Proliance Orthopedic Varied
Hip Replacement Home Instructions

Hip Replacement Home Instructions

Hip Replacement Home Instructions

You may increase your activity gradually. Let your hip symptoms guide you. How active you were before surgery may influence how quickly you can return to your normal daily activities.

  • Your Hip Incision: Most hip replacement wounds are closed with absorbable suture that does not require removal. Thin steri-strip tape may be applied to the incision or you may have a clear glue covering or removable sutures. It ok to shower once you get home letting the water run over the bandage. This bandage is waterproof. This is removed 5 days after surgery and the steri-strips are allowed to peel off on their own (do not peel them off; cut the edges as they elevate). You can take a tub bath four weeks after surgery if the incision is well healed, clean and dry

    • Sometimes non-absorbable sutures or staples are required. If your incision has no drainage, you may shower before the staples are removed. If you have sutures or staples when you go home, change the gauze dressing that covers your incision every day. Your surgeon will tell you when your local health care provider should take out any sutures or staples. This is usually 1 to 2 weeks after surgery. After the sutures and staples are taken out, tape such as Steri-Strips™ may be placed over the incision to keep it closed. The tape strips should stay in place for 7 to 10 days.

  • Ice: You may use ice packs to your hip as often as needed following surgery. This may be especially helpful before and after your exercise sessions. Heat is not recommended, as it may increase swelling. An ice machine is an excellent option and can be obtained at our office and provided to you at the time of your joint replacement.

  • Walker/Crutches: A walker or two crutches will be used for walking after surgery. Unless instructed otherwise, you may bear weight as tolerated and use the walker/crutches for 2-3 weeks, then advance to a cane in the opposite hand for 2 weeks or until you can walk without a limp. Our office has professionals to help you decide which ambulation aid is best for you and can custom fit these aids for you. These can be provided to you at the time of you joint replacement.

  • Physical Therapy: The therapists in the hospital will teach you an exercise program, which you will continue at home twice daily. You will also learn about precautions to take for the safety of your new hip. Much of the success of your new hip replacement surgery will depend upon how you take care of it. Outpatient physical therapy may be prescribed.

  • Driving: You will not be able to drive for four weeks after your surgery. Although you will feel as if you are able, your insurance coverage would be in jeopardy, and your safety is of prime concern during the healing period. You may start to drive again three weeks after surgery if you are not taking narcotic pain medication during the day.Use good judgment when you decide to drive. Do not drive if pain medication that you take before sleeping makes you feel tired or light-headed the next morning.

  • Sexual Activity: You may resume sexual activity with caution as desired following your hip surgery. If you have specific questions, please do not hesitate to ask.

  • Sleeping: It is often difficult to get to sleep. We suggest trying Tylenol PM or Benadryl, purchased over the counter, to promote drowsiness. http://www.aahks.org/getting-a-good-nights-sleep-after-hip-or-knee-replacement-surgery/

  • Exercise: To regain maximal use of your hip, make sure exercise and activity are part of your regular daily routine.Follow your physical therapist's instructions regarding how much weight to put on your operated leg. Most patients are allowed full weight bearing but sometimes bone quality and specific technical considerations require limited weight bearing after surgery.You may switch from a walker or crutches to a cane when you feel steady on your feet unless your surgeon tells you otherwise. You may stop using a cane when you can walk without a limp.Walk at least three times a day. As you feel able, increase the distance and number of times you walk each day.

  • Daily living: You may want to use a toilet seat riser to raise the height of your toilet seat. The riser can help you sit down and stand up more easily. In public restrooms, use the handicapped-accessible stall with a raised seat.Sleep in any position that is comfortable.Before you get into a car, have someone move the seat back to give you extra leg room. When you get into a car, sit on the seat and slide your buttocks backward. Then have someone help you bring your legs into the car together. Stop to stretch and walk every 1 to 2 hours during a car ride. This is to prevent blood clots in your legs.Continue to wear support stockings at home until your follow-up appointment unless you are told otherwise (Figure 3). You may take off the stockings at night, but wear them during the day.

  • Pain Control:Your health care provider will work with you to help you manage your pain.

  • Some common pain relievers can affect blood thinning. Examples include aspirin, aspirin-containing products, ibuprofen (Advil™, Motrin™), and naproxen (Aleve™, Naprosyn™). Ask your health care provider what you should take to manage your pain.

