Usually the patients considered for T.H.R are
- Young patient
- Osteoarthritis of hip joint
- Rheumatoid Arthritis
- Avascular Necrosis
There is a progressive increase in chronic pain and difficulty in walking, stair climbing and rising froma chair.
Usually there are two types of prosthesis which are commonly used for the surgery: Cemented and Uncemented Prosthesis.
Difference of cemented and uncemented prosthesis:
Cemented prosthesis is usually used in older patients who are less active and have less bone moneral density.
Uncemented Prosthesis is used in younger and more active individuals.
The primary disadvantage of uncemented rposthesis is the extended recovery periof. Because it takes long time for natural bone to grow and attach to prosthesis, hence the person has to limit his activitties for upto 3 months to protect hip.
Your hospital stay my last for a week. If you go home you will need help for several weeks.
The following steps can make your home coming easier:
- In kitchen as well as other rooms, place items of daily use within reach so you dont have to reach up or bend down.
- Rearrange furniture you can walk easily with walker or stick.
- Get a good chair that is firm and higher than average seat.
- Remove rugs or area rugs that could make you slip.
- Securely fasten electrical cords around perimeter of the room
- Install a shower chair grab bar and raised toilet.
- Use assistive devices such as long handle sponge and grabbing tool or reacher to avoid bending too far.
Once you get home, stay active.The key is not to overdo it while you expect some good and some bad days, you should notice gradual improvement over time.
WEIGHT BEARING : Discuss with your physical therapist regarding the weight bearing of operated leg as the rehabilitation protocol will be different for cemented and uncemented prosthesis.
STANDING: Move your operated leg first and pushoff the armrest of chair to stand up.
SLEEPING POSITIONS: Sleep on your back with legs slightly apart on your side with abduction pillow.Be sure to use the pillow atleast 6 weeks or untill your doctor tells you to use. Sleeping on stomach is alright.
SITTING: For atleast 3 months donot cross your legs at knees. Make sure the seat height is good so as to avoid bending of hip beyond 90 degreesGet up and move around possibly every 1 hour.
SEX: Some sex positions can be safely resumed 4-6 weeks after surgery. Ask your doctor regarding the same.
CLIMBING: Stair climbing should be limited if possible untill the wound is healed.
Following pattern of stair climbing should be followed.
GOING UP :
- the unaffected leg should step up first
- then bring affected leg to same step
- then bring the cane
- put the cane first
- next bring the affected leg down the step
- finally step down with unaffected leg.
DRIVING: You can begin driving an automatic car 4 to 8 weeks after consulting your doctor and symptoms after surgery.
SITTING INTO CAR: Be sure the passenger seat is pushed all the back.Recline the seat as far as possible.with the walker in front of you slowly back up the car seat.Swing your legs into the car.Lean back if you need to avoid the hip more than 90 degrees.
GETTING OUT OF THE CAR: Push the seat all the way back.recline the seat and lift your legs out.lean back if you need to.place walker up in front of you and stand up on unaffected leg.
RETURN TO WORK: Depending on the type of activities you eprform it may take as long as 3 months to 6 months to return to work.
OTHER ACTIVITIES: Walk as much as you like once doctor gives you permission, but remember donot substitute walking to exercise.Swimming is recommended once suture are removed and wound is healed.Acceptable activities are dancing, golfing with spike less shoes and cart,bicycling on level road.Avoid activities that involve impact or stress on joints such as tennis, badminton or contact sports like baseball, football,squash, jumping or jogging, Lifting weights is not a problem but carrying heavy and awkward objects that cause to stagger is not advised especially if you must go up and down stairs or slopes.
Do’s and Dont’s
The do’s and dont’s vary depending on orthopaedic surgeons apporach.Your doctor and Physical therapist will provide you with a list of the same to remember with your new hip.The precautions will help you to prevent the new joint from dislocation and ensure proper healing.
- Donot cross legs at knee for atleast 8 weeks
- donot bring knee up higher han your hip
- donot lean forward while sitting or as you sit down
- donot try to pick up something on the floor while ou are sitting
- donot turn your feet excessively inwards or outwards
- donot reach down to pull your blanket when lying down
- donot bend at waist beyond 90 degrees
- donot use pain as a only guide for what you may or may not do
- Keep skin dry and clean
- Notify doctor if wound drains
- Swelling is normal for first 3-6 months. Elevate leg slightly <30 degrees on pillow and put ice packs for 15-20 min
- If you get calf pain , chest pain and shortness of breath notify doctor immediately
- Do exercises prescribed daily.
- A balanced diet is very important.
- Maintain an active lifestyle after surgery.
DISCLAIMER: Kindly refer your doctor and Physical therapist for the instructions depending on your surgery procedure.