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February 10, 2012

Total Hip Replacement (cont.)

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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.

What is the prognosis of total hip joint replacement?

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.

Total Hip Replacement At A Glance
  • 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.
  • Complications 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).

REFERENCE:

Klippel, John H., eds., et al. Primer on the Rheumatic Diseases. 13th ed. New York: Springer and Arthritis Foundation, 2008.


Last Editorial Review: 7/2/2010


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