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Hip precautions

It is important that for the first 6 to 8 weeks following your operation you take special care to protect the joint and prevent dislocation. You do not need to follow these precautions if your surgeon has used a lateral approach for your surgery. Your physiotherapist will discuss this with you.

Hip Precautions
DO NOT 
bend your operated hip further than 90 degrees. Sit in a high chair so that you do not bend your hip too far when you are sitting/standing. When bending down to pick something up, keep your operated leg behind you.
Hip Precautions
DO NOT turn your operated leg inwards or twist on your operated leg.
Hip Precautions
DO NOT
cross your operated leg over the midline of your body when sitting.
Hip Precautions
DO NOT cross your operated leg over the midline of your body when lying down.

After being discharged home

Medication

You will have been given a prescription for pain medication It is recommended that you take the medication as instructed. Continue all other medication unless advised otherwise.

Follow up appointments

You will receive a phone call from the hospital approximately two days after your discharge to make sure you are recovering well and answer any questions you may have.

You may have a follow up appointment with your surgeon 2-6 weeks following your surgery. You will receive an appointment in the mail. Make sure you write it in the appointments section of this book for safe keeping.

Any further follow up appointments will be made at your review.

Physiotherapy

The Physiotherapy Department may contact you to organise an outpatient physiotherapy appointment if this has been planned for you.

Diet

You may eat your usual diet but we suggest you eat more fruit, vegetables and fibrous foods. We also encourage you to drink plenty of fluid.

For more information on healthy eating the following internet links are useful.

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Constipation post operatively

Normal bowel action

The normal frequency of passing bowel motions should be from three times per day to three times per week. Bowel motions should be formed and easy to pass.

What is constipation?

Constipation is when you have hard, dry, difficult to pass bowel movements, or you go longer than usual between bowel movements.

Note - A mixture of hard and runny loose bowel motions can be a sign of severe constipation.

What causes constipation?

  • Not drinking enough water.
  • Having too much fibre in your diet.
  • Limited intake of food.
  • Lack of exercise or mobility.
  • Ignoring the urge to go to the toilet.
  • Medications - many pain relief tablets can lead to constipation.

What are the signs and symptoms of constipation?

  • Straining to pass a bowel motion.
  • Pain or bleeding from the rectum during your bowel movement.
  • A feeling that you did not empty your bowel completely.
  • Nausea/reduced appetite.
  • Stomach cramps and bloating.
  • Headache.

What can I do to manage my constipation?

  • Increase your fluid intake to 1-2 litres a day.
  • Eat regular healthy meals including all the food groups.
  • Exercise - go for regular short walk.
  • Go to the toilet around ten minutes after you have eaten.

It is important not to wait too long before you seek assistance with constipation. If your symptoms persist for 3 days, please contact your GP.

Treatment

You should talk to your GP about your constipation to ensure you are taking the most suitable bowel medication for you. These include:

  • Stool softeners
  • Bowel stimulants
  • Osmotic laxatives
  • Bulk formers
  • Suppositories and enemas

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Exercise

It is important you continue to regularly undertake the exercises you were given by your physiotherapist.

Surgical Stockings

Please wear your surgical stockings for six weeks following your surgery.

Wound care

You should keep your wound covered with the waterproof dressing applied during your hospital stay, for 5-7 days following surgery.

Wounds can take about 10 days to heal and you may notice some oozing for a few days.

After 7 days no dressing is required if the wound has healed and you may remove the dressing. If the wound is red, or oozing longer than a week after surgery, or is very swollen and painful then you should seek advice from your GP. Your GP may decide to inform your surgeon by phone call or send you to the hospital for review.

The wound and skin around the wound will be warm to touch for some weeks and sometimes months following surgery. There will be swelling of the tissues around the wound that will decrease over a few weeks to months.

Knee swelling after a knee replacement

Your knee will swell for several weeks after your operation. Continue with your exercises. To further reduce swelling, when resting, sit with your leg up, straight, and well supported. You can use a bag of ice wrapped in a clean, damp cloth and mould this around your knee for a maximum of 15 minutes to reduce swelling. This can be done two to three times per day. It is important that you do not keep ice on for long periods as it could result in an ice burn.

Limb swelling

If you have significant swelling of one or both of your legs that does not reduce by having your leg up, then consult your GP. Your GP may decide to perform an ultrasound scan or send you to the hospital to investigate for a blood clot.

If you have any concerns regarding your health after your discharge from hospital, please seek advice from your GP.

