HIP RESURFACING RECOVERY

(Following is a Birmingham Hip Resurfacing patient's recovery guide prepared by Dr. Vijay C. Bose and Team)
    

1st post-op day

The intravenous fluids are discontinued if you are taking them orally. For the first 48 hours following any surgery; pain is common due to the cutting of tissues. For this pain, powerful (narcotic analgesics eg. Tramadol) is given. You can request the nurse for these injections. These medicines also cause slight dizziness. If you feel comfortable, you can start walking with a walker on the first post-op day. If dizzy due to medications, the walking is postponed to the next day. You have to do deep breathing exercises, Static quadriceps and gluteal contraction exercises. The last dose of narcotics are given for this night.

2nd post-op day

Usually non-narcotic pain medication like inj. Diclofenac is given in the morning and blood sample taken for hemoglobin estimation. Drains are removed and the wound inspected. Last dose of antibiotic is given and the I/V cannula removed. All medications are changed to the oral formulations. Typically the following are given:
•  Iron & vit preparation
•  Chymerol forte
•  Oral painkillers like proxyvon and gastro protective agents like pantaprazole

You are also fitted with a pair of below knee Ted Stockings. Some patients will receive blood-thinning injections if indicated.

You walk with the help of a walker with the assistance of a physiotherapist for short distances. You are taken to the X-ray dept for check X-rays. You can start lying on the un-operated side with a pillow in-between the thighs (not knees or legs).

Day 3

You can walk for longer distances as comfortable. You can also start sitting in a chair with a pillow height. It is important to keep in mind that the capacity of recovery following surgery is very different among individuals. Therefore these milestones are only guidelines and variability is common. You should continue the exercise program in bed as per the instruction booklet.      

Day 4

Dressings are done again and sticker type dressing (Curapor or Surgiwear) is done if there is no wound ooze. You can start to use the western type toilet and wear normal clothes that are comfortable like pyjamas or baggy shorts. If the surgeon permits, a shower is possible with a special (surgiwear swimproof) dressing applied for this purpose. From this point on, the mobilization program is variable for each individual patient. In principle, you progress to elbow crutches when the phsyiotherapist deems fit.

Day 5

Once you can climb stairs with the help of elbow crutches, you are ready for discharge.

Usually you are fit to travel by car taking the front seat. The sitting is accomplished by first sitting on the car seat with the feet on the road and then lifting each leg individually into the car.

Overseas patient should keep the following points in mind during the flight:

•  To carry a bottle of water to ensure adequate intake of fluids
•  Compulsory wearing of TED stockings during the flight.
•  Requesting an aisle seat and taking a few steps in the corridor every half hour
•  To do ankle pump exercises when seated

At home

At home, you walk with a pair of crutches usually for about 10-15 days and when completely comfortable you can discard the crutch on the side of the operation first. Then when the other crutch is also felt unnecessary, this can also be discarded. Walking, climbing stairs or cycling can be done for long periods of time. At about 12 days, skin clips are removed. Overseas patients can get this removed by a doctor locally. (A letter to this regard is given at the time of discharge.) The next follow up visit is at 6 weeks when a check X-ray is repeated. Overseas patients can do this locally and send the X-rays to the doctor. A request for this is also given at the time of discharge. The subsequent compulsory visit to the doctor is at 6 months post-op.

Post-op restrictions in Birmingham Hip Resurfacing

There are no post-op restrictions after a Hip Resurfacing operation and you can use it as a normal hip. However, the soft tissues around the hip joint, which were contracted at the time of the hip disease, will take time to relax following the excellent movement that has been restored in the hip. Hence, if there is pain while attempting a certain activity like sitting on the floor, it implies the you are not yet ready for that particular activity. You should give a gap of about a week and then try it again. Likewise, the activity level improves in a stepwise manner till the soft tissues also become normal. In general, you are ready for sports (inclusive of contact sport) at about 3 months post-op.