To
understand a total hip replacement you
should first understand a little about
the structure of the hip joint. The
hip joint is a ball and socket with
the ball component attached to the top
of the femur (the long bone of the thigh).
The socket is part of the pelvis. The
ball rotates in the socket to permit
you to move your leg backward, forward,
sideways and in a twisting motion. On
the right is a picture of a healthy
hip. The cartilage covers the ends of
the thighbone and pelvis. This allows
the ball to glide easily in any direction
inside the socket.
In
a hip requiring Hip Replacement Surgery,
the worn cartilage no longer serves
as a cushion. As the damaged bones rub
together, they become rough, with a
surface like sandpaper. This rubbing
results in pain with almost any movement
and steadily decreasing mobility.
In a total hip
replacement the ball replaces the head
of the thighbone. The stem component
of the ball, which is made of a metal
alloy, is inserted into the marrow of
the thighbone. A cup made out of a durable
plastic material replaces the worn socket
in the hip. The prosthesis is held in
place by either new bone growing into
it or by bone cement.
Before
Your Hip Replacement Surgery
One
you have contact us to let us know that
you wish to proceed, we set a target
date for your treatment once you confirm
your travel arrangements, we then dispatch
a confirmation letter explaining your
full itinerary, together with a "you
and your hip surgery" booklet,
and a patient pre-surgery questionnaire.
- If you
think you may have a moth infection
or bad tooth, visit your dentist
beforehand.
- Arrange
for someone to help you around
the house for a week or two
after coming home from the hospital.
- Set up
a "recovery station" at
home. Place the TV remote control,
radio, telephone, medicine, tissues,
reading book, waste basket, and
pitcher and glass next to the spot
where you will spend the most time
while you recover.
- Place
items you use every day at arm
level to avoid reaching up or
bending down.
- Stock
up on kitchen supplies and prepare
food in advance, such as frozen
casseroles or soups that can
be reheated and served easily.
- Completed
and return the patient pre-surgery
questionnaire.
- Bring
with you slippers, trainers or
walking shoes, loose comfortable
clothing, dressing gown or bath
robe, personal toiletries, eye
glasses, dentures, reading materials
or anything to help you relax such
as a personal walkman and music.
- We provide
crutches.
- Bring
phone numbers of people you may
want to call.
- Bring
a small amount of money for telephone
calls and items such as a magazine.
- Passport.
- Form E111
(obtainable from your local post
office).
- Bring
any medication and a list of
any medicines that you have
been taking.
- Bring
along any medical reports, MRI's
or x-rays that may be in you
possession. It is not necessary
to have a medical referral and
if you
are unable to get hold of your
medical records we can manage
without them.
- 5 days
before travelling, some vitamin
& iron tablets may be taken
to boost your immune system, and
an antiseptic cleansing shower
gel
such as "Hubiscrub" may
be used to reduce any germs that
may be present on your skin. These
are obtainable from your local chemist.
What's
Involved in the Surgery?
The
day before Surgery
You will undergo
a number of tests and x-rays, you
will receive a clinical examination
and have a consultation with the consultant
orthopaedic surgeon.
The
Night Prior to Surgery
You will be
asked not to eat or drink anything
after midnight.
The
Day Of Your Surgery
You will meet
a registered theatre nurse who will
care for you until you are moved to
the operating theatre. The anaesthesiologist
will review your history and type
of anaesthesia used. An IV will be
started and sedative medication will
be administered, Epidural anaesthesia
may be started at this time.
The
Hip Replacement Operation
Your surgery
generally takes 1½ to 2½
hours, don't be surprised if the time
for your surgery passes by. The theatre
schedule is flexible to allow for
some procedures to overrun.
After
your Surgery
After
surgery is completed you will be moved
to the recovery area in intensive
care for a short time, if you have
any medical history of heart problems
you may well be held in intensive
care for a few days. This is just
a precautionary measure. Whilst you
are in intensive care especially trained
nurses will closely monitor you.
You
will then be transferred to your room
where your family will be allowed
to be with you.You will have received
extensive physiotherapy during your
stay in the hospital, therefore you
will be in good shape for your return
home. Continue to take any prescribed
medication and follow the doctor's
instructions regarding the medication.
Follow the physiotherapist's exercises
and instructions for your hip. Wear
an apron for carrying things around
the house. This leaves hands and arms
free for balance or to use crutches.
Use a long-handled "reacher"
to turn on lights or grab things that
are beyond arm's length.
Preventing
Blood Clots (Thrombosis)
After
surgery, clots may form in the veins
of the leg as a result of immobility.
This could lead to a post-operative
complication known as a Deep-Vein
Thrombosis. For this reason you will
receive a form of low weight heparin
to ensure that thrombosis doesn't
occur.
You
may receive some of these drugs to
take home with you.
Recovering
from Surgery
You
will have:
- A dressing
over the hip and mid thigh area.
- A foam
wedge pillow between your legs.
This is to help keep your new
hip in place during early healing.
- You may
have a drain from the surgical
site. This drainage tube collects
any bloody fluid that has accumulated
under the skin and muscle. This
tube is usually removed the day
after surgery.
- A bar
(trapeze) will be hanging over
the bed. Use it to help lift
your body when you change positions.
- An IV
(intravenous infusion).
- Vital
signs taken which consist of
blood pressure, pulse, respiratory
rate and temperature.
- A Foley
catheter (urine bag) to monitor
the amount and colour of your
urine. This is usually removed
1 or 2 days after surgery. You
can
normally drink fluids and eat.
-
It
will normally take 4 to 6 weeks
to become fully mobile following
your Hip Replacement Surgery.
Please remember that each person
is different
so times will vary, if you are
older or in poor physical condition,
or not
very mobile it may take longer
to recover from your surgery.
In these
circumstances we recommend that
you avail yourself of the extra
weeks stay and physiotherapy.
Please
note that after Hip Replacement Surgery
you are not permitted to drive for 2
months.
Rehabilitation
and Physiotherapy following Surgery
Your participation
in physical therapy is essential to
your success. The more committed and
enthusiastic you are, the quicker your
improvement and recovery will be. A
physiotherapist will visit you on the
day after surgery and will start to
instruct you on the exercise program.
You will receive physiotherapy each
day following the surgery.
These sessions
are normally one on one with a physiotherapist.
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