  • If you do not take a blood-thinning medication, you may take acetaminophen or generic Tylenol as needed for pain. Talk to your health care provider about the dose you should take and the schedule you should follow. If you take more than the recommended dose of acetaminophen, you could damage your liver.

  • If you take aspirin for your heart, ask your health care provider whether you should continue to do so.

  • Blood Thinners: Most patients are treated with aspirin after total hip replacement. Some patients (for various medical reasons) will be taking Coumadin for 14-21 days following discharge from the hospital. This blood thinning medication is used to help prevent blood clots. A prescription for a specific dosage and time period is given to you at the time you leave the hospital. Your dose will be adjusted by the coagulation Clinic at VMC where weekly blood draws will be performed. Aspirin and arthritis medications MAY NOT be taken until 48 hours after the prescription has been completed. If you take aspirin for cardiac reasons, continue to do so while on the Coumadin. Tylenol or Tylenol ES every four to six hours may be used for pain relief in addition to the prescription narcotic analgesics (commonly hydrocodone, Darvocet-N or oxycodone). Following the completion of the prescribed Coumadin, you should take one aspirin each morning for one month. Mark this on your calendar.

    • Foods that contain vitamin K can lower the effectiveness of anticoagulant medication. You may continue to eat foods with vitamin K if you eat about the same amount of these foods each day. If you do not eat these foods, do not start.

The following foods have moderate or high amounts of vitamin K:

  • Asparagus

  • Avocado

  • Broccoli

  • Brussels sprouts

  • Cabbage (including coleslaw and sauerkraut)

  • Cauliflower

  • Endive

  • Garbanzo beans

  • Green scallion

  • Greens (collard, mustard, turnip)

  • Kale

  • Lentils

  • Lettuce

  • Liver

  • Seaweed

  • Soybeans

  • Swiss chard

Certain oils, alcohol and teas may affect how the anticoagulant medication works. Do not drink green tea. If you eat or drink the following foods or beverages, consume about the same amount every day:

  • Canola oil

  • Soybean oil

  • Alcoholic beverages

  • Teas - those made with sweet clover, sweet woodruff or tonka beans

Many nutritional supplements affect how warfarin works. If you take a supplement while taking warfarin, take the same amount each day.

Tell your health care provider if you take:

  • Multivitamins that contain vitamin K.

  • Vitamins that contain 400 IU (international units) or more of vitamin E.

  • Herbal products (including garlic supplements).

  • Liquid meal replacement drinks (such as Ensure™ or Slim Fast™).

  • Lifting: Do not lift anything that weighs more than 20 pounds until after your follow-up appointment.

  • Diet: Constipation may occur as a side effect of pain medications. It also may be a result of decreased activity after surgery. To help prevent constipation:

    • Eat high-fiber foods, such as fresh fruits and vegetables and whole grains.

    • Drink 6 to 8 glasses of water every day, unless you are told otherwise.

Contact your surgeon or health care provider if you have:

  • Fever, a temperature above 100.4 degrees Fahrenheit or 38 degrees Celsius for two days.

  • Increased pain that does not stop even after you take pain medication.

  • Drainage with pus, bad smell, redness, swelling, pain, heat or opening at the incision or somewhere else on your operated leg.

  • A urinary tract infection, bronchitis or any other infection.

  • Calf or thigh pain, tenderness or swelling in either leg.

  • New or increased numbness or tingling in your operated side.

  • Changes in color and temperature of your hip.

  • Easy bruising, nosebleeds or blood in your urine.

  • A fall or injury.

Antibiotics

Antibiotics to prevent infection

You need to protect this new part of your body from infection. Although it is not common, your artificial joint could become infected any time bacteria get into your bloodstream. It is recommended that you talk with your health care provider about taking antibiotics before any of the procedures below. Your health care provider or dental provider will review whether or not you need antibiotics, and if you do, will recommend the antibiotic you should take. If you have ever had a reaction to a certain antibiotic, an alternative may be suggested.

Dental or oral procedureshttp://www.aahks.org/care-for-hips-and-knees/preventing-infection-in-your-joint-at-the-dentists-office/

Routine dental cleaning is recommended to maintain your dental health. If you have symptoms of dental conditions, seek immediate diagnosis and treatment.

  • Antibiotics are recommended before dental procedures.

