Hip Replacement - Post discharge

Should the patient still require help from the nursing staff after discharge from the hospital to the hotel ,this can be provided. Any equipment that they may require to use in the hotel such as a toilet seat or armchair will be provided from the hospital. The room should have a walk in shower cubicle to facilitate washing. It will no longer be possible for the patient to sit in a bath or on the floor and it is important when dressing that the hip is protected. The operated leg should be dressed first. To apply shoes it may help to use a long handled shoehorn, but if the patient has to bend down to adjust the shoe it should always be from the middle with the legs open and never from the side. Socks / stockings can be put on using a sock aid if necessary. These small aids are available from Boots the Chemists or from a shop that sells disability aids close to where they live. Alternatively we can supply them.

The patient will continue to be monitored as necessary by the physiotherapist either in the hotel or in the hospital department which is situated next door. Post operatively the exercises are basically the same as pre operatively but with a few additions:

1. Move your feet up and down from the ankles
2. Move your feet in a circle anti- clockwise and clockwise.
3. Put a towel or small pillow under your knee. Pull your foot towards you and straighten your      knee so that the heel comes off the bed. Hold for a count of five.
4. Tighten the muscles of your thigh to straighten your knee and try to lift your leg a few       inches off the bed. Hold for a count of five and then lower.
5. Lying on your back, lift your leg slightly off the bed and then take it out to the side, hold for      a few seconds and then bring it back in keeping the gap between legs. Relax
6. In lying bend and straighten your leg. Putting a piece of hardboard or melamine under      your leg will make this movement easier. Make sure the hip, knee and ankle stay inline      and that the leg does not drift inwards.
7. In sitting lift your leg to straighten your knee. Hold for a few seconds and then lower it      down again.
8. Whilst standing holding onto a support in front of you:
     • Go up onto tip toes, lower down and rock back onto heels keeping bottom in.
     • Squat bending knees and hips then straighten up
     • Lift right knee up to touch bar and then lower. Repeat with left.
     • Standing straight lift right leg out to the side. Hold then lower down. Repeat with left.
     • Walk sideways, five steps one way the other

When going up and down stairs the good leg always goes up first, and the operated leg goes down first. The sticks stay with the operated leg.
When the stitches or clips are removed by the out patient nurses, the wound should be kept dry for a few days. After this it can be washed normally. However the patient is not allowed to sit in a bath and should use a shower. Should the stitch line need moisturising the best thing is E45 cream or a similar product. The stitch line may be numb for a while after surgery due to the nerves to the skin being cut- this will return to normal in time as the nerves grow back into the skin. Eventually they will be able to do most things including kneeling (if absolutely necessary), though it is better not to strain the joint if it can be avoided.

The patient will see the Consultant and the physiotherapist before they fly back to the UK. Any queries they may have can be addressed at this time. However the physiotherapist can always be contacted through the hospital or through the Personal Care Manager and will contact the Consultant on the patients behalf if the patient has a problem that the physiotherapist cannot sort out.
Some patients may have to continue having a heparin injection for a while after the surgery- this will be prescribed in the hospital. The hospital staff will continue to administer the injection after discharge from the hospital – either by the patient coming to the hospital or the nurses will visit the hotel.