Total Hip Replacement

XII. POSTOPERATIVE RECOVERY
Immediately following surgery, you will be taken to the recovery room where you will stay 1 to 2 hours. Your blood pressure, circulation, respiration, temperature, and wound drainage are carefully monitored. Patients may be transferred to an intensive care unit (ICU) for a day or two if close monitoring is needed. Most patients will be transferred directly to their own room. Private duty nurses are generally unnecessary.

Through an intravenous (I.V.) tube which was placed in your arm vein during surgery, you will be given antibiotics and fluids. The I.V. will be disconnected on the first post op day, if antibiotics are still needed, they can be given to you orally for a few more days. Because you will probably feel some discomfort after surgery, pain medication will be given to you every three or four hours as needed or you will have a special machine called P.C.A. in which you may self-medicate. A tube (Foley catheter) is inserted into your bladder during surgery to keep it empty and this is removed on the first post op day.

Several measures are used to help prevent the formation of blood clots in your legs which can become dangerous. Mechanical leg or foot pumps are placed on your legs during surgery and will remain on day and night until you get your blood thinner and become ambulatory. These help in preventing blood pooling in your legs while your leg muscles are not performing this function. You will be encouraged to do bed exercises (isometrics and ankle circles) which the nurses and physical therapist will teach you. Blood thinning drugs (Lovenox, Arixtra, and Fragmin or Coumadin) are given and blood is drawn to determine the appropriate dosage with Coumadin only. For our out of state patients, the medical social worker at Lexington Medical Center will mail your prescription of the blood thinner. This must be filled in your hometown and brought with you to South Carolina. This will be used once you go home from the hospital.

In order to prevent respiratory complications you will be asked to breathe into "blow bottles" and cough several times a day.

The wound dressing is usually changed on the second day after surgery, or as indicated by the physician. Usually, all the stitches are buried under the skin (subcuticular closure) and dissolved after several months. Usually, there is no need for suture or staple removal.

Each day you should feel a little more comfortable as your hip heals and becomes stronger.

On the first day following surgery the physical therapist will get you out of bed to a chair and later you will begin to walk short distances in the morning. All lines and catheters are removed.  The afternoon therapy session will involve a longer walk in the hall. You will also be taught your hip exercise program by the therapist. You may be ready for discharge at the end of the first postoperative day. If you should have too much pain or difficulty ambulating, you may need to stay until the second post op day.

There are a few activities we will ask you to avoid during the first 6 months after surgery. These include jogging and impact sports, crossing your legs at the knees, and repetitive lifting of 50 pounds.

THESE ARE OKAY




DO NOT DO ANY OF THE FOLLOWING




(1) Do not sit in low chairs or with your knees higher than the hip; (2) Do not lean forward; (3) Avoid extreme bending from waist. Although the risk of dislocation is less with surface replacement due to its inherent increased stability, it is still advisable that you adhere to the above precautions.

During your hospital stay, the therapist will visit you twice daily and gradually your activity level will berapidly increased. They will also help you in determining what type of equipment you will need to use at home. Some of this equipment includes a reacher which enables you to pick up things without bending past the 90 degree restriction, a sock cone which assists you in putting on nylons and socks, a long shoehorn to help put on shoes, and equipment for bathing. The therapist will also discuss safety procedures for various activities with you. Prior to discharge, a set of instruction with diagrams will give you specific guidance on how to sit, use crutches, get into or out of bed, position a chair correctly, etc. . . . Since you will not be allowed to bend your hip more than 90 degrees, special instructions for entering a car will be given to you as well. Every program is designed specifically for each patient and only equipment that will be useful to you will be suggested. If you have any questions, please ask your therapist and/or nurse.

The programs discussed above are for more "routine" first-time replacements. They may be altered for complex revisions. In these cases, weight bearing may be delayed.

Visitors are welcome during your hospital stay. However, they should be kept at a minimum especially during the first several days while you are recovering from surgery and need your rest. If family members and friends would like to speak with you during your hospital stay, please provide them with the hospital's main telephone number. You may have a family member sleep in your hospital room, the rooms are all private.