DETAILS OF YOUR SURGERY

Your Total Hip Replacement has been scheduled for: DATE The location of your Total Hip Replacement will be at: Burnside Hospital Total Hip Replacements is surgery that can affect your medical conditions. Therefore, in order to provide you with the safest possible outcome from the surgery and anaesthetic, we require all patients to undergo baseline testing. This includes: – Preadmission appointment at Burnside Hospital – Pre-operative routine bloods (This may include HIV, Hep B and Hep C screening) – Pre-operative urine sample to screen for infection – You may be referred to a physiotherapist prior to your operation. – Depending on your medical circumstances, you may be required to have a pre-operative appointment with a peri-operative physician. This will have been organised for you when booking for surgery if required.

POST OPERATIVE PERIOD

Your post operative period will last anywhere from 2-5 days, depending on your requirements. In some cases, we organise rehabilitation for you if you would benefit from more intensive rehabilitation. In general, the first 6 weeks are all about walking, and no specific exercises are required, as long as you are independently mobile.

Analgesia: For pain relief, you will only generally require tablet medications. This is given to you on an “as needed” basis. We opt to use multiple modalities for pain relief, to decrease the chance that you will require any injectable agents. In general, tablet pain relief is safe, and effective, and does not cause as much post operative drowsiness, nausea and dizziness as the injectable ones. After your operation, you will be prescribed pain relief to go home with. Only take this is required. You are not required to take pain relief constantly. If you are not in pain, you should stop taking your pain relief.

Walking: Due to the benefits of the anterior approach for total hip replacements, we encourage all patients to walk the day of surgery, or the next morning. You will require the help of a physiotherapist or nurse to begin with, who will assess your legs to see if it is safe to do so. In some cases, the spinal anaesthetic or nerve blocks may still be working, which affect your muscle strength. It is best to wait until these have worn off fully prior to commencing any walking. During your stay in hospital, you will start with a walking frame, and progress to a walking stick. You will also be required to practice walking up and down steps. Once you can achieve these milestones, you can go home. In general, most patients only require a walking stick on discharge. If you are using a walking frame, do not worry – every progresses at different rates. It is better to be safe than to fall over.

Showering: The wound dressing placed on your leg will be a waterproof dressing. You can see the two green ends. Under the clear part is a small strip of absorbant dressing which covers your wound fully. Under this are steristrips which act to keep the scar nice and thin as it is healing. For the first 2 weeks, you are encouraged to keep the wound clean and dry. Your dressing will be removed by Dr Liew at the 2 weeks appointment. Until your first post operative appointment, you will learn how to stick a bag over your dressing to keep it dry. Even though the dressing is waterproof, there are small gaps under the edges which can let dirty water in. Keeping it dry allows the skin to heal without issue, and decreases the risk of infection significantly. After your wound has been inspected by Dr Liew, you will be given further instructions – in general, you will be allowed to get the wound wet. Dr Liew will place a small strip of Hypafix over your dressing at your appointment, which will fall off on its own after about a week. This is expected.

Driving: In general, you will be able to drive quite early in your post operative course. This is due to the fact that your surgery does not cut any of the muscles to the hip, so your rehabilitation is relatively quick. You will be allowed to drive once you are walking well independently and can move yourself in and out of a car with relative ease. For most patients, this occurs after your 2 weeks appointment with Dr Liew. Some patients may take longer. Safety is the priority.

Wound: The wound lies beneath the white strip you can see. If it remains white, with small areas of ooze, then this is normal. If the entire white area becomes discoloured in anyway, you should advise Dr Liew by calling (08) 7325 4850. In some cases, your wound dressing will need to be changed prior to your 2 week appointment. This is rare.

Dislocation risk: All total hip replacements can dislocate, however, total hip replacements performed via a direct anterior approach tend to be a lot more stable than for other approaches. You will be allowed to sit up in bed as you wish, and sit on a normal toilet seat. During the first 6 weeks, you should be careful about falling, as the twisting force on your leg may cause the hip to dislocate. Because your total hip replacement will be performed using a direct anterior approach, you will not have the same post operative restrictions as hips performed via other means. In general, the only position to avoid is pushing your leg back behind you and twisting at the same time. This is a very unusual position to be in, and you are unlikely to find yourself in this position unless you specifically try to perform it.