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WHAT IS A HIP REPLACEMENT?
A total hip replacement is reconstructive surgery to the hip to restore motion and function and to relieve pain. It is a replacement of both articulating surfaces, with metal or plastic components.
The prosthesis consists of two parts; a metal femoral component topped by a spherical ball, fitted into a plastic acetabular socket. The prosthesis is made of stainless steel and polyethylene.
WHY A HIP REPLACEMENT ?
- When the cartilage between the joint surfaces is damaged, arthritis develops and the bone is exposed, pain develops and movement is restricted.
- Difficulty in walking will occur and the leg can become shorter.
- Rumatoid arthritis - a illness, where joint pain, stiffness and swelling will occur.
- Avascular necrosis - Bone lost due to blood starvation.
- Injury
TIPS BEFORE YOU COME IN FOR YOUR OPERATION
- In the event of you being overweight, endeavor to loose a few kilograms.
- Create open areas in your home for greater maneuverability.
- Roll up all loose mats so that you do not slip and fall.
- Ask someone to take care of your pets to prevent them jumping all over you.
- Place items that you are going to use on a regular basis, at an easy accessible height.
PRE OPERATIVE PREPARATION
- Do not eat, drink or smoke for at least 6 hours prior to your operation.
- On being checked into your ward, the nursing staff will obtain a full medical and surgical history. All allergies are recorded.
- Depending on your doctor, blood tests may be done to see if you may have an allergy to anesthetic. They can also request blood from the blood bank for you (if you have not arranged this yourself).
- Theatre consent document needs to be signed by you. This will give the doctor authorisation to perform the procedure.
- Ensure that you understand what the doctor is going to do, and that the specific hip is clearly identified (left/right).
- X-rays must accompany you to the theatre.
- You will be asked to wear a theatre gown.
- Your doctor will instruct our ward staff how to prepare the area that you are going to be operated on:
- Pre medication is given to you as prescription.
- You are wheeled to theatre by nursing staff and a porter.
- Special pillows will accompany you to theatre. This will keep your legs apart after the operation.
- After the operation you will be either sent to the Intensive Care Unit or back to your own unit.
POST OPERATIVE
- Observations are done initially every 15, 30 and 60 minutes, until you are stabilised. This normally takes 4 hours. You might be connected to a monitor which performs the same procedure as above.
- You will have an intravenous line (drip).
- Depending on your doctor, you might have a Pain pump. This will assist you to control the pain.
- Any bleeding in and around the operated area will be monitored. With new technology it is possible to recycle your blood back into your system.
- Records are kept to insure a balance of intake and output of all liquid.
- You will be given something to eat and drink once you are fully awake and are not nauseous.
- Pain medications will be prescribed by your doctor, and will be administered as per his instructions.
- You will be kept as comfortable as possible.
- The following day you will be visited by a physiotherapist. You will be instructed on exercises that needs to be done in bed. The physiotherapist consults with your doctor and once they both are in agreement that sufficient progress has been made, you will be allowed to get up. You will also be supplied with a walking aid.
- Bandages and draining tubes will be removed as instructed by your doctor.
- Constipation may occur, and you will be asked everyday as to whether you have had any bowel movement.
- A normal diet will be provided.
- Further blood tests will be done to ensure that you have not suffered blood loss.
- You will also be supplied with an "elevated toilet seat" which you place on your existing toilet, to make your position more comfortable.
- Your stay in hospital will be approximately 7-10 days.
- Full recovery will take up to 6 months.
- Ongoing support and help will be there for you at all times.
PRACTICAL TIPS
- Your hip can become displaced; do not try the following movements:
- Flexion of your hip.
- Crossing your legs
- Bending to your side.
FOR AT LEAST 2-3 MONTHS AFTER YOUR OPERATION
- Please adhere to the following instructions:
- Sleep on your back with the pillow between your legs.
- Never lie on your operated hip.
- Sleep on a hard mattress.
- Don't bend forward to pull up the sheets.
MOBILITY:
- Do not sit in low comfortable chairs, rather sit in a higher chair with armrest.
- Where possible use a shower instead of taking a bath.
STAIRS:
- Up: First with the normal leg, then the walking aid and lastly the operated leg.
- Down: First with the walking aid, then the operated leg and lastly the normal leg.
ELEVATED TOILET SEAT:
- The aid that will help you to sit more comfortably and assist you to stand up easier.
CAR:
- For the first 6-8 weeks you may not drive.
- Move the passenger seat as far back as possible.
- You may resume driving after 3 months.
- Sit carefully and lift your legs into the vehicle in one movement.
- To climb out of the vehicle reverse the procedure.
EXERCISES:
- Swimming is good exercise. Running is not recommended
- You may play Golf after 12 months.
- Walking is excellent.
GOING BACK TO WORK:
- You may go back to work within 8 weeks.
ON DISCHARGE
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