  • Delay elective dental procedures, such as orthodontics or implant placement for 6 months after hip replacement surgery

Urologic procedures

  • For six months after surgery, delay higher risk urologic procedures, for example, any stone manipulation including shock wave lithotripsy, transrectal prostate biopsy, endoscopic procedures of the upper tract (ureter and kidney) and any procedure involving entry into your urinary tract.

  • For one year after surgery, if any of these higher risk procedures are necessary, antibiotics are recommended.

  • Beyond one year after surgery, antibiotics are not recommended for most people. However, antibiotics are recommended if you are at higher risk of infection. For example, you are at higher risk if you have an indwelling catheter, a history of recent or recurring urinary tract infections or prostatitis, are taking immune-suppressing medications such as chemotherapy or disease-modifying medications, or have had prior joint infection or complex joint reconstruction.

Gastrointestinal procedures

Gastrointestinal procedures include any procedure during which an instrument or tube is inserted into your body. This may include upper endoscopy, colonoscopy or sigmoidoscopy.

  • Antibiotics are not recommended before most gastrointestinal procedures.

  • For six months after surgery, delay non-urgent endoscopy, for example, to follow-up on reflux. If you are due for a 10-year screening colonoscopy, wait six months.

  • If you experience symptoms of gastrointestinal bleeding, seek emergency diagnosis and treatment.

If you have questions about antibiotics, talk with your health care provider.

FOLLOW-UP OFFICE VISITS

Most patients are discharged from the hospital on the third or fourth postoperative day. Follow-up office visits are routinely advised for:

1. 1-2 weeks after surgery for staple removal.
2. 4 weeks after surgery for an x-ray and exam of knee motion.
3. 3 months after surgery for exam and assessment of activities.
4. 6 months, 1 year, and annually thereafter for x-ray and exam.

Please call our office appointment desk to schedule appointments: 425-656-5060

PRESCRIPTION REFILLS

Refills for pain medicines may be obtained by contacting our office during business hours. It is the policy of our office that narcotic pain relievers will not be refilled or phoned in after hours or on the weekends. Prescription anti-inflammatory medications may be resumed 48 hours following the last Coumadin dose.

UNDERSTANDING THE RISKS OF TOTAL HIP REPLACEMENT

As with any surgery, there are certain risks. The following are some of the more common complications of which you need to be aware and things that we do to try to prevent them.

  • Infection: There is always a risk of infection with any surgery. You will receive antibiotics in surgery and several doses after surgery to reduce this risk. The risk of infection after Total Knee Replacement is approximately one percent.

  • Blood Clots: When you have surgery on the knee, circulation is impaired during healing. A blood thinner medication will be prescribed for you, which will help to keep your blood a little thinner than normal to prevent blood clots. We begin the first dose on the evening of surgery. Each day in the hospital, blood will be drawn to check your blood thinning level. Another thing that will help to prevent blood clots is to elevate both feet while sitting to prevent blood pooling in the lower legs and perform ankle-pumping exercises.

  • Dislocation of the Prosthesis: There are certain positions and activities which are dangerous to the stability of your prosthesis, especially for the first few months. The therapist will teach you how to sit, rise from sitting, and turn from side to side safely, as well as other precautions. You will be given a sheet of written instructions regarding these precautions.

  • Limb Length Inequality: We make every effort to equalize your leg lengths at the time of surgery. However, at times it is necessary to lengthen your leg to gain better stability after surgery. Occasionally, this will require you to use a shoe lift on your opposite shoe.

  • Numbness: It is important to know that during surgery, trauma can occur to the nerves around the hip, resulting in weakness or numbness in the operated leg.

  • Severe Complications: Again, with any major surgery, there is a possibility that any of the above complications, as well as problems with anesthesia, could be severe enough
    to result in death. If there are any questions or concerns regarding these complications, please feel free to discuss them with your surgeon.

ANTERIOR HIP PRECAUTIONS

Do not

  • Get in the "limbo" position for 8 weeks

POSTERIOR HIP DISLOCATION PRECAUTIONS

Do not

  • Cross your legs

  • try to put on your own shoes or socks

  • bend to the floor

  • sit in low chairs or sofas

  • bend your leg so that your knee is higher than your hip

  • turn your knee inward with your hip flexed

Do

  • Turn only with a fat pillow between your legs

  • Continue your exercises as taught by physical therapy 3 times a day