Post Operative Instructions
Post Operative Topics
Exercises
Anatomy
Common Questions
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Dr. Ward uses Depuy Actis hip replacement. The metal component that attaches to the femur (femoral stem) and the acetabulum (acetabular cup) is made of a titanium alloy metal. It is coated with hydroxyapatite which helps bone grow around the stem. The femoral head is made of a ceramic material and the this articulates with cup that has a plastic highly cross-linked polyethylene liner. The bone grows around the stem and cup to fixate it. No cement or adhesives are needed for fixation.
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We can now expect a hip replacement to last 20 or more years. The most common reasons for requiring a revision surgery on a hip replacement is not wear and tear but rather fracture or infection.
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Most likely. Every airport security is a little different but 90% of joint implants will set off the security system at the airport. It is not necessary to have a card to go through security. You should not have to show them your scar. Plan ahead and anticipate that you may need to be further evaluated by the security officer.
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Nothing to worry about! This is called a suture abscess and occurs because the body is trying to break down the suture under your skin and sometimes it will form a little abscess. No need to go on antibiotics for it. You can pop it like a pimple if you’d like or let Dr. Ward know at the next visit.
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This happens occasionally. It’s called suture spitting and occurs when your body tries to reject the suture. It might look like fishing wire is coming out. You can clip it with finger nail clippers or if leave it alone and it will eventually fall out on its own.
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That is a normal part of healing. You will have increased blood flow to your hip as it tries to heal which will cause increased warmth and a little redness. That is normal to have that for up to three months. It will decrease with time and is usually nothing to worry about.
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That is very common. As your hip heals you will continue to work with physical therapy on your range of motion. This causes the scar tissue to release and stretch out. This will cause an ache in your hip for up to around three months.
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If you had your right hip done then it is advisable to not drive until you are off the walker and only using a cane for balance. You need to be confident about your ability to slam on the breaks in case of an emergency. If it is your left hip then you can usually drive much sooner but a reminder that you cannot drive while taking pain medication!
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General minimum time off for people that work at a desk is two weeks and for someone that is on their feet to return at 4 weeks. That being said, most people are more comfortable going back to work at 4 weeks for office jobs and 6 weeks for standing jobs.
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Because you rely on your other side of your body to support you while you are healing Dr. Ward generally recommends waiting until the three month mark to have the other side done.
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Yes and No. This is controversial and many doctors have differing opinions.
Because an infection in your hip is a major catastrophic and life changing event, Dr. Ward recommends that you take antibiotics before invasive dental procedures that may cause bleeding. For general cleaning it is not necessary to take antibiotics. Some dentist offices will provide antibiotics or feel free to call Dr. Ward and he will put some in for you.
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Because you are favoring your surgical hip your other joints will hurt more then usual. As you start walking more normal then this pain should usually return to normal.
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Possibly, but usually not. Let me explain…The biggest reason your leg may feel longer is because prior to surgery your leg had actually shortened over time as you developed arthritis and loss cartilage but it didn’t feel abnormal because it did it very slowly. Your pelvis will tilt to adjust for this. During surgery we use x-ray and a sophisticated computer system to restore your leg lengths to as close to equal as possible usually within a couple millimeters. On rare occasions, for stability reasons, you will have a slightly longer leg but this is usually only a couple millimeters. The feeling of unequal leg length will normalize after a couple months. It’s rarely needed to put a lift in your shoe.
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Schedule your physical therapy to start 7-10 days after surgery. Wednesday or Thursday following your discharge.
You will participate in physical therapy for 3-6 months after surgery
Good pain control is important around physical therapy. Take medication prior to therapy so you will not be limited by pain.
Doing home exercises is important. Included are exercises that you can do at home between physical therapy sessions.
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Resume your regular diet after surgery. Increase use of fiber and drink plenty of fluids to prevent constipation from the anesthesia and narcotics. Avoid the use of supplements however multi-vitamins may be taken. Do not drink alcohol while taking pain medication.
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You should have an appointment scheduled with Dr. Ward between 10 and 14 days from the day of surgery. If not, please contact our clinic as soon as possible. (520) 881-1394
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You may resume your home medication as before surgery. Do not mix pain medication with other pain medication or sedatives other than what is described above.
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You may sleep on your back or either side. If you sleep on your side, sleep with a pillow between your legs to prevent crossing them. Avoid excessive bending at the waist.
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It is uncommon to get a blood clot after surgery but you are at increased risk following surgery. Injury to the leg (surgery) induces clotting cascade to stop the bleeding which increases risk of blood clotting in the veins. Another risk factor is not moving as much after surgery which results in pooling of the blood.
To prevent blood clots Dr. Ward will put you on a blood thinner temporary for the first 14 days. For those that are not already on a blood thinner a simple baby aspirin (81mg) twice a day is good enough. If you were on a blood thinner prior to surgery then you may restart your blood thinner the evening on the day after surgery.
The best way to prevent blood clots is movement! When your calf muscles contract they squeeze the blood in your lower legs which helps move the blood back to your heart. This helps reduce the risk of blood clots and helps reduce swelling. Simply pumping your ankles while resting will help reduce swelling and blood clots!
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Unfortunately pain is unavoidable but we want to make it as tolerable as possible. Stay
ahead of your pain during the first 3 days of surgery and then you may start to back off.
Trying to catch up on your pain if you get behind is very difficult and can become very uncomfortable!
The sharp pain will decrease after the first week or two although not completely resolve. It is common to have discomfort at night like a tooth ache for about the first six weeks. Continuing to take anti-inflammatory medications will help decrease this.
Ice is one of the best things you can do to help decrease your pain in your hip. It is a excellent pain killer and also helps decrease swelling which will help with you range of motion and decrease the feeling of tightness.
Staying ahead of your pain for the first three days is important to avoid getting behind.
You will learn when to take your medication but general recommendation is before physical therapy and before bed.
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Constipation is a common side effect of pain medication. Reducing pain medication as you are able to tolerate will help reduce constipation. Walking is one of the best ways to get your bowel moving (just like your dog). High fiber diets with plenty of water also aids it gut mobility. Dr. Ward will also prescribe Docusate medication which is a stool softener. Take this medication as you need it after surgery. If you continue to have constipation that does not seem to be resolving then try Miralax which is a bowel stimulant. Just be cautious that once the “dam” breaks then things will continue to flow!
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If you had a spinal anesthesia for your surgery there is a possibility that you can have temporary changes in your urination. The spinal anesthesia may temporarily paralyze your bladder leading to difficulty urinating. In males this may lead to inability to urinate and in females this may result in overflow incontinence. The effects usually only last 1-3 hours but may last longer. It is generally required to urinate prior to discharge home. If you notice inability to urinate for greater then 8 hours then it is recommended to go to the ER to be evaluated. It is also possible to experience increased need to urinate for the first couple days following surgery. This may be due to the fluid that is administered during surgery and your temporary water retention after surgery. This is generally temporary although can cause urgent need to use the restroom. Being mindful to frequently empty your bladder is recommended.
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Dr. Ward is happy to refill your medication as you need it. There are strict laws with prescribing pain medication and so Dr. Ward is only able to do so much at a time. Please let the office know 1-2 days before you anticipate needing it. We don’t refill medications on the weekend so be sure to plan ahead!
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It is common to have bruising around the hip, buttock, and may even extend down to the ankle. This varies with people but is nothing to worry about and will resolve after a week or so.
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Compression stockings can help reduce swelling which can also help reduce some discomfort. Unfortunately they can be difficult to put on and are often too tight at the top and may even make things worse. If you find they are too difficult to put on or do not tolerate them then Dr. Ward is ok with you not wearing them.