Total Hip Replacement Surgery Home Care Instructions

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1 Total Hip Replacement Surgery Home Care Instructions Surgery: Date: Doctor: This handout will review the care you need to follow once you are home. If you have any questions or concerns, please ask your nurse or doctor. Our staff is here to help you. If you have questions after you are at home, please call the numbers at the end of this handout. Activity The total recovery time after a total hip replacement varies from person to person. For most people, recovery is a six to eight week process. Surgery can cause you to feel weak and tired. Common sense will tell you when you are doing too much. On the other hand, too little activity can delay the return of your strength and stamina. Follow these guidelines to help keep your recovery process on track. Follow the home exercise program your physical therapist (PT) has shown you. This includes the instructions for weight bearing. Your weight bearing status is: The correct use of your crutches or walker will prevent injury to your hip. You may need to use a cane until you can walk without a limp. By six to eight weeks most patients no longer need to use a cane, walker, or crutches.

2 Walking is good for you. Set a time to walk, at least twice each day. Let pain be your guide. As you get stronger, increase the distance you walk each day. Keep doing your exercises 3 times a day for 3 months. Then switch to a maintenance program doing the same exercises 3 times a week for at least one year. Hip Dislocation Precautions Do not cross your legs at any time. Do not bend your hip more than 90 at any time. Your knee should never be higher than your hip. Do not let your hip turn inward (i.e. pigeon-toed). To prevent falls, use caution when getting up too quickly after eating, lying down, resting, or using the toilet. Sitting It is fine for you to sit in a comfortable chair as long as your knees stay lower than your hips and your legs are not crossed. You may wish to use chairs with side arms or a pillow on the seat to make it easier to get out of the chair. Avoid sitting for long periods of time. Sleeping You may be given a wedge-shaped pillow to place between your legs for six weeks while sleeping. This helps prevent crossing your legs. If you are not given a wedge shaped pillow, please place two pillows between your legs while sleeping. By six weeks, you may be able to sleep with just one pillow between your legs.

3 Lifting Extra weight increases the force on your new hip. You should not gain or lift over 30 pounds. Housework You may do light housekeeping. Remember to maintain your hip dislocation precautions. Sports You may resume using an exercise bike with no resistance six weeks after surgery. Do not play any impact sports like tennis, jogging, or volleyball. Check with your doctor before you resume sports. Sexual Activity When you are ready, you may resume having sex. You must maintain hip dislocation precautions. Choose positions that do not cause you to sit with your knees raised higher than your hips. Do not let your knees touch each other. Do not allow your foot and leg to roll inward. Bathing Sponge bathe for two weeks after surgery to avoid getting the incision wet. Your incision may be closed with staples or sutures. If you have staples, your doctor will decide when you may shower. In most cases, this is 24 to 48 hours after your staples are removed. If your incision is closed with sutures, it may be covered with steri-strips (small pieces of tape) on the skin. The steri-strips will slowly peel off. If the steri-strips are still in place after 10 days, you may gently remove them.

4 Care of Your Incision Proper care of your incision helps to prevent infection. Keep your incision clean and dry. Change your dressing every other day and as needed. You may leave it open to air when the incision is dry. Do not wash directly on the incision. Wash around the incision gently with soap and water and then let it air dry. Do not use any creams, lotions, ointments, or alcohol near or on the incision. Check the incision daily to be sure it is clean and dry. Check it for redness, swelling and drainage. Some redness and swelling is normal. A small amount of clear or slightly blood tinged drainage from your incision is normal. If you have a brace, you will also be given brace care instructions. Check for Signs and Symptoms of Infection A persistent fever of 100.5ºF or 38.1 C for 24 hours Increase in swelling Increase in redness around the site Increase in drainage from site A mild fever is common after joint replacement surgery. A fever does not always mean infection. The fever should slowly decrease in time. Swelling As you become more active, you may notice some swelling in your leg or foot. There are some things you can do to prevent or decrease this swelling. Raise your legs between periods of walking. Lie flat on your back and raise the operative leg above the level of your heart. Maintain hip dislocation precautions. Keep doing your ankle pumps and quad sets. See PT exercise sheet. If swelling occurs after you exercise, use the ice therapy method to the site.

5 Ice Therapy Method Ice the incision area for 20 minutes as often as needed. Do not put the ice directly on the skin. Use a ready-made ice pack or put ice in a plastic bag and wrap in a towel before you use it. Pain Management You may need to use pain medicine at home. Do not drive if taking narcotic pain medicine. If needed, take it as prescribed. The pain medicine can cause you to be unsteady on your feet. In most cases you should not take Non-Steroidal Anti-Inflammatory (NSAIDS) medicines (i.e., ibuprofen, Motrin, Advil, Aleve ) for 6 weeks after your surgery. Ask your doctor when it s okay. Do not take aspirin unless prescribed by your doctor. If you aren t sure about a medicine, please call the Orthopedic Clinic. Some patients find pain relief from methods other than pain medicine. These include: Ice therapy Deep breathing exercises Distraction Repositioning Constipation Many things can cause constipation. They include: surgery, narcotic pain medicine, decreased activity level, and a change in your diet. Please see Health Facts for You Constipation from Opioids (Narcotics) in your Post-Operative Total Hip Replacement Surgery Packet. Deep Vein Thrombosis (DVT or blood clot) Patients who have total joint replacement are at a greater risk of getting a deep vein thrombosis or blood clot. Symptoms of a blood clot include: Severe leg swelling Pain, redness and/or tenderness in calf

