A Patient Guide to Hip Resurfacing Surgery - Surface Replacement Arthroplasty

 

Surgery: _____________________________________

 

Date: ________________________________________

 

Doctor: ______________________________________

 

 

 

Valet parking is free and open from 7:00 am-7:00 pm.  It is between the clinic and hospital doors.

 

To go to the Outpatient Surgery Center, enter at the clinic entrance.  Once inside the lobby, it’s the 1^st door on your left

 

To go to the Ambulatory Procedure Center, enter at the hospital entrance.  Follow the gray path past the D elevator.  Turn left when you see the APC sign.

 

To go to the First Day Surgery Unit, enter at the hospital entrance.  Follow the gray path to the D elevator.  Take the D elevator to the 3^rd floor and turn left to the First Day Surgery Unit entrance.

 

This is the 2^nd floor…

To get to the …

Cafeteria: H4/1 – H elevator to the 1^st floor

ECG: F6/354 – F elevator to the 3^rd floor

Pulmonary Function: E5/520 – E elevator to the 5^th floor

Inpatient X-Ray:  E3/3 – E elevators to the 3^rd floor

Admissions:  2^nd floor across from the information desk

 

 

Getting Ready

 

Within 30 days of your surgery, you must have a physical done by your local doctor.  This will include blood work, a chest x-ray, ECG, and other tests as needed.  You will be given forms for your doctor to complete.  Your doctor should FAX the forms to the Orthopedic Clinic (608) 263-1266 before your work-up day.

 

On the day of your work-up visit, bring any x-ray films or other papers that your local doctor has given you.  Also, bring along the information packet that you received in the Orthopedic Clinic.  Expect to be at the clinic about 3 hours.

 

Physical Therapy

 

You will likely be allowed to bear as much weight as feels comfortable right after the surgery.  If this is not the case, you will be told of your weight-bearing status before your first walking session.  Make sure you practice using your crutches or walker.  Try placing little or no wieght on the surgery leg.  If you can handle this, it will be easy for you to walk with more weight.  A few minutes of practice each day is just fine.  This will help prepare you for walking with the crutches or walker.  You will be trained to use crutches or a walker while in the hospital and may also be seen by Occupational Therapy for teaching you how to use devices that make your daily routines easier (raised toilet seat, reachers, long bath brush).

 

You will have home PT for the first 1-2 weeks unless you go to a rehab center.  Then, you will be followed by a PT in an outpatient clinic.  You must schedule these outpatient PT visits before your surgery.  Phone numbers are listed below. You should have your first clinic PT visit for one hour 10 – 14 days after the surgery.  You will need to schedule visits for 30 minutes twice a week for the first three weeks so you can regain strength and get back to walking normally as soon as you are able.  Make sure you have someone drive you to the clinic for the first few weeks, until you and your therapist decide you are ready to drive.  You won’t be able to drive until you are no longer taking narcotic pain medicine.  You must be able to show enough reaction time and control with your right leg.

 

Phone numbers for physical therapy

Remember to schedule these before your surgery.

 

If you have GHC you will need to schedule your therapy at the GHC Clinic, Princeton Club West.

 

If you are not from the area, you will need to find a physical therapy clinic in your area.

 

UW Health clinics

 

UW Rehabilitation Clinic – 608-263-8412

6630 University Avenue

 

UW Hospital and Clinics – 608-263-8060

600 Highland Avenue

 

Research Park – 608-263-4765

621 Science Drive

 

Princeton Club West – 608-265-7500

8042 Watts Road

 

Princeton Club East –608- 265-1221

1726 Eagan Road

 

GHC clinic

Princeton Club West – 608-662-5060

8054 Watts Road

 

Planning Ahead

 

People who have a hip resurfacing find it useful to plan ahead.

 

• Depending on the approach your surgeon uses, you may be able to go home after 2-3 nights in the hospital.  For instance, if your hip surgery is on a Monday, you could plan to go home Wednesday or Thursday.  You may wish to speak with the surgeon about his plan.
• If you plan to go home and you live alone, you should arrange for someone to stay with you at least for a few days.  Most people who go home need home health services for physical therapy and blood draws.  A nurse case manager or social worker will work with you and your insurance company to arrange this.
• You will need to arrange for a ride home.  A 4-door car works best.
• When you can safely return to work or your other routines will depend on your recovery time.  It will also depend on the type of work or activity you do.  You should discuss this with your doctor. 
• You may want to move items from lower shelves to waist level.  You will be unable to reach to items below the waist.
• Because extra weight increases forces on your new hip, you should avoid heavy lifting (30 – 50 pounds), especially for the first 6 weeks after surgery.  After the first 6 weeks, occasional heavy lifting is okay, but try to avoid doing this on a daily basis.
• Get your raised toilet seat ahead of time.  Some insurance cover this and some do not.  These can be purchased at local health supply store, or Walgreen’s, Shopko, Wal-Mart.  If you want to try to have insurance cover the cost, ask your doctor for a “script for a raised toilet seat” which is often needed for coverage. 

