If you live alone this can pose a more challenging recovery from surgery. This is made much easier by organising yourself at home before you are admitted .
Washing - Put a chair in the bathroom so you can sit at a basin to wash. A long handled sponge will make washing your feet easier. Washing your hair will require assistance.
Meals - Move essential kitchen equipment to a height where you can easily reach them. Stock up the freezer with esay to prepare meals. Put a chair in the kitchen so you wont need to carry meals from the kitchen, which will be difficult with a walking aid.
Anti-thrombotic Stockings - You will need these for 6 weeks. They need to be changed changed every 2/3 days to check the skin integrity and prevent them doubling over and causing pressure areas. You will need assistance with this. This company can help:
Adaptive aids - You may wish to consider a raised toilet seat which makes it more comfortable to use the toilet initially after surgery, and a 'helping hand' to pick things up if dropped. Please ask at your preadmission appointment.
You should not drive until you feel you have the speed and mobility to perform an emergency stop - it is your own responsibility to restart driving when you feel it is safe to do so. Generally this will be six weeks after joint replacement and two weeks after arthroscopic surgery. An automatic could be driven two weeks after left sided joint replacement surgery, but you should inform your insurer if you plan to return to driving early.
Total hip replacement is one of the most successful surgical innovations of the 20th century. Surgery predictably restores mobility and function. It enables young adults to continue to work, look after their children, and participate in low impact sports; and elderly patients whose mobility is deteriorating to maintain their independence.
Surgery involves removing the worn out joint and replacing it with a new painless bearing. There are many different types of hip replacement. I recommend implants with a known track record and therefore the most predictable long term outcomes. I use a minimally invasive posterior surgical approach to the hip to minimise muscle injury and blood loss, which enables patients to walk the same day as their surgery.
Most patients have a shorter leg due to bone and cartilage loss as a result of their arthritis. One of the goals of surgery is to lengthen your leg to correct that leg length discrepancy. I use computer templating to more accurately achieve this and optimise your muscle function.
The majority of patients are admitted the morning of surgery. They have a spinal anaesthetic and some sedation. This makes for a swifter recovery from anaesthesia, so they can start to walk and rehabilitate the same day. Most patients are safe to go home two days after surgery, and walk independently at six weeks.
I recommend implants which have known track record and therefore a more predictable longevity.
For younger patients I usually use uncemented implants which bond to the bone, and a hard on hard ceramic on ceramic bearing (Depuy Corail/Pinnacle).
For more senior patients I usually use a cemented stem to support weaker more osteopaenic bone and an uncemented cup. Depending on level of mobility I would suggest either a ceramic or metal on polyethylene bearing (Stryker Exeter/Trident).
At your outpatient appointment you will be asked to have an Xray of your hips with a calibration ball. This will demonstrate the degree of established arthritis, and calibrate the Xray so we can accurately plan your operation.
I will ask you some questions to establish how much your hip joint is affecting you lifestyle and whether this is the right time to intervene and replace your hip joint. I will also ask questions about your medical health to calculate the likely level of risk your are exposed to by both anaesthesia and surgery. I will then examine your hip to assess how painful it is, and its current range of movement.
You will be asked to have an Xray so we can see how worn your hip is and it can be used to plan your surgery. If we agree this is the right procedure for you, you can discuss timing and the centre where you would like to have your surgery with Gill. You will be asked to attend a preadmission clinic appointment prior to surgery to check your medical health approximately two weeks before your admission.
Most admissions are for two days. You will leave hospital with crutches, which you should use for the first 4 weeks, and then drop to one so you are walking independently by 6 weeks.
Air travel within 12 weeks of surgery carries an increased risk of thromboembolism. This risk can be reduced by for example keeping well hydrated and walking during the flight, taking a shorter flight and longer after the surgery. If essential anticoagulants can be prescribed to reduce this risk, but another consideration should be the healthcare system at the destination if their was a problem.
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