In this section we will discuss a few things you need to know in regard to surgery and recovery. We will cover some common hospital protocols as well as precautions your doctor and staff will be taking to avoid complications which can result from surgery.
Surgery and recovery
When surgery is completed, you will be taken to the recovery room for a period of observation. The staff will monitor your blood pressure, heart rate, respiration and body temperature. Special attention will be given to your circulation and sensation in the feet and legs. When you wake up and your condition is stabilized, you will be transferred to your room.
While protocol differs from hospital to hospital, here is a list of things you may see when you wake up:
- A large dressing applied to surgical area
- A drain tube leading into the surgical area
- An IV will continue to be used to provide adequate fluids and administer antibiotics and other medication
- A patient-controlled analgesia (PCA) device connected to your IV for pain relief
- A catheter may have been inserted into your bladder as side effects of medication often make it difficult to urinate
Post-operative care and precautions
As with any major surgical procedure, post-operative hip complications can occur following hip resurfacing surgery. The following is a list of some of the complications with brief descriptions of each.
Early infection
In a small percentage of patients undergoing hip resurfacing surgery early infection can occur. Your physician will closely monitor your incision to minimize the risk of infection. Always remember to wash your hands after any contact to the incision site, especially when the sutures are still in place.
If you experience any of the following symptoms of early infection, contact your physician immediately:
- Drainage and/or a foul smell from the surgical incision
- Temperature above 100.4˚F (38˚C) for two days
- Redness, swelling or increased pain at or near your surgical incision
Late infection
Preventing your hip joint from infection is extremely important. Your new joint is artificial and does not have your body’s natural protection against infection. Bacteria from a variety of sources can enter your bloodstream and invade the area surrounding your new joint. Therefore, you will need to take antibiotics prior to the following procedures to protect your hip from infection.
- Internal examinations of the bladder (cystoscopy), colon (colonoscopy) or rectum (proctoscopy)
- Dental work including teeth cleaning
- Surgery of any kind
- Placement of a tube into the ureter to drain urine from the body (urinary catheterization)
Inform your physician or dentist doing any of these procedures that you have an artificial joint and need to be given antibiotics to protect yourself against infection.
Late pain or instability
Some pain is normal and expected during your rehabilitation period and the pain should slowly decrease in the weeks following surgery. If you experience any of the following symptoms, contact your physician immediately. These symptoms may be a signal of a serious problem such as bone breakage, dislocation, infection, device loosening, movement or breakage. Any of these symptoms may require medical attention including surgery.
- Serious, immediate, constant hip pain or pressure
- Feeling of unsteadiness
- Sudden inability to put weight on your hip after early post-operative pain goes away
Continuing evaluation
Remember to follow your physician’s schedule for routine examinations after your hip resurfacing surgery. These routine examinations will include regular X-rays to look for any problems relating to hip bone or device breakage, position changes, or anything else abnormal. These X-rays will also check the progress of bone healing around your new implant.
Rehabilitation after hip resurfacing surgery
Most hip resurfacing patients are in the hospital from four to six days and the surgery usually takes two to four hours to perform. You will use a walking aid (cane, crutches) for about six weeks after surgery while your hip muscles are healing. You may be told not to bend your hip or waist to more than a 90-degree angle during your rehabilitation.
One of the most critical factors in achieving successful hip resurfacing surgery depends upon your diligence in physical rehabilitation. You must actively participate in the rehabilitation process, working on your own as well as with your physical therapist to achieve optimal results.
The physical therapists will begin working with you as early as a day or two after surgery. They will teach you the following proper techniques. Although these activities may seem simple, you must learn to do them safely so that the hip does not dislocate or suffer other injury.
- How to climb stairs
- Getting in and out of bed
- Getting in and out of a chair
- Getting in and out of a car
The physical therapist may also give you a list of exercises to do at home every day. These exercises will help you become as independent as possible in your personal care and daily activities after you return home.
Most of your rehabilitation will occur once you have checked out of the hospital. Your physical therapist will design an exercise program to increase the motion and strength of your hip as well as teach you the exercises, making sure you know the proper way to do the exercises before you begin.
Hospital discharge and home instructions
Before leaving the hospital, your doctor and staff will help you adjust to recovery in every way possible. They will show you safe techniques of simple activities like getting in and out of bed, bathing, going to the bathroom, managing steps and getting in and out of a car. Of course, progress varies from patient to patient, so discharge instructions may vary. You will receive specific instructions and precautions from your orthopaedic surgeon, nurse and physical therapist that should be continued until you return for your follow-up examination with your surgeon.
- Use a walker or crutches to assist with walking. Remember to ask how much weight you can put on your operated leg.
- Wear your support stockings, TED hose.
- Your orthopaedic surgeon will talk to you about when you can drive. A general rule is four to six weeks after surgery.
- Continue your exercise program you learned in the hospital. Walking is the most important exercise you will participate in.
Life after hip resurfacing surgery
After you have completed your hip rehabilitation, you should experience improved range of motion and have plenty of strength in your hip to return to most everyday activities. Below are a few warnings to keep in mind after your hip resurfacing surgery. Remember to listen to what your body tells you. If you begin to have pain or swelling, contact your physician for advice.
- Take care to protect your new hip from too much stress and follow your surgeon’s instructions regarding activity level.
- Do not perform high-impact activities such as running and jumping during the first year following your surgery to allow your hip bones to heal properly.
- Early device failure, such as breakage or loosening, may occur if you do not follow your surgeon’s limitations on activity level. Early failure may occur if you do not protect your hip from overloading due to activity level or fail to control your body weight. Accidents such as falls may also cause early device failure.
- Loosening of the device may cause too much wear of the metal parts and result in very small metal particles being created that can result in bone loss around device and additional loosening.
- Early device failure or loosening may require additional surgery to remove the device (revision surgery).
- Artificial hip joints can wear out over time and may require replacement.
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