Instructions for after your Total Hip Replacement Surgery

Hip Precautions

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.

1. 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

2. Keep a pillow between your legs when in bed to maintain alignment

3. Do not swivel or twist on your affected leg - keep your feet pointing forward

4. When sitting in a chair ensure your hips are higher than your knees

5. Do not bend your affected leg more than 90 degrees

6. Do not bend down past your knees, use your long handled aid to pick things up

7. These precautions are very important during the first six weeks after surgery

Mobility

By the time you leave hospital you will be walking short distances. Aim to gradually increase the frequency and distance of your daily walks. Avoid walking on uneven or unstable ground. Remember to also ensure you take regular rest periods as needed. You can progressively wean off your crutches as comfort allows. It is important that you generally use a crutch for the first two or three weeks, even it is only a single crutch just as a reminder to prevent any excessive twisting movements.

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

The main exercise are walking and lifting your leg out to the side while standing at a bench for support. The physiotherapist will give you a pamphlet with some exercises that you can practice. Feel free to do these as often as you can without causing pain.

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. If in doubt ask your nurse prior to discharge.

Wound

The water proof 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 an 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.

Sports, Gym and Gardening

Are to be avoided for at least six weeks after surgery.

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.

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