The initial rehabilitation generally takes 5-7 days during the hospitalstay. It will gradually begin on 3rd day with standing, followed bytaking a few steps with the aid of a walker or crutches.You will beallowed to take weight as tolerated on the operated limb beginning2 -3 day after the surgery. Most patients with a stable hip and goodmuscles will be able to walk with the stick and will also be able toclimb stairs before discharge from the hospital.The other part of initial rehabilitation includes learning to sit andgetting up from the chair, commode shifting and physical therapy tofurther strengthen your muscle and improve your motion. You willalso be told some don’ts e.g. not to bend forward more than 90degrees, always using a thick pillow between your legs and using ahigh chair including high toilet seat (if your chair is low, using acushion is mandatory).
Medical and Lab evaluation: You would be admitted a day prior tothe surgery. Your will be reviewed by your surgeon and a team of ananesthetist, physician and physiotherapist on the day of admission.All your investigations including blood, urine, X-ray Chest & ECG willbe taken and a fresh X-ray of the affected hip will also be taken. Youwill be advised some basic exercises of hip, knee and chest.
Operation preparation: You will be required to scrub the surgicalwater the night before and on the morning of surgery, you will behelped by a nursing aid, after which she will cover your hip and thiswith a sterile towel. After midnight, you will not be able to eat ordrink.On the operation day: For surgery we prefer to anaesthetize yourlegs only by spinal – epidural anaesthesia or alternatively you may begiven General Anaesthesia. The duration of surgery routinely is 11/2to 2 hours. Your doctors will talk to your family after the surgery toreport your progress. Some of you may have to stay in the ICU themonitoring of vital parameters for a day.
After the surgery: Immediately after the operation for few days atriangular pillow is used in between the legs. It is a must, though itmay be little uncomfortable. The drainage tubes are removed on the2nd post operation day and the dressing is changed on 3rd postoperation day. You will be allowed to sit up in the bed from 2nd dayonwards. A physiotherapist will help you do hip and knee exercisesand chest physiotherapy.
Before surgery your surgeon will like to ensure that your condition iswell enough to undergo this operation. He will also like to excludecertain conditions likely to affect this surgery.
Being overweight, smoking and consuming alcohol in largequantities will affect the outcome of your surgery.
Inform your doctor about any focus of infection e.g. dental, throat,boil/furuncule (skin infection), urinary tract infection etc. They mustbe treated before you can be taken for this surgery.
Blood requirement will be determined as per your haemoglobin levelbefore operation. Blood transfusion is not usually required forPrimary Total Hip Replacement. However upto 3-4 units of bloodmay be required for revision surgery.
Inform your doctor about anti-rheumatoid medicines, painkillers etc.before the operation as some of them may need to be stopped orchanged.
Commit to the success of this surgery. Accept its limitations.
Total stay in the hospital routinely varies from 5-7 days, but can belonger depending on your medical condition.
Artificial hip joint is a good hip joint but not a normal one. Thesuccessful outcome of this surgery with newer long lasting durablematerial and standardized techniques is excellent. Over the yearsremarkable advances have been made in joint replacementtechnology to improve their durability. 90-95% hip replacements aresuccessful for 15 years. By 10 years approximately 25% of all artificialhips will look loose on X-rays, but only few of these will be thesymptomatic enough to require revision. Obesity, heavy labour jobsand very strenuous activity can affect the longevity of the artificial hipjoints.