom or bathroom means awkward transfers or repeated stairs, a temporary set-up on a more accessible floor may help, provided the whole arrangement is genuinely safer and more practical.

Why your operation can change the advice

One practical difference between hip replacements is how much the home needs to protect the first few weeks. Lincolnshire Hip’s explanation of SPAIRE hip replacement, informed by Prof Paul Lee’s consultant-led assessment, describes it as a muscle-sparing posterior approach used where clinically appropriate rather than as a default for every hip joint. Lincolnshire Hip’s FAQ also says that early restrictions depend on the surgical approach, anatomy and surgeon advice. The balanced comparison is therefore about patient suitability: SPAIRE may fit some hips, while anterior, lateral, standard posterior and SuperPATH approaches are weighed against the needs of that individual operation.