Total Hip Replacement (cont.)
What other postoperative instructions
are given to patients with total hip joint replacements?
Patients will continue to use supportive
devices as monitored and recommended by the therapist and attending
physician. Medications are likely to be given to further prevent
blood clots in the legs. These include warfarin (Coumadin) or
aspirin medications. Occasionally, heparin (enoxaparin [Lovenox]) can be
given by self-injection. Medications are given for pain, sleep,
and occasionally for muscle relaxation.
Gradually, patients become more confident and less dependent on
supportive devices. Patients are instructed to look for signs
of infection including swelling, warmth, redness, or increased
pain in or around the surgical site. The patient should notify
the doctor's office immediately if these changes are noted or
if there is injury to the hip. The wound site will be inspected
regularly by the attending physician. The sutures, which are usually
staples, are removed several weeks after the operation.
How can patients protect the total hip
joint replacement in the long term?
Patient education is important to
ensure longevity of the replaced hip. Strenuous exercises such
as running or contact sports are discouraged, since these activities
can re-injure the replaced hip. Swimming is ideal in improving
muscle strength, and promoting mobility and endurance.
Patients should be aware and notify any caregivers that they have
an artificial joint. Antibiotics are recommended during any invasive
procedures, whether surgical, urological, gastroenterological,
or dental. Infections elsewhere in the body should also be treated
to prevent seeding of infection into the joint. This is important
because bacteria can pass through the bloodstream from these
sites and cause infection of the hip prosthesis.
Hip joint replacement surgery is one of the most successful joint
surgeries performed today. In well-selected patients, who are appropriate candidates for total hip replacements, the procedure lasts at least 15 years in nearly 95% of patients. Long-term results have been improving
impressively with new devices and techniques. The future will
provide newer techniques which will further improve patient outcomes
and lessen the potential for complications.
- The prosthesis for a total hip replacement can be
inserted into the femur bone with or without cement.
- Chronic pain and
impairment of daily function of patients with severe hip arthritis are reasons
for considering treatment with total hip replacement.
- Complication and risks of total hip replacement
surgery have been identified.
- Preoperative banking of the blood of patients planning
total hip replacement is considered when possible.
- Physical therapy is an essential part of
rehabilitation after a total hip replacement.
- Patients with artificial joints are recommended
to take antibiotics before, during, and after any elective invasive
procedures (including dental work).
Last Editorial Review: 4/25/2008
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