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Institute of Orthopaedics and Joint Diseases at Apollo Health City, Hyderabad is one of the best Joint Replacement Units in South India with the largest number of Joint Replacements (Hip, Knee & Shoulder) performed in the state which include primary and revision. With state-of-the-art technology and Operation .

Theatres with Laminar Flow, the latest technology for joint resurfacing procedures using metal on metal articulation, advanced techniques like Computer Assisted Surgery (CAS), Arthroscopy (Diagnostic & Therapeutic) of knee & Shoulder & Arthroscopic Surgeries with advanced techniques in ligament repair.

Speciality Services

Our team of experts are amongst the finest in the world, be it in academic qualifications, clinical expertise, hands-on experience or in research publications. Committed to patient centric care , they contribute to our record of unmatched clinical outcomes.


 
Apollo Jubilee Hills Ortho Team
Dr.Jayaramchander PingleView Doctor's Profile
Dr.K.J.ReddyView Doctor's Profile
Dr.Somashekhar Reddy.NView Doctor's Profile
Dr.S . Krishna ReddyView Doctor's Profile
Dr.Balvardhan ReddyView Doctor's Profile
Dr.Sharat Kumar ParipatiView Doctor's Profile
Dr.Karthik PingleView Doctor's Profile
Dr.Pereddy. Somashekhara ReddyView Doctor's Profile
Dr.Mohan KrishnaView Doctor's Profile
Dr.Raghava DuttView Doctor's Profile
Dr.Chandrasekhar Reddy SVView Doctor's Profile
Dr Prabhat LakkireddiView Doctor's Profile
Dr.Hari Krishna AnkemView Doctor's Profile
Dr.R.Srinivas ReddyView Doctor's Profile

 
Apollo Sec Bad Ortho Team
Dr. Chandrashekhar ReddyView Doctor's Profile
Dr.Naveen Reddy.PView Doctor's Profile
Dr. Mithin AachiView Doctor's Profile
Dr.Vemuri Venkat RamanaView Doctor's Profile

 
Apollo Hyderguda Ortho Team
Dr.M.Hari SharmaView Doctor's Profile
Dr.Ajay Kumar PView Doctor's Profile

 
Apollo DRDO Ortho Team
Dr. S.Krishna ReddyView Doctor's Profile
Dr.Naveen Reddy.PView Doctor's Profile
Dr. C RaviView Doctor's Profile

Orthopedic Problems and Surgeries

The dept of orthopedics at Apollo Hospitals, Hyderabad deals with the following conditions

Shoulders, Arms, Hand, & Wrists

  • Carpal Tunnel Syndrome
  • Volar plate avulsion injury
  • Triangular Fibrocartilage complex
  • Dupuytrens Disease
  • Arthritis of various parts
  • Tennis Elbow or lateral epicondylitis
  • Calcium deposits on shoulders
  • Acromioclavicular Joint Trauma
  • Bicep Tendon Injuries
  • Rotator cuff injuries and tears

Spinal

  • Osteoporosis
  • Disc problems
  • Scoliosis

Knee, Hip, Foot & Ankle

  • Total & partial knee and joint replacement surgeries
  • Replacement of Hip joints
  • Cartilage repairs
  • Club foot
  • Anterior Cruciate ligament (ACL) injuries
  • Total Hip replacement surgeries
  • Plantar Fasciitis

Others

  • Trauma Management
  • Care for Fractures

Sports Medicine

  • Injury care
  • Physiotherapy
  • Rehab programs

Sports Medicine

  • Arthroscopic Surgery
  • Knee and Joint Replacement Surgeries (Click for education material)
  • Articular Surfacing (Hip Resurfacing) (Click for education material )
  • Hip Replacement
  • Limb lengthening and re-plantation surgeries
  • Correction surgeries for Poliomyelitis

Patients with paralysis, stroke, trauma, cancer, heart disease, surgery etc. Can be left with some form of disability, which can be in the form of physical, psychological, or social disability. A structured multi-disciplinary approach can help such patients get back to normal. This center offers support to such patients by maximizing the ability of the person to function optimally within the limitations placed upon them by a disease process.

