XIV. LONG-TERM PRECAUTIONS
Postoperative Activity Advice
You may be able to take part in physical activities which before surgery
were impossible. There is a difference between patients who have polyethylene
bearings and those with metal-on-metal bearings. The problem relates primarily
to wear of the plastic bearing which is analogous to tire wear. That is,
the more you use it, the more wear occurs. Metal-on-metal devices have
considerably reduced wear. Swimming is encouraged. However, very rough
or heavy activities may shorten the life of the implant. The rotation
stress on the lead leg and hip in golf may be minimized by use of a smooth
spikeless shoe. Bicycling risk factors are related to the pedal stress
of uphill topography. It is too soon to assess whether the adverse risks
of heavy activity with new metal-on-metal surface replacements are as
minimized as we hope. Your doctor, by serially following your x-rays and
scans, can advise you about risk factors which may affect the life of
the implant.
Infections
Infection may localize at the site of the artificial implant and can cause
major complications. Therefore, if at any time you should contract an
infection anywhere in your body, especially those which cause high fever,
you should have it treated immediately by your physician. Special precautions
should be taken for bladder infections, ingrown toenails, tooth and gum
infection or when having dental work done before undergoing surgical procedures.
In general, Amoxicillin 3 grams is recommended 1 hour before and 1.5 grams
6 hours after any dental procedure. If you are allergic to Amoxicillin
or Penicillin, Erythromycin stearate is recommended (1 gram 1.5 - 2 hours
before and 500 mg. 6 hours later). The need for special precaution
during routine dental check-ups is controversial. If your gums tend to
bleed during the cleaning process, antibiotics are recommended as described
above. If possible, all dental work should be delayed until four months
following surgery. Antibiotic coverage for other surgical procedure or
infections is individualized according to the possible bacterial contamination,
and therefore, you should notify the respective physician or surgeon so
they can prescribe the appropriate medication.
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