Instructions for after your Total Hip Replacement Surgery
Hip Approach
Hip replacement can be performed through different surgical approaches. Mr Peterson utilises either the “Anterior Approach” or the “Mini Posterior Approach”. The decision in approach is influenced by body size and shape, bone anatomy, complexity of surgery etc. The approach will be customised to you to ensure the best outcome for you. Make sure you understand which approach has been selected as this will influence restrictions or precautions after surgery.
Hip Precautions for the Anterior Approach
The only precaution is that you don’t extend and externally rotate your hip in the first 6 weeks after surgery. This might occur if you lie on your stomach in bed to sleep or if you twist and rotate your body over your hip resulting in your foot turning out.
You can come off your crutches as soon as you are confident.
You can drive as soon as you feel safe.
Hip Precautions for the Posterior Approach
In order to prevent dislocation of your new hip it is important that you continue to follow the hip precautions and you should be familiar with these before you leave the hospital. If not ask your nurse or physio. The following restrictions apply for the first 6 weeks after surgery.
Do not cross your legs at knees or ankles. Your operated leg should always be kept out to the side, so you can always see the inside of your knee.
Keep a pillow between your legs when in bed to maintain alignment.
Do not swivel or twist on your affected leg - keep your feet pointing forward.
When sitting in a chair ensure your hips are higher than your knees.
Do not flex your replaced hip more than 90 degrees.
Do not bend down past your knees, use your long handled aid to pick things up.
Mobility
Follow the instructions in the app or booklet regarding exercises and walking. This can gradually increase as comfort allows. Don’t push yourself too hard in the first 1-2 weeks. From the 3rd week you should be increasing your walking distances. Each day go for a walk on the flat. Take your crutches if needed but try not to put weight through them, just have them with you if you need them to get you home. Walk further each day but check in with yourself to see how your body coped. Some pain at the end of the day is expected but pain the next day means you pushed too hard.
Rest
It is also important to have rest periods during the day while you are recuperating from your surgery. Listen to your body as it will tell you what you need.
Exercises
Follow the instructions in the app or booklet. These are a one size fits all! Younger more athletic patients might find that some of the exercises become too easy. This is not a problem. Just gradually increase your walking distance each day and then check in with a physio as to what else you can do safely if you would like to push harder. Be cautious though, this is a hip for life, so going a little slower now and having no issues is better than pushing too hard and having a complication!
Pain Relief
It is important to take your pain relief regularly in order to provide good pain control to optimise your recovery. Pain needs change over time. It is reasonable to lessen the amount of pain medication that you are taking as you feel that your recovery is progressing. This includes both anti-inflammatories and Paracetamol.
Wound
The waterproof dressing is left in place for the first week after surgery. You will notice some sticky tape butterfly type dressings which are called steri-strips sitting on the wound itself. Generally these will start to peel away but if they have not come off after 10 days feel free to remove them.
If you have a concern about your wound such as increasing redness, pain, or discharge contact Mr Peterson’s rooms on (03) 539 0988 or your GP.
Limb Swelling
It is not uncommon to experience swelling, often of the entire limb, which may persist for several months. Rest periods, lying down, during the day are recommended. Bruising is also not uncommon.
Bowels
Constipation can be a common problem due to a combination of reduced mobility and medication. Prevention is better than cure so remember to drink plenty of fluids and eat a healthy nutritious diet with adequate fibre. Sometimes medication may need to be used to help with this.
Bladder
If you have had a urinary catheter in during your stay in hospital you may notice an increase in urinary frequency after this is removed, this should settle within a few weeks.
Sexual Activity
May be resumed when you feel like it and your wound is well healed. In order to adhere to the hip precautions it is recommended that you are the "passive" partner as lying on your back with your hips and legs apart is the most stable position for your hip.
Driving
You can return to driving once you feel that you have full confidence and control. For most patients this will be three to four weeks after surgery. Some patients that this may be longer particularly if you are finding that you are more dependent on your crutches. You should however be able to make a sudden movement and emergency full brake confidently without hesitation before you commence driving.
Work
Your return to work timing is very dependent on your job. For most patients undertaking sedentary work this can be three to four weeks. Light work is often six to eight weeks and heavy physical manual labour will be ten to twelve weeks. Each person’s work situation is different and you should discuss this with Mr Peterson.
Antibiotic Alert
It is important to see your doctor if you have skin, chest, urine or other infection as an antibiotic treatment may be needed to protect your new hip.
Dental Surgery
If you require dental surgery you should inform your dentist that you have had a hip replacement as you may need covering antibiotic treatment beforehand.
Reasons to seek medical help
1. Excessive or increasing pain
2. High temperature
3. Drainage is noted from the incision site
4. Calf pain, leg swelling, shortness of breath or chest pain
If chest pain or shortness of breath is of sudden onset, call 111
If chest pain or shortness of breath is of sudden onset, call 111
Follow-up Appointment
You should leave the hospital with your follow-up appointment arranged at four weeks after surgery. Generally we will arrange for an x-ray just prior to this appointment on the same day.
If you have any concerns or need to alter your appointment please contact Mr Peterson’s rooms on (03) 539 0988. Your follow-up will be at the Collingwood Centre, level 1, 105 Collingwood St, Nelson.