TOTAL HIP REPLACEMENT: WHAT TO EXPECT AFTER DISCHARGE HOME

WHAT TO EXPECT AFTER TOTAL HIP REPLACEMENT:

DAY 0-1:

REBOUND PAIN WHEN THE SPINAL WEARS OFF.  IF you are not having pain, you don’t have to take the narcotics given – stop narcotics if you’re having nausea/vomiting/dizziness.

YOU START THE MULTI-DRUG PAIN PROTOCOL.

YOU START YOUR HOME EXERCISE PROGRAM:

FIRST 2 WEEKS – FOCUS IS LIMITING STEP COUNT and SWELLING MANAGEMENT NOT STRENGTHENING:

EVERY HOUR WHILE AWAKE SHOULD INCLUDE:

30-40 minutes of ICING and LEG ELEVATION.  ICING CAN BE DONE 24/7 AS LONG AS THE SKIN IS PROTECTED FROM FREEZER BURN.  THIS SHOULD BE DONE 30-40 minutes per hour the first 10-14 days postop.

Flexible ice packs or Ice machines with a bladder are commonly used by patients.  They are not covered by insurance and need to be purchased online.

 

 

AT HOME EXERCISES:

• 10 ankle pumps per hour                                                                       

 

 

• 30 steps per hour of WALKING WITH A WALKER

 

 

 

DAY 1-5:

SWELLING AND BRUISING OF BUTTOCK, HIP, AND THIGH.  THE AMOUNT OF SWELLING AND BRUISING VARIES FROM PERSON TO PERSON – EVERYONE RESPONDS DIFFERENTLY  – THIS IS NORMAL.

DAYS 5-8:

Pain and swelling are DIRECTLY RELATED TO ACTIVITY LEVEL – 30-40 minutes of ICING and LEG ELEVATION per hour.  DON’T OVERDO IT!

DAY 7: 

OK to remove dressing and leave open to air.  The Steri-Strips (white tape) across the incision will fall off on their own – if still on, they can be removed after 2 weeks postop.  OK to shower with the wound uncovered now, using Hibiclens soap over the incision in the showers (NO SUBMERSION OF THE WOUND UNTIL SCAB GONE – USUALLY 3-4 WEEKS POSTOP).

DAYS 7-14:

Depending on fitness level, WALKER is discontinued, continue to use of cane if limp is still present.

 

AFTER 2 WEEKS, PHYSICAL THERAPY (PT) can either be:

1. SELF-DIRECTED using instructions (Home Exercise Program ie HEP)

Step count LIMITS:

1. 1. 2000 steps/day maximum WEEK 3
   2. 2750 steps/day maximum WEEK 4
   3. 3500 steps/day maximum WEEK 5
   4. 4500 steps/day maximum WEEK 6
   5. progress by 1000 steps/day in each subsequent week letting pain/swelling be the guide.

2. Outpatient PT  (OPPT)

ALL STUDIES SUGGEST YOUR HIP FUNCTION/OUTCOME DOES NOT RELY ON FORMAL PT, but on you doing the Home Exercises.

PT Videos: Bob and Brad