WHAT TO EXPECT
How long does a total hip replacement last?
If you have your hip joint replaced today, over 95% of hip replacements will be functioning well at 10 to 15 years post operatively. With continued improvements in hip replacement technology, your new hip may last well beyond this.
What is the recovery time?
Everyone heals from their surgery at a different pace. In most cases, however, you will likely use an assistive device for 2 to 4 weeks after your operation. You will wean to no assistive device at all. In general, most patients are close to almost full recovery at 3 months.
How long will I be in the hospital?
This varies from patient to patient. Average length of stay for a total hip replacement is less than 24hours and most patients go home the same day. This is highly dependent upon your condition before surgery, your age, and medical problems which can influence your rehabilitation.
When can I walk after surgery?
Almost everyone is walking with an assistive device on the day of surgery.
Will I need general anesthesia?
While general anesthesia is a safe option most hip and knee replacements are performed under regional anesthesia. Choices for regional anesthesia include spinal anesthesia or one of a variety of peripheral nerve blocks.
When will the dressing be removed?
7 days after surgery. It is easiest to loosen the top two corners in the shower and peel it off in a downward motion.
When do my stitches or staples come out?
Your incision can be closed in a variety of ways. If you have stitches, they are absorbable and do not need to be removed. If you have staples, they should be removed at 2-3 weeks post operatively.
BATHING & GROOMING
How do I clip my toenails and shave my legs?
At first you will need assistance with this from a family member or caregiver.
When can I shower (get incision wet)?
Incisions with an Aquacel (tan) or Tegaderm (clear) dressing may shower any time after surgery. These are waterproof dressings.
When can I immerse my hip in water (e.g. bath, swimming pool, ocean, hot tub)?
The incision must be completely healed before it is immersed in water (generally around 4 weeks) and there is no drainage from the incision.
What are the dislocation precautions for my hip (positions that I should avoid)?
Your therapist will review any special precautions if required for your surgery.
What is a dislocation of the hip?
A dislocation of the hip occurs when the femoral head (ball) comes out of the acetabulum (socket). This risk is very small, typically less than 1%, however one of the well-known complications of a hip replacement.
I think my leg lengths are different, what should I do?
It is not uncommon to feel as though your leg lengths are different. At surgery, leg lengths are assessed very carefully and an attempt is made to make them as equal as possible. Sometimes the new hip has to be lengthened in order to obtain proper muscle tension (to help avoid hip dislocation). Your muscles and body take time to adjust to a new hip. In rare cases, a shoe lift may be prescribed for a true difference in leg lengths. In most cases, however, no treatment is necessary.
What medications do I need to stop taking prior to surgery?
Please let your physician know if you are on any blood thinning medications such as Aspirin, Coumadin, Pradaxa, Plavix or NSAIDs (Aleve, Ibuprofen, Naproxen or any other anti-inflammatory drugs). Any medication that causes thinning of the blood is stopped 10 days prior to surgery.
If you are on any hormone replacement (Estrogen or Progesterone) therapy by mouth or oral contraceptives, please let your physician know. Hormone medications are stopped one month prior to surgery and resumed one month post-surgery.
Herbal supplements and vitamin supplements with high levels of Vitamin E or fish oil need to be stopped one month prior to surgery. You may resume your supplement after surgery.
What should I do if I am currently seeing a pain management clinic?
If you are seeing a pain management clinic prior to surgery, you will need to follow up with their office for pain management after surgery.
How long will I be on a “blood thinner”?
Typically you will be on a blood thinner up to 30 days. The exact type and duration will be determined by your physician based on your specific medical history and risk. Of note, if you are on Coumadin (Warfarin), it is extremely important to have your blood thinner level checked regularly, and your Coumadin dose adjusted accordingly.
Should I take iron supplements?
Iron supplements help your body replenish its iron stores and blood count which may be depleted post operatively. You may take over-the-counter iron supplements or a multivitamin with iron for this purpose. Please note that iron may contribute to constipation and also darken the stool.
I am constipated, what should I do?
It is very common to have constipation post operatively. This may be due to a variety of factors, but is especially common when taking narcotic pain medication. A simple over-the-counter stool softener (such as Colace) is the best prevention for this problem. It is also helpful to include a fiber supplement like Fibercon or Metamucil. A gentle laxative (such as Senekot or Milk of Magnesia) may also help. In rare instances, you may require a suppository or enema.
Can I drink alcohol?
You should avoid alcohol if you are taking narcotics or other medication. Otherwise, use in moderation at your own discretion.
REHABILITATION AND RETURN TO ACTIVITY
Do I need physical therapy?
Outpatient physical therapy plays an important role in your early recovery. Your therapist will help you walk, regain motion, build strength and help you reach your post-operative goals. Your therapist will keep your surgeon informed of your progress.
Can I use weights?
As everyone’s strength varies, consult with your surgeon before using weights. No squats, lunges or leg presses should be done early after surgery.
When can I return to work?
This depends on your profession. If your work is sedentary, you may return as early as 2 to 4 weeks post operatively. If your work is more rigorous, you may require up to 3 months before you can return to full duty.
When can I travel?
You may travel as soon as you feel comfortable. It is recommended that you get up to stretch or walk at least once an hour when taking long trips. This is important to help prevent blood clots. Long flights or car rides may increase the risk of a blood clot. Use of a blood thinner such as aspirin may be indicated.
What activities are permitted following surgery?
You may return to most activities as tolerated including walking, cycling, gardening and golf. Some of the best activities to help with motion and strengthening are swimming (after your wound has healed) and a stationary bicycle.
What activities should I avoid?
You should avoid impact activities such as running.
Can I have sex?
You may resume sexual activity when you feel comfortable. In the early time period after surgery avoid any position of the hip that is not comfortable.
Can I go up and down stairs?
Yes. Initially, you will lead with your non-operated leg when going up stairs and lead with your operated leg when going down stairs. You can use the phrase, “Up with the good, down with the bad” to help you remember. As your leg gets stronger, you will be able to perform stairs in a more regular pattern.
DISCHARGE FROM HOSPITAL
How can swelling of my leg and foot be avoided?
The position to avoid is the surgery leg and foot being in a dependent position or on the floor. The best way to avoid swelling is to elevate the leg straight out in front of you, either on another chair or in a recliner chair. It is also best to elevate the ankle above the heart.
Will I go to a rehabilitation facility or home upon discharge?
It depends. Most people go home within 24 hours after surgery however some people require discharge to a rehabilitation facility (usually subacute facility) in order to gain the skills needed to safely return home. Many factors are considered for this decision.
When can I drive?
Do not drive until you are confident you have regained adequate reaction time to safely drive. Typically, this takes at least 2 to 3 weeks after surgery. Test your driving ability in an empty parking lot with someone with you prior to driving in traffic. Do not drive if you are taking narcotics.
Should I wear compression stockings (TEDS)?
These are not required post-operatively.
Should I use ice or heat?
Ice can be used for the first several days, particularly if you have a lot of swelling or discomfort. Once the initial swelling has decreased, you may use ice and/or heat.
When do I need to follow up with my surgeon?
A follow up appointment should be made post-operatively at
2-3 weeks post operatively for a wound check. You will then be seen at regularly intervals for repeat evaluations and Xrays.
Who should I call with questions?
In the case of an emergency, do not call the office, call 911. For all other inquiries, please call my medical assistant Christi at 615.329.6600 EXT 1512. Calls after 5PM Monday-Friday and on weekends need to go to the TOA Operator at 615.329.6600.