joint . The "ball part of the joint is the top part of the thigh bone. The "socket" is a part of the pelvic bone. The "ball " � fits into a groove in the pelvic bone called the acetabulum. This gives the name "ball and socket " �. Tough tissue that is flexible, called cartilage, covers the parts of the joint in a normal hip. The cartilage lets the hip glide easily. The cartilage can become worn and cause bone to rub on other bone. This rubbing often leads to pain, stiffness, and trouble walking. Sometimes, drugs and exercises can help you with the pain. When a hip joint stops working, you may need hip joint replacement (arthroplasty) surgery. � �
Hip replacement surgery may be done in more than one way: � �
- Traditional Surgery:
- Both joint surfaces of the thigh bone and pelvic bone are replaced.
- The joints are cemented to the bone.
- Bipolar Hip Replacement:
- A plastic cup is fitted into the socket of the pelvic bone.
- It is not cemented in place.
- The thigh bone has the bipolar prosthesis.
- This prosthesis swivels and is designed to lessen the wear and tear on the cartilage.
- Bipolar hip replacement is most often is done in older patients with a certain type of break at the top of the thigh bone.
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What care is needed at home?
- Ask your doctor what you need to do when you go home. Make sure you ask questions if you do not understand what the doctor says. This way you will know what you need to do.
- Talk to your doctor about how to care for your cut site. Ask your doctor about:
- When you should change your bandages
- When you may take a bath or shower
- If you need to be careful with lifting things over 10 pounds
- When you may go back to your normal activities like work or driving
- Be sure to wash your hands before and after touching your wound or dressing.
- Have someone to drive and help you at home to help for the first few weeks.
- Keep your house safe and clutter-free. This will make it safer for you to walk.
- You may need to put on the long, tight socks given in the hospital while you sleep.
- Use your walker or crutches when you move around.
- Keep your weight off the operated leg as much as possible until your doctor or physical therapist says it is okay to put a small amount of weight on it.
What follow-up care is needed?
- You may need to have more therapy before going home. A short stay in rehab or a skilled nursing facility will often help.
- You may need to have a nurse come visit you at home to check on you. Physical therapists can also come to your home to help with exercises.
- Your doctor may ask you to make visits to the office to check on your progress. Be sure to keep these visits.
- If you have stitches or staples, you will need to have them taken out. Your doctor will often want to do this in 1 to 2 weeks.
- You may need to keep doing therapy at an outpatient clinic.
What drugs may be needed?
The doctor may order drugs to: � �
- Help with pain
- Prevent blood clots
- Prevent infection
- Help with other problems you may have like trouble sleeping or hard stools
Will physical activity be limited?
- You will need to use a walker or crutches to help you walk. Follow your doctors orders on how much weight you can put on the operated leg. This can range from no weight-bearing to full weight-bearing.
- You may not be allowed to do certain hip movements right after the surgery. These can cause the hip joint to move out of the socket. Ask your doctor what movements are safe for you. Your doctor may suggest you follow these hip precautions:
- Keep your legs from turning in or out.
- Avoid moving your operated leg backwards and out to the side.
- Avoid crossing your legs or ankles.
- Avoid taking long steps when walking.
- Avoid kneeling on your operated leg. If you have to kneel, then kneel on both knees so the operated hip is not pushed back.
- Avoid the straddling position.
- You will be able to do more as you get stronger. Your physical therapist can talk with you about a walking program. Most often, you should limit stair climbing to one flight of stairs per day when you first return home.
- Ask your doctor when you can have sex. Once your doctor tells you that it is OK, do not put full weight on your hip joint. To keep stress off the joint, lie on your back and have your partner support his or her weight.
What problems could happen?
- Dislocation � � � it is important to keep from doing some movements. These can cause the hip joint to move out of the socket. This is less common than with a traditional approach. Ask your doctor what movements are safe for you. Your doctor may suggest you follow these hip precautions:
- Keep your legs from turning in or out.
- Avoid moving your operated leg backwards and out to the side.
- Avoid crossing your legs or ankles.
- Avoid taking long steps when walking.
- Avoid kneeling on your operated leg. If you have to kneel, then kneel on both knees so the operated hip is not pushed back.
