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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
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.
DO NOT turn your operated leg inwards or
twist on your operated leg.
DO NOT cross your operated leg over the midline of your
body when sitting.
DO NOT cross your operated leg over the
midline of your body when lying down.
being discharged home
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.
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
The Physiotherapy Department may contact you to organise
an outpatient physiotherapy appointment if this has been
planned for you.
You may eat your usual diet but we suggest you eat more fruit,
vegetables and fibrous foods. We also encourage you to drink plenty
For more information on healthy eating the following internet
links are useful.
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
What are the signs and symptoms of
- Straining to pass a bowel motion.
- Pain or bleeding from the rectum during your bowel
- A feeling that you did not empty your bowel completely.
- Nausea/reduced appetite.
- Stomach cramps and bloating.
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.
You should talk to your GP about your constipation to ensure you
are taking the most suitable bowel medication for you. These
- Stool softeners
- Bowel stimulants
- Osmotic laxatives
- Bulk formers
- Suppositories and enemas
It is important you continue to regularly undertake the
exercises you were given by your physiotherapist.
Please wear your surgical stockings for six weeks following
You should keep your wound covered with the waterproof dressing
applied during your hospital stay, for 5-7 days following
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.
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
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
- If your wound becomes red, painful, inflamed, or has a lot of
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
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.
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
Check with your health professional if you are unsure when to
safely resume sexual activity
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
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.
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
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
You should think about using a stool while preparing food,
washing up and using the stove top, to provide short breaks
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
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
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
If you are following hip precautions use a long handled easy
reacher with a sponge or flannel wrapped around it to wash your
Wrap a towel around a reacher to dry your legs.
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
Have items packed into several smaller bags for easier
If possible, use a trolley to push your groceries rather than
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.
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
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
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.
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.
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