Total Hip Replacement

  • Medical Author:
    William C. Shiel Jr., MD, FACP, FACR

    Dr. Shiel received a Bachelor of Science degree with honors from the University of Notre Dame. There he was involved in research in radiation biology and received the Huisking Scholarship. After graduating from St. Louis University School of Medicine, he completed his Internal Medicine residency and Rheumatology fellowship at the University of California, Irvine. He is board-certified in Internal Medicine and Rheumatology.

  • Medical Editor: Jerry R. Balentine, DO, FACEP
    Jerry R. Balentine, DO, FACEP

    Jerry R. Balentine, DO, FACEP

    Dr. Balentine received his undergraduate degree from McDaniel College in Westminster, Maryland. He attended medical school at the Philadelphia College of Osteopathic Medicine graduating in1983. He completed his internship at St. Joseph's Hospital in Philadelphia and his Emergency Medicine residency at Lincoln Medical and Mental Health Center in the Bronx, where he served as chief resident.

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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 at home. A doctor will determine how long a patient needs to take this medication. Additional 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 reinjure 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.

Measurements of metallic substances that can erode away from the metal portions of hip replacements can indicate toxicity or wear of the prostheses. With high levels of cobalt measured in blood of these patients, it is suggested that an MRI of the hip be performed to be certain an abnormal growth of tissue (pseudotumor) is not present.

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 most 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, mobility, and lessen the potential for complications.

REFERENCE:

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

Medically Reviewed by a Doctor on 11/18/2015

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