【Learning points】
- The nursing staff will assist and guide you to get out of bed the next day after the artificial hip joint surgery.
- After surgery, you need to maintain the correct posture of the hip joint and avoid crossing your legs, bending over to wear socks, squatting deeply, or sitting on a chair that is too low.
- If the surgical site is red, swollen, oozes, has fever, or is in pain and unable to move, please return for examination.
I. 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.
II. AFTER SURGERY PRECAUTIONS
- 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.
- 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.
- 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.
- 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.
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Figure 1. The drainage tube is placed on the same side of the surgical site to avoid pulling it
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- 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.
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(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. |
Figure 2.Dorsiflexion of the foot |
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(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 |
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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 |
Figure 4.Quadriceps exercise |
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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. |
Figure 5.Hip lift exercise |
III.Prohibited and permitted postures are as shown in the figure below (to be followed after surgery)
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Figure 6.The bending angle between the leg and the body at thesurgical site should not be less than 90 degrees |
IV.Steps of wearing pants (Figure 13-Figure 24)
V.Precautions for home care
- According to the guidance of medical staff, use crutches and walkers for three months to reduce the weight on the hips.
- 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.
- 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).
- Observe the symptoms of artificial hip dislocation: severe pain, surgical foot can not internally rotated, the operated feet are shortened, and the joints have abnormal rattling sounds.
- 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.
- 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.
VI.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.
VII.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
- Tanaka, H., Yamada, N., Kurishima, H., Mori, Y., & Aizawa, T. (2022). Association between Hip Center Position and Isokinetic Hip Muscle Performance after Anterolateral Muscle-Sparing Total Hip Arthroplasty. Medicina, 58(538) ,1-8.https://doi.org/10.3390/medicina58040538Zhao, X., Bai, R., & Yang, J. (2022). Effect of Painless
- Rehabilitation Nursing for Hip Replacement Patients. Computational and mathematical methods in medicine, 2022, 5164973. https://doi.org/10.1155/2022/5164973