Home Going Instructions After Total Hip Replacement

Introduction:

Total hip replacement (total hip arthroplasty) is a cost-effective and successful orthopedic surgical procedure that replaces damaged bone and cartilage with prosthetic components. After total hip replacement, the patient should follow instructions when in the hospital and after going home. Following these instructions make sure that the recovery is faster and the patient will be able to resume normal activities sooner.

What Are the Instructions to Follow When in the Hospital?

After the surgical procedure, the patient will be admitted to the hospital for two or three days. This is the period during which the patient recovers from anesthesia and also from the surgical procedure. After the surgical procedure, the patient will be transferred to the recovery room (PACU), where they stay for one or two hours before being shifted to their rooms.

The patient should follow the following instructions when in the hospital after surgery:

• Patients should walk and start moving with the help of a nurse.

• Patients should wear compression stockings on their legs. These stockings help in improving blood flow.

• Patients are asked to do “ankle pumps” by moving their ankles up and down.

• Patients are asked to use a spirometer to prevent the occurrence of pneumonia. The patients are asked to breathe in deeply and breath out into the device.

• Patients are, at times, given anticoagulant (blood thinner) medications to reduce the risk of clot formation.

If surgery is done on an outpatient basis, the patient can be discharged on the same day. The following things are made sure of before the patient is discharged:

• The patient can have food and use the bathroom on their own.

• The patient can get out of bed on their own.

• The patient is in a condition to do the suggested home exercises.

• The patient can walk with an assistive device (cane or walker).

• The patient’s pain control is acceptable.

At the time of discharge, the doctor will provide the homegoing instructions. The doctor will also discuss the possible complications and the precautions to be taken to avoid same.

How to Prepare the Home Post-surgery?

The changes at home can be addressed and made before surgery. These changes include:

• Rearrange one’s home such that one can minimize using stairs and can walk freely with crutches or walkers.

• Remove loose rugs that may cause slipping while one walks.

• All necessary items should be kept within reach to avoid bending down.

• Use a firm mattress.

• Use a high bed that helps place the hips at a higher level than the knee.

• Use a chair that is firm and has a higher-than-average seat.

• Install shower chair and raised toilet seat in the bathroom.

• Avoid keeping small pets at home.

• Use good lighting.

• Remove cords and loose wires from the floor that can cause the patient to fall.

What All to Take Care of When at Home?

When at home post-surgery, the patient will be able to walk with the help of an assistive device. The assistive device may be needed for at least two to four weeks more. The patient should not dislocate the artificial hip and follow the home exercises suggested by the physician or physiotherapist. A family member or someone is needed for help throughout the day for at least two weeks after surgery to support all daily activities.

How to Take Care of the Wound?

The following things are done for proper wound care:

• Keep the wound dressing clean and dry.

• The wound dressing can be changed as per instructions given by the doctor.

• Do not pull forcefully while changing the dressing.

• Remove the dressing with clean hands to avoid infection.

• Ask the doctor when one can take a bath (usually, all dressings are waterproof and not a problem nowadays).

• If signs of infection are seen, like redness, swelling, or drainage from the wound, then contact the physician.

What Are the Medications to Be Taken?

Only the medications given by the doctor should be taken. The medications prescribed usually include:

• Opioid analgesics.

• Anticoagulants.

• Antinausea medications.

• Stool softeners.

• Iron supplements.

• NSAIDS (non-steroidal anti-inflammatory drugs).

• Antibiotics.

What Is the Diet Plan?

The diet plan usually includes

• A balanced diet.

• Avoid alcohol.

• Drink plenty of fluids.

• Avoid gaining weight as it causes more stress on the joint.

What Are the Self-Care Measures to Be Taken?

The self-care measures to be taken include:

General Instructions:

• Always avoid crossing the legs or ankles when in any position, be it sitting, standing, or lying down.

• Avoid bending too much forward from the waist.

• Avoid pulling legs beyond the waist.

While Sitting:

• Use a firm chair that has a straight back and armrest.

• Avoid chairs that are too low. If using low chairs, use a pillow and sit on it.

• Keep the feet about six inches apart, with knees and feet pointed ahead.

• Avoid sitting in the same position for more than 30 to 40 minutes.

When Dressing:

• Avoid dressing in a standing position. Either use a chair or any other stable position.

• Avoid crossing over legs or bending forward while dressing.

While Bathing:

• Always keep the bathroom floor dry and clean.

• A stable plastic chair can be used for sitting in the shower.

• Avoid sitting at the bottom of the bathtub.

• Use an elevated toilet seat.

While in Bed:

• Avoid sleeping on the side of the new hip and on the stomach.

While in the Car:

• Avoid long car rides, stop the car in between every two hours, and walk for some time.

• Too low car seats should not be used, in such cases, use a pillow.

• Always get into the car from street level.

• Start driving only once the doctor says it is alright to start driving.

What Time Does It Take To Resume Normal Activities?

The following are the general instructions to follow:

Air Travel:

• The pressure changes can result in swelling of the operated leg.

• Always ask the doctor when air travel will be safe.

• Inform the screener about the artificial hip, as there are chances that the metal detector can cause an alarm.

Sports and Exercises:

• Follow the exercises given by the doctor or physiotherapist for at least two months post-surgery.

• Low-impact activities (like doubles tennis, bicycling, golfing, etc.) are preferred to high-impact activities (like basketball, singles tennis, skiing, etc.).

Going For Work:

• Depending on the type of work one do and the speed of recovery the time to rejoin work varies.

Sexual Activity:

• The doctor will advise on when one can safely resume sexual activity.

Weight Bearing:

Depending on the surgical procedure full weight bearing may be immediately possible or may be delayed.

Conclusion:

There are certain instructions to be followed, exercises to do, and care to be taken in all the daily activities for some time following total hip replacement. Care should be taken even in the home arrangement, including the bathroom. All the post-surgical instructions must be followed to ensure that the patient recovers faster and can do all daily activities normally without pain.