Post-Total Hip Replacement: Essential Guidelines for Recovery and Care

Total Hip Replacement

I underwent surgery on May 7, 2016, for a "right pelvic fracture with associated right hip dislocation," which led to post-traumatic arthritis nearly two years later, resulting in a total hip arthroplasty on March 27, 2018.
I have some questions as follows:
1.
Are there any dietary restrictions, such as certain beverages or foods, like coffee? Or can I start consuming them after a specific period?
2.
Should I continue with the rehabilitation program arranged by the physical therapist? If certain movements are prohibited within the first three months, will the therapist be aware of that? What specific movements are allowed after the surgery?
3.
My attending physician did not specifically mention the need for rehabilitation; does that mean I do not need it? Is it sufficient to just walk daily, and is it okay to walk for extended periods?
4.
The attending physician mentioned that I can drive and ride a motorcycle, but advised against the motorcycle due to the risk of falling.
Regarding driving, since car seats are typically higher in the front and lower in the back, will my knee be slightly elevated compared to my hip joint? Is that slight elevation acceptable?
5.
In the future, when visiting a dental clinic for any treatment, should I always request to take antibiotics beforehand? Is this necessary for visits to any medical specialty?
6.
Will I still be able to sit cross-legged in the future?
7.
How can I prevent dislocation, infection, or other complications? Thank you.

Justin, 30~39 year old female. Ask Date: 2018/04/21

Dr. Shi Guozheng reply Orthopedics

1.
No.
2.
Rehabilitation is necessary and is usually well understood.
3.
Strength training for the muscles helps to stabilize the joints.
4.
Driving should be avoided for six weeks post-surgery; the seat should be elevated to prevent dislocation.
5.
Dental treatments may cause transient bacteremia, so it is important to inform your dentist that you have artificial joints.
6.
It is best to avoid certain activities.
7.
Be cautious of dislocation within three months post-surgery; loosening may occur later on.
It is advisable to avoid high-impact activities.
To prevent infections, maintain a healthy body and do not let your immune system weaken.

Reply Date: 2018/04/21

More Info

Post-total hip replacement (THR) recovery is a critical period that requires careful attention to various aspects of lifestyle, rehabilitation, and medical follow-ups. Here are essential guidelines to help you navigate your recovery effectively:
1. Dietary Restrictions: After hip replacement surgery, there are no specific food or drink restrictions unless advised by your healthcare provider. Generally, you can resume your normal diet, including coffee, unless you have other health conditions (like hypertension) that require you to limit caffeine. It’s always best to consult your doctor or a nutritionist for personalized advice.

2. Rehabilitation Therapy: Continuing physical therapy is crucial for a successful recovery. Even if your doctor hasn’t explicitly mentioned it, engaging in a structured rehabilitation program can significantly enhance your recovery. Physical therapists are well aware of the limitations and precautions necessary during the initial months post-surgery. They will guide you on which movements to avoid, especially within the first three months, such as crossing your legs or bending your hip beyond 90 degrees. Regular sessions will help strengthen the muscles around your hip, improve your range of motion, and reduce the risk of complications.

3. Walking and Mobility: While daily walking is beneficial, it should not replace formal rehabilitation. Walking helps maintain mobility and cardiovascular health, but structured exercises prescribed by a therapist are essential for building strength and stability. If you experience pain or discomfort while walking, it’s important to communicate this to your healthcare provider.

4. Driving Considerations: Your doctor’s advice regarding driving is generally sound. After six weeks post-surgery, many patients can resume driving, provided they feel comfortable and can safely operate the vehicle. The height of the car seat can affect your knee position relative to your hip; however, a slight elevation of the knee above the hip is usually acceptable. Ensure that you can comfortably and safely control the vehicle before resuming driving.

5. Antibiotic Prophylaxis: After receiving a hip replacement, it is often recommended to take antibiotics before dental procedures or surgeries to prevent infections, particularly if you have a history of joint infections or if your doctor advises it. Always inform your dentist and other healthcare providers about your hip replacement to determine if prophylactic antibiotics are necessary.

6. Sitting Positions: Sitting cross-legged or in a "lotus" position is generally discouraged in the early stages of recovery, as it can increase the risk of dislocation. It’s best to follow your healthcare provider’s recommendations regarding sitting positions, especially in the first few months post-surgery.

7. Preventing Complications: To minimize the risk of dislocation, infection, or loosening of the implant, adhere to the following guidelines:
- Avoid high-impact activities and movements that place excessive stress on the hip joint.

- Maintain a healthy lifestyle, including a balanced diet and regular exercise, to support overall health and immune function.

- Follow your rehabilitation plan diligently, focusing on strength and flexibility exercises.

- Be cautious with any activities that involve twisting or sudden movements.

In summary, your recovery from total hip replacement involves a multifaceted approach that includes dietary considerations, ongoing rehabilitation, careful mobility practices, and preventive measures against complications. Always stay in close communication with your healthcare team to ensure a safe and effective recovery process.

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