 

Some people need further rehab or nursing home care before being able to return home.  A social worker or nurse case manager can work with you to arrange for these services.  If you know that you plan to go to a nursing home, it is helpful to visit nursing homes in your area ahead of time.  Please tell the nurse your plans at your pre-op visit.

 

To prevent falls after surgery, prepare your home in advance.  Watch out for

 

• Loose rugs or carpets.  Remove all of them.
• Pets that may run in your path.
• Water spills.
• Bare slippery floors.
• Long cords across floor, such as phone or fan cords.
• Ice on steps and porches, etc.

 

After Surgery

 

Physical Therapy

 

Some patients may begin physical therapy on the day of surgery; others will begin the day after.  The therapist will come to your room.  You will learn how to

• move comfortably in bed.
• get in and out of bed safely.
• use the walker or crutches to walk and go up and down stairs.
• get in and out of a car safely.
• start some gentle exercises.
• protect your hip during these activities.

 

Discuss taking pain medicine before your PT.  It’s also a good idea to have a family member or friend attend one therapy session with you, so that he can see how you walk and what exercises you are doing. 

 

In the hospital, PT is most often scheduled twice per day.  This will help to improve the strength and flexibility of your leg.  Once home, you will keep doing the exercises 2-3 times per day. 

 

An occupational therapist may train you to use assistive devices so that you are able to bathe, dress, and fix meals.  Some of the devices that others have found helpful include a dressing stick, a long-handled sponge, a stocking aid, elastic shoelaces, long-handled reachers, and bathroom aids.  Due to your hip precautions, you will not be able to reach your feet for at least 6 weeks.  You will either need daily help with self-care or you will need to use assistive devices to help you be more independent.

 

Pain Relief

 

After surgery, you will receive scheduled pain pills (Oxycontin®) twice each day for one to three days.  Extra pain medicine can be given between the scheduled doses.  It is important to let your nurse know if you need more pain medicine.

 

Blood Clot Prevention

 

People who have hip surgery are at higher risk for getting blood clots.  To decrease the risk of a blood clot, you will be taking medicine to thin the blood.  Most patients take this medicine for 2 to 6 weeks.  While taking it, your blood may need to be drawn twice per week to check its “thinness”.  If your blood needs to be drawn, a nurse case manager or social worker will arrange for it.  She will discuss the details with you before you go home.

 

You will need to wear elastic stockings for 6 weeks.  You should remove them 2 times each day for skin care.  You should always sleep with them on.

 

 

Always Remember Hip Precautions

 

For the first 6 weeks after surgery, you will need to avoid certain movements and activities in order to protect your new hip.  After 6 weeks, you will work with your physical therapist to slowly progress past these precautions.

• Do not cross your thigh over the midline of your body at any time.
• Do not bend your hip more than 90 degrees.
• Do not let your thigh turn inward (pigeon-toed).
• Avoid lifting more than 30 pounds for the first 6 weeks.  After the first 6 weeks, occasional heavy lifting is allowed but is not recommended on a daily basis

Phone Numbers

 

If you have questions or concerns, please call the Orthopedic Clinic, at

(608) 263-7540.  Nights and weekends, this number will be answered by the paging operator.  Ask for the orthopedic resident on call.  Leave your name and phone number with the area code.  The doctor will call you back.

 

If you live out of the area, call 1-800-323-8942.

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Exercises after Hip Resurfacing

 

These pictures show the first exercises which you will perform after hip resurfacing.  The easiest exercises are shown first, followed by more advanced exercises.  You will slowly work towards the more challenging exercises guided by your physical therapist.

 

Quad Sets/Extension Exercise 1 of 14

• Sit or lie on your back with involved leg straight.
• Press the back of your knee into the bed.
• This will tighten the muscle on top of your thigh and move your kneecap as shown (upward).
• Hold 5 seconds.
• Do 10 repetitions per hour while in hospital (note: once home, 10 repetitions 3 times per day)

 

 

Hamstring Sets

Exercise 2 of 14

 

1.  Lie as shown with your operated knee slightly bent.

2.  Press your heel to bend, as if sliding heel towards your buttocks.

3.  Hold 5 seconds.

4.  Do 10 repetitions per hour while in the hospital; once home, 10 repetitions 3 times per day.

 

 

 

 

 

Gluteal Sets

Exercise 3 of 14

 

1. Lie on your back, not on belly as shown.
2. Tighten your buttocks together firmly.
3. 3.     Hold 5 seconds.
4. 4.     Do 10 repetitions per hour while in the hospital; once home, 10 repetitions 3 times a day.

