Hip replacement - discharge

You had surgery to replace all or part of your hip joint with an artificial joint called a prosthesis. This article tells you what you need to do to care for your new hip when you leave the hospital.

When You're in the Hospital

You had a hip joint replacement surgery to replace all or part of your hip joint with an artificial joint. This artificial joint is called a prosthesis.

What to Expect at Home

By the time you go home, you should be able to walk with a walker or crutches without needing much help. Most people do not need them after 2 to 4 weeks. Check with your health care provider about when to stop using crutches.

You should also be able to dress yourself with only a little help and be able to get into and out of your bed or a chair by yourself. You should also be able to use the toilet without much help.

You will need to be careful that you do not dislocate your artificial hip, especially in the first few months after surgery. You will need to learn exercises that make your new hip stronger and take special precautions.

You will need to have someone with you at home for 1 to 2 weeks after you leave the hospital or rehab center. You will need help preparing meals, bathing, moving around the house, and doing other daily activities.

Over time, you should be able to return to your former level of activity. You will need to avoid some sports, such as downhill skiing or contact sports like football and soccer. But you should be able to do low impact activities, such as hiking, gardening, swimming, playing tennis, and golfing.

Home Setup

Your bed should be low enough for your feet to touch the floor when you sit on the edge of the bed. Your bed should also be high enough so that your hips are higher than your knees when you sit on the edge. You may not need a hospital bed, but your mattress should be firm.

Keep tripping hazards out of your home.

• Learn to prevent falls. Remove loose wires or cords from areas you walk through to get from one room to another. Remove loose throw rugs. Do not keep small pets in your home. Fix any uneven flooring in doorways. Use good lighting.

  Prevent falls

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• Make your bathroom safer. Put hand rails in the bathtub or shower and next to the toilet. Place a slip-proof mat in the bathtub or shower.

  Bathroom safer

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• Do not carry anything when you are walking around. You may need your hands to help you balance. You can attach a pocket or holder to your walker or crutches to hold things instead.

Put things where they are easy to reach.

Place a chair with a firm back in the kitchen, bedroom, bathroom, and other rooms you will use. This way, you can sit when you do your daily tasks.

Set up your home so that you do not have to climb steps. Some tips are:

• Set up a bed or use a bedroom on the first floor.
• Have a bathroom or a portable commode on the same floor where you spend most of your day.

Activity

You will need to be careful to not dislocate your new hip when you are walking, sitting, lying down, dressing, taking a bath or shower, and doing other activities. Avoid sitting in a low chair or soft sofa.

Keep moving and walking once you get home. Try not to sit for more than 45 minutes at a time. Get up and move around after 45 minutes if you will be sitting longer.

Do not put your full weight on your side with the new hip until your provider tells you it is OK. Start out with short periods of activity, and then gradually increase them. Your provider or physical therapist will give you exercises to do at home.

Use your crutches or walker for as long as you need them. Check with your provider before you stop using them.

After a few days you may be able to do simple household chores. Do not try to do heavier chores, such as vacuuming or laundry. Remember, you will get tired quickly at first.

Wear a small fanny pack or backpack, or attach a basket or strong bag to your walker, so that you can keep small household items, like a phone and notepad, with you.

Wound Care

Keep your dressing (bandage) on your wound clean and dry. You may change the dressing according to when your provider told you to change it. Be sure to change it if it gets dirty or wet. Follow these steps when you change your dressing:

• Wash your hands well with soap and water.
• Remove the dressing carefully. Do not pull hard. If you need to, soak some of the dressing with sterile water or saline to help loosen it.
• Soak some clean gauze with saline and wipe from one end of the incision to the other. Do not wipe back and forth over the same area.
• Dry the incision the same way with clean, dry gauze. Wipe or pat in just one direction.
• Check your wound for signs of infection. These include severe swelling and redness and drainage that has a bad odor.
• Apply a new dressing the way you were shown.

Sutures (stitches) or staples will be removed about 10 to 14 days after surgery. Do not shower until 3 to 4 days after your surgery, or when your provider told you to shower. When you can shower, let water run over your incision but do not scrub it or let the water beat down on it. Do not soak in a bathtub, hot tub, or swimming pool.

You may have bruising around your wound. This is normal, and it will go away on its own. The skin around your incision may be a little red. This is normal too.

Self-care

Your provider will give you a prescription for pain medicines. Get it filled when you go home so you have it when you need it. Take your pain medicine when you start having pain. Waiting too long to take it will allow your pain to get more severe than it should.

In the early part of your recovery, taking pain medicine about 30 minutes before you increase your activity or do your physical therapy can help control pain.

You may be asked to wear special compression stockings on your legs for about 6 weeks. These will help prevent blood clots from forming. You may also need to take blood thinners for 2 to 4 weeks to lower your risk for blood clots. Take all your medicines the way your provider told you to. It can make your bruise go away more easily.

Your provider will tell you when it is OK to start sexual activity again.

People who have a prosthesis, such as an artificial joint, need to carefully protect themselves against infection. It used to be recommended that you need to take antibiotics before any dental work or invasive medical procedures, however, the recommendation has been changed except for high risk patients. Make sure to check with your provider, and tell your dentist or other surgeons about your hip replacement.

When to Call the Doctor

Contact your provider if you have:

• A sudden increase in pain
• Chest pain or shortness of breath
• Frequent urination or burning when you urinate
• Redness or increasing pain around your incision
• Drainage from your incision
• Blood in your stools, or your stools turn dark
• Swelling in one of your legs (it will be red and warmer than the other leg)
• Pain in your calf
• Fever greater than 101°F (38.3°C)
• Pain that is not controlled by your pain medicines
• Nosebleeds or blood in your urine or stools if you are taking blood thinners

Also contact if you:

• Cannot move your hip as much as you could before
• Fall or hurt your leg on the side that had surgery
• Have increased pain in your hip
• Have difficulty with walking and bending your hip
• Feel like your hip have slipped or out of position