Post-operative Hip Care and Precautions

As with any major surgical procedure, post-operative complications can occur following total hip replacement surgery. Below is a list of some of the more common complications that can occur after hip replacement surgery. This list is not meant to be all-inclusive.

Thrombophlebitis

This condition, also commonly referred to as deep vein thrombosis, occurs when blood clots are formed in the large veins of the legs. In some cases, these clots can become dislodged from the veins, travel through the circulatory system, and become stuck in the critical arteries of the lungs. This scenario, called a pulmonary embolism, is a serious medical condition. The following steps may be taken by you and your physician to avoid or prevent thrombophlebitis:

1. Blood-thinning medication (anticoagulants, aspirin)
2. Elastic stockings (TED hose)
3. Foot elevation to prevent swelling
4. Foot and ankle exercises to optimize blood flow
5. Pneumatic devices placed on the feet to improve circulation

IMPORTANT: If you develop swelling, redness, pain and/or tenderness in the calf muscle, report these symptoms immediately to your physician.

Infection

Infections occur in a small percentage of patients undergoing hip replacement surgery. Unfortunately, infections can occur even when every effort is made to prevent them. The following steps may help to minimize the risk of post-operative infections.

1. Closely monitor the incision and immediately report and signs of redness, swelling, tenderness, drainage, foul odor, increasing pain, or persistent fever.
2. Always wash your hands before and after handling your incision site, especially when the sutures are still in place.

Pneumonia

A possible side effect of surgery is the development of pneumonia. The following steps may help minimize this risk.

1. Deep breathing exercises: A simple analogy to illustrate proper deep breathing is to: “smell the rose and blow out the candles.” In other words, inhale slowly and deeply through your nose, and exhale slowly through your mouth at a slow and controlled rate. A simple rule of thumb may be to perform these deep breathing exercises 8-10 times every waking hour.
2. Coughing: This activity helps to loosen the secretions in your lungs and excrete them from your pulmonary system.
3. Incentive spirometer: This simple device provides visual feedback while performing deep breathing exercises. Your nurse or respiratory therapist will demonstrate the proper technique.

Hip Dislocation

One of the most common problems following total hip replacement is hip dislocation or subluxation. Because the prosthetic ball and socket are smaller than the natural anatomy, the ball can become dislodged from the socket if the hip is placed in certain positions. The following precautions must be taken to prevent hip dislocation.

1. Do not bend forward to reach your feet. You must no bend your hips at greater than a 90-degree angle.
2. Do not bend forward to reach your feet. You must no bend your hips at greater than a 90-degree angle.
3. Do not lift your knee higher than your hip on the operated side.
4. Do not cross your legs.
5. Do not allow your legs to internally rotate (feet turned in).
6. Do not twist while lying or standing.
7. Sleep on your back with a pillow between your knees to prevent crossing.

For more detailed information regarding the prevention of hip dislocation, refer to the hip rehabilitation section.

Some Content Courtesy of Smith & Nephew Orthopaedics