- Avoid the straddling position.
- Blood clot or DVT (deep vein thrombosis) � � � To avoid these, your doctor may ask you to do ankle pumping exercises. Your doctor also may order blood thinning drugs or compression stockings.
- Lung infection � � � Taking deep breaths can help keep you from getting a lung infection. Take at least 10 deep breaths each hour while you are awake.
- Infection � � � Be sure to take all drugs as ordered.
- Other problems during or after surgery may include broken bones, nerve or blood vessel damage, bleeding, the chance of the leg not being the same length as the other leg, or loosening of the prosthesis.
When do I need to call the doctor?
- Signs of a very bad reaction. These include wheezing; chest tightness; fever; itching; bad cough; blue skin color; seizures; or swelling of face, lips, tongue, or throat. Go to the ER right away.
- Sudden shortness of breath or a sudden onset of chest pain could be a sign that a blood clot has traveled to your lungs. Go to the ER right away.
- Signs of infection. These include a fever of 100.4 � �F (38 � �C) or higher, chills, very bad sore throat, ear or sinus pain, cough, more sputum or change in color of sputum, pain with passing urine, mouth sores, or wound that will not heal.
- Signs of wound infection. These include swelling, redness, warmth around the wound; too much pain when touched; yellowish, greenish, or bloody discharge; foul smell coming from the cut site; cut site opens up.
- More pain in your hip
- More swelling in your hip
- You are not feeling better in 2 to 3 days or you are feeling worse
Helpful tips
- For sleeping:
- If you sleep on your side, have your operated leg on the bottom.
- Use a pillow between legs when rolling or when sleeping on your side.
- If you lie on your side when sleeping, be sure to put a pillow between your legs to keep them from crossing. If you lie on your back, put a pillow or rolled towel on either side of your operated leg. This may help keep it from rolling inward or outward.
- For walking and moving about:
- If you step backwards, lead with your nonoperated leg and take small steps.
- When going up and down steps, always go up with your stronger leg first. When going down steps, lead with your operated leg.
- Do not turn (pivot) using your operated leg.
- Put a small fanny pack around your waist with items such as phone numbers, phone, and notepad.
- In the bathroom:
- A raised toilet seat in the bathroom can help you to get up and down easier.
- For bathing, a grab bar and tub bench may be helpful.
- Grab bars near the toilet may be helpful.
- Around the house:
- Avoid sitting in low chairs. Higher chairs with firm cushions will be easier to get out of.
- When getting up from any surface, push up on the chair, bed, or toilet seat. Then, grab the walker once you are standing. Pulling up on the walker may cause it to tip and you to fall.
- Make sure all hand rails are secure in your home.
- Using special tools, like a reacher, long-handled sponge, sock aid, or long-handled shoe horn, may make your daily activities easier.
Teach Back: Helping You Understand
The Teach Back Method helps you understand the information we are giving you. The idea is simple. After talking with the staff, tell them in your own words what you were just told. This helps to make sure the staff has covered each thing clearly. It also helps to explain things that may have been a bit confusing. Before going home, make sure you are able to do these: � �
- I can tell you about my procedure.
- I can tell you how to care for my cut site.
- I can tell you what changes I need to make with my activities.
- I can tell you what I will do if I have shortness of breath, chest pain, hip pain or swelling, or signs of a wound infection.
Where can I learn more?
American Association of Hip and Knee Surgeons � �
http://www.aahks.org/patients/resources/MIS_Patients.pdf � �
National Institute of Arthritis and Musculoskeletal and Skin Diseases � �
http://www.niams.nih.gov/Health_Info/Hip_Replacement/default.asp � �
Consumer Information Use and Disclaimer
This information is not specific medical advice and does not replace information you receive from your health care provider. This is only a brief summary of general information. It does NOT include all information about conditions, illnesses, injuries, tests, procedures, treatments, therapies, discharge instructions or life-style choices that may apply to you. You must talk with your health care provider for complete information about your health and treatment options. This information should not be used to decide whether or not to accept your health care providers advice, instructions or recommendations. Only your health care provider has the knowledge and training to provide advice that is right for you. � �
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Copyright � � 2015 Clinical Drug Information, LLC and Lexi-Comp, Inc. � �