THR - Total Hip Replacement

 

Hospital recovery

 

 

When you have recovered from your anaesthetic the staff in the recovery room will summon porters to assist in moving you to the ward.

 

You will need to rest after the operation, as your body has been subjected to a major trauma that it is not used to handling. You will also need pain relief, and the nursing staff will probably ask you your pain level on a '1 to 10' scale, 1 being no pain, 10 being the worst imaginable. The pain relief may be given orally (pills, capsules, liquid or injections), or in the cannula that will still be in the back of your hand for even faster pain relief. One other form of pain management is Patient Controlled Analgesia (PCA), where you have to press a button to administer extra pain relief into the cannula; the controller for this will only let you administer a safe amount, so you cannot get too much. You will also probably receive blood thinning medicine to stop blood clots forming. The main benefit of PCA is that you do not have to wait for someone to give you the pain relief.

 

You may find that you have a drain to stop blood from pooling in the wound site; typically this will end in a 'blood bag'. The blood collected is usually re-infused back into the patient as there is no problem of blood matching - it is your blood.

 

If you have a catheter fitted, you will find it extremely easy to pass water, but this will hamper any movements you wish to make. You may be fitted with a pair of inflating stockings, these inflate and deflate regularly every minute or so to help with blood flow in your lower legs. You may also have a wedge shaped pillow between your legs to help ensure that you lay correctly.

 

Another well-kept secret is that if you are not fitted with a catheter, you may have a little 'accident' if you are given a bedpan as it is easy to 'miss' it and end up wetting the bed. Oh and beware the cold rim! [renee01952]

 

The nursing staff and physiotherapy staff will want to get you up and mobile as soon as possible, probably in the following day (Day One after the operation). They will advise you on how to get in and out of bed, and how to use mobility aids such as a walking frame, sliding sheet (to aid getting in to bed, and into a car), crutches or sticks. The main thing is not to twist when turning, use small steps instead.

 

The physios will want you to move your feet and legs to make sure the blood keeps flowing properly in your legs. I found that having my iPod playing music was relaxing and at the same time encouraged me to move my feet to the 'beat'.

 

For the first few days you will probably feel tired very rapidly. As your body is trying to use all your energy to repair itself.

 

You may be liable to faint due to low blood pressure, if you do feel faint, call for the nursing staff to help you before you pass out.

 

Narcotic painkillers can make you very sleepy and cause you to breathe slowly, because of this you will be checked often at the start of your recovery. Constipation is another side effect of Narcotic painkillers. [maggie93798]

 

On day two after the operation, you will probably be able to try your walking skills in the ward, with or without assistance from a physiotherapist as required. Remember not to twist when turning, but use lots of very small steps.

 

On day two or three, you may be ready to try climbing stairs. This is usually the 'yardstick' used to tell if it is time for you to go home. If you pass the 'test', preparations will be made to discharge you.

 

If you are not ready to do these things at these times, do not worry, we all start with different level of health and fitness, and we have different healing rates.

 

If you have a traditional plaster dressing, you should have the wound site re-dressed before you leave. It is a very good idea to have the person that will be looking after you when you get home present to see how to do this, as it can be quite daunting to manage removing and replacing a dressing of this length.

Traditional 10 cm x 25 cm waterproof dressing

 

There are some newer types of wound dressings used which do not require changing, you will be advised when the dressing can be removed.

 

 

Wound care

Your wound site can leak clear fluids, which do not necessarily indicate an infection. To quote 'Nursing Times'  ... "Exudate is a fluid produced as part of the normal wound-healing process, and is essentially blood from which the platelets and red cells have been filtered out. It leaks from capillaries in the tissues surrounding a wound as a consequence of increased capillary permeability."

 

 

You should be provided with a 'discharge pack' with a spare pair of TED socks (if you have to wear them), spare dressings, pills to take, information leaflets on wound care and mobilisation, and an appointment card for you to return to have the stitches or clips out, to see the physiotherapist, and to see your consultant.

 

 

The pills you are issued with will vary from person to person and may include:-

Strong pain killers (Please be aware that it may be illegal to pass these on to another person).

Ordinary strength pain killers

Anti-inflammatories.

Anticoagulant blood thinners (sometimes these are injected, if so you will be shown how to do this).

Laxatives

 

Remember to take all your things home with you!

 

You will be restricted to bend no more than 90° at the hip. The reason for this is the dislocation risk is high, especially at the start of your recovery, due to the operation weakening your muscles.

 

Dislocation risk graph

 

Dislocation

Dislocation of the hip is extremely painful and can occur at any stage but there is more risk of it happening in the early days. Surgery to relocate the hip joint incurs a tremendous cost to the health care system and the patient has to go through a lengthy recovery period. It is possible to have a cage or constrained liner put in place, this then prevents you from dislocating. Whether the hip is cemented or un-cemented doesn't make any difference, as it's the ball and socket that come apart. [mary0606]

Sitting and bending to the floor causes the majority of hip dislocations, and although most of the risk will be over after six months, you should not expect to be completely healed until around twelve months after the operation. [morriewynn]

 

 

It is so difficult to gauge how individuals will respond to the operation. Every single person has had a different experience for whatever reasons; any pre-existing medical conditions, your own personal healing capabilities, your fitness levels pre operation, even a positive mental attitude has as much to do with it as the skill of your surgeon and the nursing staff. [billiemaw]

 

When dressing, you may find it useful to use the hooked end of the long-handled shoe horn or even the handle of a pair of walking sticks held upside down. Just put the hook through the side of your pants (operated side) and drop them on the floor close to your foot. You'll be able to pull them over your foot and up your leg. Either do the same with your good leg or lift your good leg through the other pants' leg. Then you can pull them up without bending. [CelsB]

 

I also would just like to add that the surgeons, doctors, nurses and hospital staff all do a fabulous job, sometimes against all the odds. They are at work at all kinds of hours for long times. This is a fabulous operation that will change your life, and it is available free of charge in the UK, incredible! How lucky we all are! [billiemaw]

 

Uncommanded spasms Typically in the first few days, you may suffer from spasms in the lower body and legs.

 

 

 

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Page last updated: 10 August 2018 - 15:20