Health education numbe:ORTH-101
Information for hip replacement patients A. INTRODUCTION：
Artificial hip replacement is an artificial structure implanted to replace the articular surface formed by the original bones of the
human body, which can reduce and eliminate the pain of the hip joint, so as to provide a more stable hip joint and improve the function of daily activities.
B.AFTER SURGERY PRECAUTIONS
1.In order to maintain the position of the new hip joint, a pillow should be placed between the legs after the operation to keep the legs open for three months to avoid joint dislocation.
2.For wound pain after surgery, the doctor will prescribe oral painkillers for you to take regularly; if the pain does not improve after taking the painkillers for more than 1 hour, please inform the nurse to evaluate your condition and use other painkillers if necessary . Taking
painkillers must pay attention to slow down and avoid bending over, so as not to cause dizziness and fall due to postural hypotension.
To deliver intelligent and holistic medicine and to provide the best healthcare Compassion Quality Innovation Accountability
All information above has been reviewed by orthopedics surgeons specialists Edited and published by the Department of Nursing,
Taichung Veterans General Hospital
Set date: 2014.08.01 Revised date:2019.09.07 Review date:2022.12.16
3. On the day after the operation, with the assistance and guidance of the nurse, every two hours, turn over with a pillow to prevent pressure injury; from the first day after the operation, the head of the bed should be raised at least 3 times a day, and the head of the bed should be
raised at least 3 times a day by a rehabilitator or nurse. Assist with getting out of bed; also raise the head of the bed when eating to avoid choking.
4.The drainage tube at the wound should not be pulled or twisted. It should be placed on the same side of the surgical site to keep it
unobstructed (Figure 1); the doctor will arrange the date of removal of the tube according to your condition.
Figure 1. The drainage tube is placed on the same side of the surgical site to avoid pulling it
5.Dorsiflexion exercise on the day after surgery (Figure 2), straight leg raising exercise (Figure 3), quadriceps exercise (Figure 4), and hip lift (Figure 5) on the first day after surgery, to strengthen the muscles.
(Step 1) Keep the dorsum of the foot up for 5 seconds, 200 times a day.
(Step 2) Keep the dorsum of the foot down for 5 seconds and then relax, 200 times a day.
(Step 1) Lie down. (Step 2) Lift your feet off the bed, keep your knees straight, hold for 5 seconds and then slowly lower them.
Figure 3.Straight Leg Raise Exercise
Figure 4.Quadriceps exercise
Figure 5.Hip lift exercise
Lie on your back with your knees straight on the bed, press your knees down, and keep your knees fully straight for 5 seconds, 100-150 times a day.
You can use the feet without surgery to do the hip-lifting exercise to avoid skin pressure and injury, and also strengthen the muscle strength and the ability to get out of bed and walk in the future.
C. Prohibited and permitted postures are as shown in the figure below (to be followed after surgery)：
Figure 6.The bending angle between the leg and the body at thesurgical site should not be less than 90 degrees
X
Figure 7.The chair should have armrests, do not sit on a chair that is too low, and do not cross your legs
X
Figure 8.Do not sit on a low toilet, avoid leaning forward, and straighten the legs at the surgical site
Figure 9.Knee can not be inside eight
X O
X O
Figure 10.The leg at the surgical site should not cross the midline of the body
Figure 11.When sleeping on the side, a pillow must be placed between the legs
X O
X O
Figure 12.When bending over, the leg at the surgical site should take a step back
D. Steps of wearing pants (Figure 13-Figure 24)
Figure 13.Preparation tools: two hangers
Figure 14.Straighten the hanger to make a bracket hook
Figure 15.Straighten the hanger Figure 16.Another bracket used as a trousers opening frame (right side)
X O
Figure 17.Making trousers open frame (left side)
Figure 18.The trousers open frame is completed
Figure 19.Hanger pull hook, open rack Figure 20.Tie the trousers to the open frame
Figure 21.Take the hanger and pull the hook, hook the trousers to open the rack, and then put on the trousers
Figure 22.Wear the surgical foot first (left foot)
E.Precautions for home care
1.According to the guidance of medical staff, use crutches and walkers for three months to reduce the weight on the hips.
2.Before the stitches are removed, please avoid drinking alcohol or Chinese herbal medicines such as angelica and ginseng. You can take a bath three days after the stitches are removed. You must be careful to slow down when entering and leaving the bathroom to avoid slipping and injury again.
3.You can gradually resume activities six weeks after the operation, and you should not engage in more strenuous behaviors, such as climbing mountains and avoiding excessive bending. It is recommended to take a walk (because the time for bone and soft tissue repair varies from person to person, the time point should still be based on the advice of the attending physician).
4.Observe the symptoms of artificial hip dislocation: severe pain, surgical foot eighth, the operated feet are shortened, and the joints have abnormal rattling sounds.
Figure 23.Wearing a healthy limb (right foot)
Figure 24.Remove the hanger hook and the trousers opener, and put on the trousers
5.Follow the doctor's instructions to return to the outpatient clinic on time. If the following conditions occur, such as increased wound pain, swelling of the surgical foot, discharge, fever, chest pain or difficulty breathing, please call immediately: 04-23592525 to ward extension 6075 or the 24-hour "All-round Health Consultation Center" "04- 23741353.
6.Before performing minor surgery or visiting the dentist in the future, remind your doctor.With implants, antibiotics are prescribed by a physician as appropriate to preventimplant infection.
F. Summarize
After hip arthroplasty, it is necessary to observe the correct body position to prevent dislocation. In addition, the affected limb can be started to perform progressive rehabilitation exercises on the day of the operation, so as to be able to get out of bed on their own to assist in activities; after returning home, the signs of dislocation should be observed , such as severe pain, shortening of the injured foot, inward rotation of the knee, abnormal rattling, to restore mobility and quality of life as soon as possible.
G. References
袁素娟(2021)‧肌肉骨骼系統疾病之護理‧於劉雪娥總校閱，
成人內外 科護理下冊
(八版，562頁、559-575頁)‧華杏。Tripp, H., & Fencl, J. L. (2020). Perioperative Nursing Considerations for Patients Undergoing Total Hip or Knee Arthroplasty. AORN journal, 111(2), 227-232. https://doi.org/10.1002/aorn.12943
Zhang, C., & Xiao, J. (2020). Application of fast-track surgery combined with a clinical nursing pathway in the rehabilitation of patients
undergoing total hip arthroplasty. Journal of International Medical