 

Ankle Circles

Exercise 4 of 14

• Move your ankle around slowly in a large circle.
• Repeat in the opposite direction.
• Do 10 repetitions per hour while in the hospital; once home, 10 repetitions 3 times per day.  Precautions: this movement should come from the ankle only, not the hip.  Do not turn your entire leg inward.  Your knee should stay facing forward (up).

 

 

 

 

Hip Adduction

Exercise 5 of 14

• Sit with a ball or large pillow between your knees as shown.  You may also do this exercise lying on your back with your knees bent.
• Squeeze thighs together tightly.
• Hold 5 seconds, slowly relax.
• Do 10 repetitions, 3 times per day.

 

 

Hip Flexion

Exercise 6 of 14

 

1. Lie on your back.
2. 2.     Bend your involved knee and slide the heel up towards your buttocks as shown.
3. 3.     Hold 5 seconds, slowly relax.
4. 4.     Do 10 repetitions, 3 times per day.

 

 

Hip Abduction

Exercise 7 of 14

 

1. Lie on your back.
2. 2.     Slide your involved leg out to the side as far as you can, then return to the starting position.  Remember not to cross the midline of your body.  Keep your foot and knee pointing straight up.  When this exercise becomes easy to do you will progress to standing up to do it (exercise #10).
3. 3.     Hold 3 seconds, slowly relax
4. 4.     Do 10 repetitions, 3 times per day.

 

 

Short Arc Quad/Extension

Exercise 8 of 15

 

1. Lie on your back with a 6-inch roll under your involved knee.
2. 2.     Raise your heel off the floor until the knee is straight.
3. 3.     Hold 3 seconds and slowly lower.
4. 4.     Do 10 repetitions, 3times per day.

 

 

Hip Extension

Exercise 9 of 14

• Stand holding onto a solid object.
• Lift your involved leg backward as shown.  Do not bend over at the waist.
• Hold 3 seconds, slowly relax.
• Do 10 repetitions, 3 times a day.

 

 

 

 

 

Hip Abduction

Exercise 10 of 14

 

1. Stand holding onto a solid object.
2. 2.     Lift your involved leg out to the side as shown.  Keep your toes facing straight ahead and do not hike up through the waist.  Remember not to cross the midline of your body.  When this exercise becomes easy to do, you will progress to lying on your side (exercise #13).
3. 3.     Hold 3 second, slowly relax.
4. 4.     Do 10 repetitions, 3 times per day.

 

 

Hip Flexion

Exercise 11 of 14

• Stand holding onto a solid object.
• Life your involved leg forward as shown, keeping the knee straight.  When this exercise becomes easy, you will progress to lying down (exercise #14).
• Hold 3 seconds, slowly relax.
• Do 10 repetitions, 3 times per day.

 

Hamstring Flexion

Exercise 12 of 14

• Stand holding onto a solid object as shown.
• Slowly bend your involved knee.
• Hold 3 seconds and slowly lower.
• Do 10 petitions, 3 times per day.

 

 

 

 

 

 

 

Hip Abduction

Exercise 13 of 14

 

• Lie on your side with the involved leg on top and a pillow between your knees to avoid crossing the midline of your body.
• Bend your lower leg slightly for support.
• Raise top leg straight upward, keeping foot and knee pointing straight ahead.  Try to move just through your hip and not your lower back.
• Hold 3 seconds, slowly relax.
• Do 10 repetitions, 3 times per day.

 

Straight Leg Raise

Exercise 14 of 14

• Lie on your back with the involved knee straight and the other knee bent as shown.
• Keep the leg completely straight, and then raise it about 12-18 inches.
• Hold 3 seconds and slowly lower.

Do 10 repetitions, 3 times

 

The information provided should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. A licensed physician should be consulted for diagnosis and treatment of any and all medical conditions. Call 911 for all medical emergencies. Any duplication or distribution of the information contained herein is strictly prohibited.

Last Updated: 04/13/2010

Copyright © 04/13/2010 University of Wisconsin Hospitals and Clinics Authority. All rights reserved. Produced by the Department of Nursing. UWH #6573

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