After your hip replacement

 

In the Operating room


At the end of the operation, the anaesthetist will wake you up in the operating theatre although the first thing you are likely to recall is the recovery ward. You will remain there for 1-2 hours under the care of a specially trained recovery nurse. If you have received a local anaesthetic block you should feel no pain but you will also notice that you will not be able to move one or both legs. This weakness will wear off later in the day, as you start to get feeling back in the legs. If you have marked pain or sickness after your operation, please let the recovery or ward nurse know. The anaesthetist will have prescribed drugs that can relieve these symptoms, and you will benefit from receiving them.


You may find several items in place to help your recovery. An oxygen mask over your mouth and nose helps your breathing. Sometimes a tube will have been placed in your bladder (urinary catheter). This is usually only in place for short time and makes passing urine easier after the operation. Rarely, a blood transfusion may be needed at this stage.


Once you are properly awake you will be returned to the ward.


Recovery on the Ward


There has recently been a huge change in the immediate post-operative management of patients. With the advent of less invasive hip surgery, patients are mobile very soon after the operation. This reduces the risk of post-operative blood clots and allows an earlier home discharge, thereby reducing the risk of catching a hospital- related infection.


Day 0

Once properly awake, you will be transferred from the recovery room back to the ward. Your pulse and blood pressure continue to be checked regularly through the day and night following surgery and so it is difficult to get a good night’s sleep.


Pain relief can be administered in a variety of ways and is usually successful and you should experience only a dull ache around the hip. It is standard practice to use a spinal anaesthetic containing diamorphine which usually gives extremely good pain relief for at least the first 24 hours post-surgery.


Occasionally patients who are feeling well enough may mobilise on the day of surgery.


Day 1

The majority of patients will start to mobilise today. This involves standing out of bed with the assistance of the physiotherapist and crutches or a frame and afterwards taking a few steps and sitting in a chair for a short period of time. If walking to the bathroom is achieved, the urinary catheter (if inserted) can be removed.


The blood level (haemoglobin) is checked and, if satisfactory, the drip is removed from the arm. Occasionally a small number of people (about 10% of cases) require a blood transfusion after the operation.

The following exercises help the circulation and reduce swelling in the legs and are repeated frequently throughout the day for the first 6 weeks after your surgery

¬Bend and straighten your ankles when you are sitting or lying

¬Lying on the bed with your leg straight, pull your foot up and tighten your thigh muscles by pushing your knee down against the bed. Hold for 5 seconds. Relax and repeat.

¬Lying on the bed, squeeze your buttock muscles together and hold for 5 seconds. Relax and repeat.

¬Lying on the bed, bend the knee of your operated leg whilst trying to keep the knee pointing outwards. Keep the foot in contact with the bed. Relax and repeat.

¬Lying on the bed, take your operated leg out to the side, keeping the knee straight. Relax and repeat.

¬When sitting, bend the knee on the operated leg as far as comfortable. Relax and repeat.


Day 2

More walking is encouraged with frequent walks up and down the ward. As much weight is taken on the operating leg as possible, unless you are instructed otherwise.

Stair climbing is commenced in patients progressing ahead of schedule. Sitting out for meals is now encouraged.


The Occupational Therapist will start to assess whether you are able to transfer on and off your chair and bed and can get washed and dressed in preparation for your return home. He/ she will also talk to you about what you are able to do when you return home and what should be avoided.


Day 3

Walking distance is increased and you will be shown how to climb stairs, if you haven’t already done so. Once you are safe on the stairs, and able to dress and undress alone, then discharge is arranged and most patients are able to return home on day 3.