The following signs and symptoms are especially important:

  • Chest pain
  • Calf pain or swelling
  • Shortness of breath
  • Fever or chills
  • Nausea or vomiting
  • Bleeding
  • If your wound becomes red, painful, inflamed, or has a lot of oozing.

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Returning To Work

Returning to work/hobbies

After your surgery it is important not to take on too much too soon. Plan your day so that you spend small amounts of time doing different tasks. Remember that you need to rest when you are tired.

At your follow-up appointment with your surgeon, you will be advised when you can return to work, drive a car, and take part in other physical activities including sport, hobbies.

If in any doubt, do not return to work without discussing it with your surgeon.

Sexual activity

Following total hip replacement, safe resumption of sexual relations can be resumed. Attention to proper positioning and comfort will enhance the return to intimacy. Avoid kneeling positions initially.
Check with your health professional if you are unsure when to safely resume sexual activity

Household tasks

You will need help with everyday household tasks. Please ask your family/whānau and friends if they can help you with this.

Dressing and undressing

Wear loose-fitting clothing. It is recommended that you sit in a chair or on the side of the bed. Dress the operated leg first and undress the operated leg last. If you are following hip precautions you should be using your Easy Reacher. You may find a long-handled shoehorn helpful.

Sleeping positions

The best position to sleep in is on your back. Unless you have been told not to, you can sleep on your side as long as you place two pillows between your legs, to prevent your operated leg crossing the midline of your body.

Making your bed

Stay in bed and pull up the top sheet and duvet. When you get out of bed the task should be simply smoothing the covers. Make sure the floor is clear around the bed to avoid tripping or falling.

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05 Meal PreparationMeal preparation

The contents of your cupboards should be arranged so that essential items are within reach without bending or stretching (between shoulder and waist height).

Avoid lifting heavy saucepans. Slide them across the bench instead. If you live alone you may need a trolley to move heavier items across the room.

Your occupational therapist can provide loan equipment if needed.

You should think about using a stool while preparing food, washing up and using the stove top, to provide short breaks from standing.

Avoid using the oven if it is not at waist height.

Small items can be carried in a backpack or an apron with pockets. Think about using a frozen meal or meal delivery service.

Laundry

Wash small loads of clothes over the week, rather than one large, heavy load. Adjust the clothesline to avoid stretching or try using a clothes horse for smaller items.

Showering / body washing

Your occupational therapist will provide you with the appropriate equipment aides for using in your shower or bath. For safety, sit on the shower chair, stool or bathing equipment provided to you. This will be adjusted to the correct height for you.

If you are following hip precautions use a long handled easy reacher with a sponge or flannel wrapped around it to wash your legs.

Wrap a towel around a reacher to dry your legs.

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Shopping

Shopping


Shop with someone who is happy to carry items for you.

Avoid shopping during peak times.

Do smaller, regular shopping trips to avoid heavy shopping bags and trolleys.

Have items packed into several smaller bags for easier carrying.

If possible, use a trolley to push your groceries rather than carry them.

If you must carry shopping, divide the weight evenly into at least two bags with one in each arm, or try using a backpack.

Consider shopping for groceries on the internet.

Cleaning

Once you return to cleaning, use long-handled aids and lightweight items. Avoid twisting and bending.

Getting in and out of the car

If possible, get into the car on a flat area such as a driveway or road. Have the car parked away from the curb so your feet are on the road. This allows room for your mobility aid and makes the car seat higher.

Avoid very low and very small cars. Do not get into the back of a 2-door car.

Have the passenger seat pushed as far back as possible with the back of the seat in a recline position.

Back yourself up towards the car so that you are facing away from it. You will be getting into the car bottom-first.

Reach for the seat back or dashboard, not the car door.

Gently lower yourself down to the seat, keeping your operated leg as straight as you can at the knee and bending at the hip, only as much as is comfortable but no more than 90°.
Shuffle yourself backwards into the seat as far as possible, leaning back against the seat until you are able to bring both legs into the car.
Getting out of the car is done in the same way, only in reverse.

Tip: Raise the passenger seat by placing a folded blanket on it, and put a plastic bag on top of the blanket to help you swivel around and slide your bottom much easier.

10 DrivingDriving

You may not be able to drive for up to six weeks following your surgery. You should discuss this with your surgeon. Before you return to driving you need to be able to get in and out of the car safely and also control the vehicle. Please check with your insurance company if you are going to drive.

Air travel

It is advisable not to fly within the first six weeks following a joint replacement. If you are planning on flying within New Zealand or overseas, it is important that you discuss this with your surgeon.

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Last updated: February 27, 2017