Total Hip Replacement
This is a commonly done surgery these days. Here, the ball and socket joint of the hip is replaced. This is a main weight bearing joint of our body. So, take care after surgery to help healing and attain proper alignment and movements.
You’ll need to follow instructions given by your doctor and your physical therapist.
Movements Not to be Done
More important than any other precautions are movements to be avoided. This is because, if you do any of these movements, there’s a risk your operated joint may get dislocated. This happens in 10% of cases, statistically.
- There should be a space between both your legs all the time. This can be achieved by placing a leg wedge or a pillow between them. Never try to bring the two leg too close to each other.
- You have to move the operated leg in a straight line. Any deviation from the straight line, left or right is not allowed. Medically speaking, abduction and adduction around the operated joint is not allowed.
- You are not allowed to sit crossed legged.
- While moving the leg in a straight line, avoid taking it too high in the front or back. Even while sitting on your bed, your knees should not be higher than your hips.
Movements to be Done
Starting movements as early as possible is advisable. This is to promote blood circulation in the affected limb. A good blood circulation would speed up healing and prevent the development of clots there.
Why do Clots Get Formed?
Blood tends to thicken over areas of recent surgery. Furthermore, as movements of the patient are much less, and due to loss of muscle tissue, there is not enough circulation of venous blood in the body. The blood gets stagnated and does not go back to the heart efficiently. This may make grounds for formation of clots.
Once clots get formed, there is always a risk that it may get stuck in any of the tiny blood vessel, obstructing it partially or completely. Such situations may give rise to strokes or angina attacks.
You may move your foot up and down, around your ankle. Likewise, movements around the knee joint may be done.
As for the hip joint, move in only in a straight line. Not sideways, no rotation around it. Let all movements be gentle, not abrupt or swift.
A walker may be helpful in early stages, where your arms are able to bear some weight of your body. This may be used for 6 to 8 weeks.
Later on, you may shift to a stick. Make sure your stick is sturdy enough and not slippery.
How to Sit?
Sit straight. Let your back be straight, not tilted. Your legs should be at least six inches apart from each other. Let both, your hip joint and your knee joint, be in a neutral position, that is, not elevated, inwards or outwards.
Limit your sitting sessions to half a hour.
A lot many muscles and soft tissues get cut during surgery to access the hip joint. This makes the area vulnerable to infections. So, antibiotics are always given.
An antibiotic cover is always prescribed just after the operation for around a week. It is recommended to take the complete prescribed course of antibiotics.
Medicines to Prevent Blood From Clotting
Aspirin or similar drugs need to be given. Initially, they are prescribed in injectable forms for around ten days. Later on, patient may be shifted to pills.
Warfarin, used to prevents the formation of blood clots, is given.
Initially, opiates need to be given. Pain is immense, especially on movements. You need to be patient. Don’t try to avoid these medicines.
Not controlling pain adequately may cause you restriction of movements, which is not good. We want you to move the leg as early as possible. This is to avoid the development of strictures there.
You need to take a healthy diet, low in calories and high in essential nutrients required for wound healing. Here’s listing what in right and what’s not. However, this is a general list, applicable on most patients. For a more specific list of food, you need to consult a dietitian.
- Avoid all junk food, like chips, burgers, fries, carbonated drinks etc. They would give you unnecessary calories and increase your weight.
- It’s advisable to keep your weight in control. Excess weight would make it difficult for you to walk.
- Avoid smoking. This would add up to the risk of clot formation. Also, it would interfere with wound healing.
- Consume plenty of fresh fruits and vegetables on a daily basis. They contain factors required to boost up your immune system and promote healing.
- Vitamin C , B, E and zinc are especially required. You may be prescribed a nutritional supplement to meet these requirements.
- Sprouted pulses, gram seed etc. are very rich in growth factors. They may be eaten raw or par boiled during healing phase.
- Take whole grains, low fat dairy. Avoid excess fatty food or fried stuff. These may be difficult to digest during these days, as you are not walking much. Also, they may add to your weight.
Initial six weeks in the actual healing time of the wound created during surgery and due to fracture. During these six months, you are expected to have got back some essential movements around your joint. You are expected to be going to the washroom on your own and doing essential activities of the day.
It would take 3 to 4 months more of gentle exercises and physiotherapy to build up muscles around the affected joint. Be gentle and gradual. A total of 6 months would make you stand, walk and carry on with most of your previous activities.