Intrductin: Anterir Ttal Hip Arthrplasty Patient Guide & Cmmn Questins This handut is a general guide t cmmn indicatins fr anterir ttal hip arthrplasty, what t expect when underging the prcedure, risks, and general recvery infrmatin. This is nt a cmprehensive guide, hwever, and any questins r cncerns shuld be addressed directly with the surgen. Hw is a Hip Arthrplasty perfrmed? - In a ttal hip arthrplasty (ttal hip replacement), the damaged bne and cartilage is remved and replaced with a prsthetic device. - The damaged femral head is remved and replaced with a metal stem that is placed int the hllw center f the femur. - A metal r ceramic ball is placed n the upper part f the stem. This ball replaces the damaged femral head that was remved. - The damaged cartilage surface f the scket (acetabulum) is remved and replaced with a metal scket (held in place by screws r cement). - A plastic, ceramic, r metal spacer is inserted between the new ball and the scket t allw fr a smth gliding surface. - Is a Ttal Hip Replacement right fr me? - The decisin t underg a ttal hip replacement shuld be made cperatively by yu, yur family, yur primary care physician and yur rthpedic surgen. - There are n abslute age r weight restrictins fr ttal hip replacements. - Recmmendatin fr surgery is based n each patient s level f pain and disability as assessed by an rthpedic surgen - There are several reasns why yur dctr may recmmend a ttal hip replacement: Hip pain that limits everyday activities, such as walking r bending Hip pain that cntinues while resting, either day r night Stiffness in a hip that limits the ability t mve r lift the leg Inadequate pain relief frm anti-inflammatry drugs, physical therapy, r walking supprts. - The mst cmmn cause f chrnic hip pain and disability is arthritis, which can include stearthritis, rheumatid arthritis, and traumatic arthritis. - TALK WITH YOUR DOCTOR. Yur rthpedic surgen will review the results f yur evaluatin with yu and discuss whether a hip replacement is the best methd t relieve yur pain and imprve mbility. - Never hesitate t ask yur rthpedic surgen any questins when yu d nt understand r are unsure f smething. - As yu prepare fr yur hip replacement, yur rthpedic surgen may ask yu t: Have a physical examinatin by yur primary care physician Take several tests, such as bld r urine, EKG, and chest x-rays Main Office Phne 512.476.2830 Main Office Fax 512.476.2832
Adjust yur current medicatins prir t surgery Lse weight prir t surgery t minimize stress n new hip and pssibly decrease surgery risks Have dental evaluatin (because bacteria can enter bldstream during dental prcedures, all majr dental prcedures (tth extractin r peridntal wrk) shuld be dne prir t hip surgery. The Prcedure: - The surgical prcedure takes a few hurs. Yur rthpedic surgen will remve the damaged cartilage and bne, and then psitin new metal, plastic, r ceramic implants t restre the alignment and functin f yur hip. - After surgery, yu will be mved t a recvery rm, where yu will remain fr several hurs while yur recvery frm the anesthesia is mnitred. When yu wake up, yu will be taken t yur hspital rm. - Yu will mst likely stay in the hspital fr a few days After Surgery: - After yur surgery, yu will mst likely feel sme pain, but yur nurses/surgen will prvide medicatin t make yu feel as cmfrtable as pssible. Talk with yur surgen if pst-perative pain becmes a prblem. - Walking and light activity are imprtant t recvery. Mst patients that under a ttal hip replacement begin standing/walking with the help f a walking supprt and a physical therapist the day after surgery, but nt in all cases. Yu will have a physical therapist that will teach yu specific exercises t strengthen yur hip and restre mvement fr walking and ther nrmal daily activities. - It is cmmn fr patients t have shallw breathing pst-peratively (due t effects f anesthesia, pain medicatin, increased time spent in bed). This shallw breathing can lead t a partial cllapse f the lungs ( atelectasis ) that makes patients susceptible t pneumnia. T prevent this, yur nurse may prvide a simple breathing apparatus ( spirmeter) t encurage yu t take deep breaths. - Yu will have stitches r staples running alng yur wund, and