Care in the recovery of hip arthroplasty

To speed up recovery after placing a hip prosthesis, care must be taken not to displace the prosthesis and having to return to surgery. Total recovery varies from 6 months to 1 year, and physiotherapy is always indicated, which can start as early as the 1st postoperative day.

Initially it is recommended to do exercises that improve breathing, the movement of the feet in all directions, and isometric contractions in bed or sitting. The exercises should be progressing each day, as the person shows capacity. Learn some examples of exercises for those who have hip prostheses.

In this recovery phase, foods that are easy to digest and rich in protein are recommended to speed up the healing of tissues, such as eggs and white meats, in addition to milk and its derivatives. Sweets, sausages and fatty foods should be avoided because they hinder healing and prolong recovery time.

Care not to displace the hip prosthesis

To prevent the hip prosthesis from leaving the site it is essential to always respect these 5 basic cares:

Do not cross your legs; Do not bend the operated leg more than 90º; Do not rotate the leg with the prosthesis in or out; Do not support the entire body weight on the leg with the prosthesis; Keep the leg with the prosthesis stretched, whenever possible.

These precautions are very important in the first weeks after surgery, but they must also be maintained for a lifetime. In the first few weeks, the ideal is for the person to lie on their backs, with their legs straight, and a small cylindrical pillow between their legs. The doctor can use a kind of belt to wrap the thighs, and prevent the leg from rotating, keeping the feet lateral, which usually happens due to weakness of the muscles of the inner thigh.

Other more specific precautions are:

1. How to sit and get out of bed

To get in and out of bed

The patient's bed must be high to facilitate movement. To sit and get out of bed you must:

To sit on the bed: Standing still, lean your good leg on the bed and sit, taking the good leg to the middle of the bed first and then with the help of your hands, take the operated leg, keeping it straight; To get out of bed: Get out of bed, on the side of the operated leg. Keep the knee of the operated leg always straight. While lying down, you should stretch your operated leg out of bed and sit on the bed with your leg straight out. Support the weight on the good leg and get out of bed, holding the walker.

2. How to sit and get up from the chair

To sit and stand

To properly sit and stand up from a chair, you must:

Chair without armrests

To sit: Stand beside the chair, keep the operated leg straight, sit in the chair and adjust yourself in the chair, rotating the body forward; To stand up: Rotate the body to the side and keeping the operated leg straight, lift up with support on the chair.

Chair with armrests

To sit: Place your back to the chair and keeping your leg with the prosthesis stretched, place your hands on the arms of the chair and sit, bending the other leg; To lift: Place your hands on the arms of the chair and keeping your leg with the prosthesis stretched, put all the force on the other leg and lift.

Toilet

Most toilets are low and the legs have to be bent more than 90º, therefore, after placing a hip prosthesis, it is important to place an elevated toilet seat so that the operated leg is not bent more than 90º and the prosthesis don't move.

3. How to get in the car

The person must be in the passenger's seat. You must:

Place the walker against the (open) car door; Place your arms firmly on the dashboard and seat. This seat should be recessed and reclined backwards; Sit down gently and bring the operated leg into the car

4. How to bathe

To take a bath in the shower more easily, without putting too much force on the operated leg, you can place a plastic bench that is tall enough to not have to sit completely. Alternatively, you can use an articulated shower seat, which is attached to the wall and you can also place support bars to help you sit and stand on the bench.

5. How to dress and put on

To put on or take off your pants, or put your sock and shoe on your good leg, you should sit on a chair and bend your good leg, supporting it over the other. As for the operated leg, the knee of the operated leg must be placed on top of the chair to be able to dress or put on. Another possibility is to ask for help from another person or use a tamper to get the shoe up.

6. How to walk with crutches

To walk with crutches, you must:

Advance the crutches first; Advance the leg with the prosthesis; Advance the leg without prosthesis.

It is important to avoid taking long walks and to always have crutches close by so as not to fall and the prosthesis does not move.

How to go up and down stairs with crutches

To correctly climb and descend stairs with crutches, the following steps must be followed:

Climbing stairs with crutches

Place the leg without the prosthesis on the top step; Place the crutches on the leg step and at the same time place the leg with prosthesis on the same step.

Down stairs with crutches

Place the crutches on the bottom step; Place the leg with prosthesis on the step of the crutches; Place the leg without prosthesis on the step of the crutches.

7. How to squat, kneel and clean the house

Generally, after 6 to 8 weeks of surgery, the patient can return to clean the house and drive, but in order not to bend the operated leg more than 90º and prevent the prosthesis from moving, he must:

To squat: Hold a solid object and slide the operated leg backwards, keeping it straight; To kneel: Place the knee of the operated leg on the floor, keeping your back straight; To clean the house: Try to keep the operated leg straight and use a broom and long-handled dustpan.

In addition, it is also important to distribute household chores throughout the week and remove carpets from the house to prevent falls.

The return to physical activities must be indicated by the doctor and the physiotherapist. Light exercises such as walking, swimming, water aerobics, dancing or Pilates are recommended after 6 weeks of surgery. Activities such as running or playing football can cause greater wear of the prosthesis and therefore may be discouraged.

Scar Care

In addition, to facilitate recovery, one must take good care of the scar, which is why the dressing must always be kept clean and dry. It is normal for the skin around the surgery to remain asleep for a few months. For pain relief, especially if the area is red or hot, a cold compress can be placed and left for 15-20 minutes. The stitches are removed at the hospital after 8-15 days.

When to go to the doctor

It is recommended to go to the emergency room immediately or consult a doctor in case of:

Severe pain in the operated leg; Fall; Fever above 38ºC; Difficulty moving the operated leg; The operated leg is shorter than the other; The operated leg is in a different position than normal.

It is also important whenever you go to the hospital or health clinic to tell the doctor that you have a hip prosthesis, so that he can take proper care.