Dr. Tozzi s and Dr. Roehrig s Patient Guide to Total Hip Replacement

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1 Dr. Tzzi s and Dr. Rehrig s Patient Guide t Ttal Hip Replacement This guide is meant t help yu better understand yur upcming hip surgery. It is generalized infrmatin, and individual patients have unique, individual circumstances which can impact their peratin and their surgery experience. Cntact yur surgen with any particular questins r cncerns. Arthritis is the prcess f wear and destructin f the cartilage (the cushin ) in yur hip, leading t inflammatin, stiffness, pain, and smetimes defrmity. Ttal hip replacement remves the arthritic bne and cartilage, replacing it with an artificial ball-scket jint that is well-aligned, well-functining and des nt have arthritic pain Yur hip replacement will be perfrmed at Jersey Shre University Medical Center. Average time spent in the hspital is 2-3 days. The surgery takes abut 90 minutes t cmplete. The entire surgical prcess (anesthesia, preparing and sterilizing, x-rays) adds anther hur r s fr the family that is waiting t hear that all the wrk went well and is cmpleted. Mst patients then g directly t an inpatient rehabilitatin facility fr a variable length f time, depending n their mbility and hme situatin. This is strngly recmmended, as it allws fr therapy multiple times per day and teaches techniques fr caring fr yurself and yur new hip at hme.

2 Yu will receive physical therapy in the hspital, at Rehabilitatin, and as an utpatient. This usually includes walking, stairs, leg exercises, tips fr activities f daily living, and imprtant hip precautins. Recvery time is variable. In the early mnths f healing, try nt cmpare yur hip replacement t ther patients r t yur ther hip (if replaced). Each hip is unique and recvers at a different rate. Mst patients can prgress frm a walker t cane within 2 weeks, nt require the cane in 4 weeks, and be functining well sn thereafter. Cmfrt, mbility, functin, and strength cntinue t imprve up t ne year after surgery. Risks an Ptential Cmplicatins: The fllwing is a (nncmprehensive) list f risks and pssible cmplicatins that yu will als find n yur cnsent frm fr surgery. Frtunately, mst are very uncmmn. Bleeding, infectin, wund healing difficulties, stiffness, dislcatin, bld clts, nerve r bld vessel damage, very rare lss f extremity, leg-length inequality, fracture, lsening f the implants, wearing away r breakage f the implants, reactin t the metals, clicking r squeaking sensatins in the hip, tendn damage r failure, failure f surgery t relieve all f the pain, lss f functin, need fr mre surgery, and anesthesia risks nt limited t strke, heart attack, death Hip Range f Mtin: Functinal hip range f mtin will cme with time. There is less urgency t regain mtin like there is with knee replacements. In fact, yu will be taught the imprtant psitins/mvements t avid in rder t lwer the risk f the hip dislcating ( ppping-ut f jint ). Such

3 precautins include: aviding lw chairs, sfas, tilets, and extreme internal rtatin f the hip. The Implants: The new hip surface will be metal-n-plyethylene (plastic), ceramic, r metal-n-metal. Yur surgen will decide with yu which is the best ptin. Mst hip replacements are inserted withut cement. The Incisin: Yur first pst-perative visit t yur surgen s ffice is abut 2-3 weeks frm yur surgery date. The staples that clse yur incisin will either be remved at rehab r in the dctr s ffice apprximately 2 weeks frm surgery. The incisin must be kept dry until the staples are remved. Yu shuld nt immerse the hip in water (bath, pl, lake, cean) fr at least 4 weeks frm surgery. Bld thinners will be prescribed after yur surgery t help reduce the risk f bld clts, a well-knwn cncern with jint replacements. Examples f these medicatins include Xarelt, Arixtra, Lvenx, Cumadin, and Aspirin. The duratin f use f these medicines may vary frm 2-7 weeks. Driving may resume after: LEFT hip replacement when ff narctic pain medicines and able t get in and ut f the car n yur wn RIGHT hip replacement when ff narctic pain medicines and able t step n the brake quickly and firmly (usually ~3-4 weeks)

4 Returning t wrk varies n yur recvery and yur duties at wrk. It may be as sn as a few weeks, r as lng as a few mnths. Yu may travel when yu are cmfrtable and have finished the pst-perative curse f bld thinners, but we strngly recmmend taking a break every hur during lng trips t get up and stretch and walk. The risk f bld clts is higher than usual in the pst-perative perid. Sprts and activities that yu can participate in are numerus. Yu shuld avid high and repetitive impact activities like running, jumping, and pen field sprts including sccer, ftball, lacrsse, and aggressive basketball. Dental wrk: Antibitics will be prescribed t yu prir t any dental wrk r invasive medical prcedure in the future. This will help lessen the risk f bacteria in yur muth reaching yur bld stream and yur hip jint. Please call yur surgen fr this prescriptin a few days befre yur appintment. Avid nn-urgent dental wrk and prcedures fr 3 mnths fllwing yur hip replacement. What else t expect: It is nrmal fr the hip and buttck t have sme swelling. Als, the perative leg will tend t feel heavy and lk smewhat swllen after surgery. Muscle spasms in the thigh and buttck are nrmal during the first few weeks. Numbness f the skin arund yur incisin is very cmmn and usually imprves with time, but may always feel different t the tuch. Incisinal drainage lasting mre than 14 days shuld be brught t the attentin f yur surgen.

5 On ccasin, yur legs may necessarily need t be a different length in rder t maintain hip stability. This is rare but a knwn pssibility, which can be addressed with a small lift in yur ther she. Yur new hip may set ff metal detectrs (airprt, curthuse, etc.) and n letter r card frm yur dctr will change hw security wrkers handle this. Hip replacements can last a very lng time. There is an 80-90% chance that yur jint replacement will still be functining well 20 years after yur surgery. It is impssible t predict hw lng yur new hip will last befre mre surgery may be necessary t change ut wrn r lse parts. The newest technlgy is imprving the lifespan f these implants. Minimally invasive surgery and cmputer-assisted surgery have a rle in certain situatins. Please refer t the fllwing link fr the American Assciatin f Hip and Knee Surgens psitin statement n these issues: Things t be cncerned abut include: Painful leg swelling Wrsening redness Persistent drainage frm the incisin Fever >101 degrees *These symptms shuld prmpt a call t yur surgen s ffice.

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