they will be remved at yur pstperative ffice visit 2 weeks after surgery. Avid getting the wund wet until it has sealed and dried. Yu may cntinue t bandage the wund t prevent irritatin frm clthing/supprt stckings. - Sme lss f appetite is cmmn fr several week after surgery. It is imprtant t prmte prper tissue healing and restre muscle strength, s be sure t have a balanced diet, ften with an irn supplement. Drink plenty f fluids. - Exercise is crucial t hme care, particularly during the first few weeks after surgery. Yu shuld be able t resume nrmal light activities f daily living within 3 t 6 weeks fllwing surgery. Sme discmfrt with activity and at night is cmmn fr several weeks. - Activity shuld include: Graduated walking prgram Resuming nrmal husehld activities Main Office Phne 512.476.2830 Main Office Fax 512.476.2832
Specific exercises as recmmended by yur surgen and/r physical therapist Pssible cmplicatins can include: Infectin Bld clts Leg-length inequality Dislcatin Lsening and Implant Wear Other cmplicatins (nerve and bld vessel injury, bleeding, fracture, stiffness) Precautins: - It is very imprtant t prevent infectin. Fllwing surgery, patients with certain risk factrs may need t take antibitics prir t any dental r medical wrk befre any surgical prcedure that culd allw bacteria t enter yur bldstream. - Warning signs f an infectin include: Persistent fever (higher than 100 degrees Fahrenheit rally) Shaking chills Increasing redness, tenderness, r swelling f the hip wund Drainage frm the hip wund Increasing hip pain with bth activity and rest - It is very imprtant t avid falling. A fall during the first few weeks after surgery can damage yur new hip and may result in a need fr mre surgery. Yu shuld use a cane, crutches, a walker, r handrails when using stairs, r have smene help yu, until yu imprve yur balance, strength and flexibility. - Yu may be asked t take special precautins when sitting, bending, r sleeping in rder t assure prper recvery and prevent dislcatin f the prsthesis. Precautins vary patient t patient, and yur surgen/physical therapist will discuss any specific precautins with yu prir t hspital discharge. - Fllw yur rthpedic surgen s directins carefully t reduce the risk f a bld clt during first several weeks f yur recvery. Ntify yur dctr immediately if yu develp: Pain in yur calf and leg that is unrelated t yur incisin Tenderness r redness f yur calf New r increasing swelling f yur thigh, calf, ankle r ft Sudden shrtness f breath Sudden nset f chest pain Lcalized chest pain with cughing Prtecting the life f yur Hip: - In rder t prtect yur hip replacement and extend the life f yur hip implant, yur surgen may recmmend the fllwing: Participate in a regular light exercise prgram t maintain prper strength and mbility f the new hip Take special precautins t avid falls and injuries. Main Office Phne 512.476.2830 Main Office Fax 512.476.2832
Make sure yur dentist knws yu have a hip replacement, and speak with yur surgen abut whether yu need antibitics prir t dental prcedures See yur rthpedic surgen peridically fr rutine fllw-up examinatins and x-rays, even if yur hip replacement seems t be ding fine Never hesitate t call ur ffice with any questins r cncerns 512.476.2830 Fr mre infrmatin: www.texashipandknee.cm Main Office Phne 512.476.2830 Main Office Fax 512.476.2832
Nrmal hip anatmy A hip with stearthritis (Left)The individual cmpnents f a ttal hip replacement. (Center) The cmpnents merged int an implant. (Right) The implant as it fits int the hip. (Left) In this x-ray f a nrmal hip, the space between the ball and scket indicates healthy cartilage. (Right) This x-ray f an arthritic hip shws severe lss f jint space. Main Office Phne 512.476.2830 Main Office Fax 512.476.2832
(Left) A standard nn-cemented femral cmpnent. (Center) A clseup f this cmpnent shwing the prus surface fr bne ingrwth. (Left) The acetabular cmpnent shws the plastic (plyethylene) liner inside the metal shell. (Right) The prus surface f this acetabular cmpnent allws fr bne ingrwth. The hles arund the cup are used if screws are needed t hld the cup in place. X-rays befre and after ttal hip replacement. Main Office Phne 512.476.2830 Main Office Fax 512.476.2832