Every year, nearly 200,000 people undergo hip replacement surgery in India, mostly due to arthritis. The vast majority of those surgeries are done with the traditional method, using a posterior or lateral (side) approach to gain access to the hip joint. With the traditional lateral method, the chance of dislocating your new hip is greater than with the minimally invasive anterior approach.
Hip dislocation after hip replacement surgery rarely occurs, but to reduce the risk even further it's essential to strictly follow your hip precautions (restrictions of certain hip positions/movements) taught to you by your physical/occupational therapists. Your new hip needs time to heal in place, particularly during the first 6 weeks following surgery. During this period, your hip muscles and bones are healing up around your new hip joint to keep it securely in place.
Commmon Hip Replacement Precautions :
Use a firm straight-back chair. If it is not high enough, use an additional cushion and a seat board. Do not sit in chairs if the seats are lower than your knees. Do not use reclining chairs, rocking chairs, low stools, low and soft sofas or couches. Don't sit on the floor; don't sit or stand or lie with your legs crossed.
Don't lift your knee higher than your hip on the side of the surgery. You will be taught to use a long shoehorn, a sock or stocking aid, a dressing stick, and elastic shoelaces. Use of this equipment will help you avoid the positions which are known to be dangerous, and which were listed on the first page.
Do not sit on the bottom of the tub. Use a bench in the tub, or take a shower standing up. A long-handled sponge will help you wash your legs and feet. Use the raised toilet seat: most toilets are too low, forcing you to sit with the operated leg too high. Reaching: Use the long reacher if you have dropped something onto the floor. Or, if you can, leave it there and wait for someone else to get it for you.
Don't take long trips without planned stops for changing position. Sit in the front, with as much leg room as possible. Avoid any car so small you have to stoop to get into it. Get into the Car Backwards: Sit down facing the curb. Slide back onto the seat while your legs are straight, and still outside the car. Swing your legs around into the car gently, and face forward. If necessary, lift the operated leg into position with your hands.
Don't plan to drive your own car too soon. If you have an automatic shift and have had surgery on the left hip, you should not think about driving for 6-8 weeks post-surgery. If your surgery was on the right hip, you should wait 8-10 weeks before driving. With a stick-shift car, you should not drive for 10-12 weeks after either R or L hip surgery.
If you have questions about the surgery or your own personal timetable for performance of any activity, be certain to talk to your doctor.
In order to avoid dislocating your new hip, you must not stress the joint in the extremes of its motions.
This can be done if you keep in mind the following precautions:
- Do not bend your hip more than 90°. For example: do not lift the knee on the operated leg higher than the hip when sitting. Do not bend or squat to pick things up off the floor.
- Do not bring the operated leg (knee) past the midline of your body (pelvis). For example: do not cross your legs. Take care not to shift your pelvis sideways without also moving your legs - pivot on your bottom instead.
- Do not stress your hip in extremes of rotation. For example: do not cross your ankles. Do not put the foot of the operated leg on the opposite knee, or bring it to the outside. Keep feet pointed forward.
Your Occupational Therapist will teach you special techniques and the use of assistive devices which will be supplied, to be sure you accomplish your daily living activities safely and independently. Be sure to ask your therapist if you have questions about any of the self-care procedures you will be taught.
Precautions After Surgery
General rules of total hip replacement that the patient needs to follow are:
- In the first six to eight weeks after the operation, the individual receiving a total hip needs to avoid bending the hip beyond 90 degrees. This can be achieved by keeping knees below the hips when sitting. Sitting on a small pillow can help with this positioning. Avoiding sitting in sofas or couches which may cause excessive bend at the hip.
- Avoid bending over from the hip to reach the floor.
- Avoid crossing the surgical leg over the non-surgical leg. When sitting, it is good advice to keep the legs three to six inches apart.
- Avoid turning the operated leg inward, i.e. pigeon-toed.
- Don't turn your toes inward
- Don't cross your legs
- don't bend your new hip more than 60-90 degrees
Your surgeon will also instruct you on how much weight he wants you to place on your surgery leg while walking.
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