6 A blood clot in your leg can break off and travel to your lungs. This is called a pulmonary embolism. Symptoms of a pulmonary embolism include: Shortness of breath Chest pain when you inhale If you have any of these symptoms, call your doctor. Blood Clot Prevention To decrease the risk of a blood clot, you may be taking medicine to thin the blood for 2 to 4 weeks after surgery. Your doctor will decide how long you will need to take it. Blood draws may be needed to check how well the blood thinner is working. Most patients need their blood drawn twice a week. It depends on the blood thinner medicine your doctor orders. 1. is your blood thinning medicine. 2. will draw your blood. Phone: ( ) 3. UW Anticoagulation Clinic Primary MD Other will tell you how much blood thinner medicine to take. Phone: ( ) Elastic Stockings (TED hose) To improve blood flow and decrease the risk of getting a blood clot, you will need to wear elastic stockings. You should wear them on the operative side during the day for 6 weeks. You should remove them 2 times each day for one hour at a time. You don t have to wear them at night. But you may do so if you wish. Please wear them until your doctor tells you to stop wearing them. You should wash your elastic stockings with soap and water. Let air dry. Driving and Travel Do not drive for two weeks after surgery or while taking narcotic pain medicine. At your two week check up, your doctor will let you know when you may drive. You may travel over two hours 6 to 8 weeks after your surgery. Stretching every hour will decrease stiffness as you travel.

7 Metal joint implants may trigger metal detectors in airports. You will get a joint replacement card at your first clinic visit. This card does not guarantee you will be able to pass through airport security without being searched. It will simply provide information to airport security. Future Medical or Dental Treatment Do not have routine dental work done for 3 months after your joint replacement. If dental work must be done in cases of infection or a dental emergency, please notify the Orthopedic Clinic. You should check with your orthopedic doctor before dental visits or other surgery. It is likely you will need to take a dose of antibiotics before your dentist appointment or other surgery to protect your hip joint from infection. Your doctor will tell you if you will need this for the rest of your life. Always tell your doctor or dentist before: All dental care (includes routine cleaning) Major or minor surgery Colonoscopy, endoscopy, rectal exams Disabled Parking Ask the clinic staff how to apply for a temporary permit at your first clinic visit. When to Call the Doctor If you have an infection in other places like your bladder, throat, or lungs, these infections can travel to the hip and cause problems. Call both your primary medical doctor and your surgeon. Increased tingling or numbness in your leg or foot. Increased pain, swelling, or redness in or around your incision site. An increase in the amount of drainage, change in the color of drainage, or any odor from your incision. Be ready to describe what the drainage looks like, how it smells, and how much there is. A new blister(s) near or on the incision. A temperature above 100.5ºF or 38.1 C for 24 hours. Sudden increase in pain or pain not relieved by medicine. A sudden "popping" feeling in your hip.

8 You cannot move your hip. Severe leg swelling, pain, redness and/or tenderness in either calf. Shortness of breath or chest pain when you inhale. A new chest pain or a new problem with breathing. Future Visits Your first clinic visit should be 2 weeks after surgery. This may have been scheduled before surgery. It it wasn t, we will help you schedule it before you are discharged. All other clinic visits will be on an as needed basis. Most patients have their first outpatient PT appointment days after leaving the hospital. You will be given a prescription for these PT appointments when you return to see the doctor in clinic. Pain Medicine Refills If you need a refill on your pain medicine, call the Orthopedic Clinic at (608) , Monday through Friday, 8:00 a.m. to 4:00 p.m. and ask for the nurse. Please call when you have a 2 to 3 day supply left of your medicine. Do not wait until you completely run out. Be ready to give the name and phone number of the drugstore where you want to pick up a refill. Please note that some pain medicines by law cannot be called in over the phone or faxed. Phone Numbers If you have questions or concerns, please call the Orthopedic Clinic, Monday through Friday between 8:00 AM and 5:00 PM, at (608) After 5:00pm and Nights and Weekends For all questions call (608) If you live out of the area, call 1(800) Ask the operator to page the orthopedic resident on call. Leave your name and phone number with the area code. The doctor will call you back. Your health care team may have given you this information as part of your care. If so, please use it and call if you have any questions. If this information was not given to you as part of your care, please check with your doctor. This is not medical advice. This is not to be used for diagnosis or treatment of any medical condition. Because each person s health needs are different, you should talk with your doctor or others on your health care team when using this information. If you have an emergency, please call 911. Copyright 4/2013 University of Wisconsin Hospitals and Clinics Authority. All rights reserved. Produced by the Department of Nursing. HF#4512.

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