Rehabilitation of sensory and cognitive function typically involves methods for retraining neural pathways or training new neural pathways to regain or improve neurocognitive functioning that has been diminished by disease or traumatic injury.

Rehabilitation & Physiotherapy

Advantages of Hip Resurfacing

Cobalt-chrome cast parts. Parts are precision machined to fit each other with small space for body fluid to lubricate. The backside of the cup has a roughened surface to allow bone to grow into implant. Nearly all major implant makers either have in production or are developing metal-on-metal hip resurfacing components.

Femoral head is preserved.

  • Femoral canal is preserved and no associated femoral bone loss with future revision. Also, the risk of microfracture of femur with uncemented stem implantation is eliminated.
  • Larger size of implant “ ball ” reduces the risk of dislocation significantly.
  • Stress is transferred in a natural way along the femoral canal and through the head and neck of the femur. With the standard THR, some patients experience thigh pain as the bone has to respond and reform to less natural stress loading.
  • Use of metal rather than plastic reduces osteolysis and associated early loosening risk.
  • Use of metal has low wear rate with expected long implant lifetime.

Activity

Some patients experience back discomfort after surgery. This is caused by the general soreness of the hip area and partly by the prolonged lack of movement required before, during, and after surgery. Periodic change of position helps to relieve discomfort and prevents skin breakdown.

The dislocation rate is very low.

There will be some precautions, mostly to prevent dislocation, which is more likely to occur the first six to eight weeks after surgery. These precautions include:

  • Using 2-3 pillows between your legs and not crossing your legs
  • Not bending forward 90 degrees
  • Using a high-rise toilet seat

Initial rehabilitation

The first day after surgery you will be assisted to a reclining chair, and physical therapy may begin. You will gradually begin to take steps, walk, and learn to climb stairs with the aid of a walker or crutches. This initial rehabilitation generally takes 4-6 days. During this time, discomfort may be experienced while walking and exercising. Pain medication will be ordered by the doctor as needed. Most patients are relieved of their painful pre-surgical hip condition.

Therapy and rehabilitation program

Following surgery, you will work with a physical therapist to become independent in walking, going up and down stairs, getting in and out of bed, and doing exercises to improve the range of motion and strength of your hip. You will be instructed by your physical therapist in a specific home exercise program to meet your needs.

Quadriceps Setting:

Tighten the muscles on the top of your thigh. At the same time push the back of your knee downward into the bed. The result should be straightening of your leg. Hold for 5 seconds, relax 5 seconds. Progress to 20 repetitions, 3 times a day .

Gluteal Setting:

Lie either on your back with your legs straight and in contact with the bed. Tighten your buttocks in a pinching manner and hold the isometric contraction for 5 seconds, relax 5 seconds. Progress to 20 repetitions, 3 times a day.

Isometric Hip Abduction:

Keeping your legs straight, together, and in contact with the bed, place a loop or belt around your thighs and attempt to spread your legs. Hold the contraction for 5 seconds, relax for 5 seconds. Progress to 20 repetitions, 3 times a day.

Do ’ s and Don ’ ts

Your new hip is designed to eliminate pain and increase function. There are certain movements that place undue tress on your new hip. For your safety, these should be avoided. This is especially true during the first few months after your surgery.

DO NOT move your operated hip toward your chest (flexion) any more than a right angle. This is 90 degrees.

DO NOT sit on chairs without arms.

DO grasp chair arms to help you rise safely to standing position. Place extra pillow(s) or cushion(s) in your chair so that you do not bend your hip more than 90 degrees.

DO Keep your involved leg in front while getting up.

DO USE high chair at home.

DO USE a chair with arms. Place your operated leg in front and your uninvolved leg well under.

DO NOT sit low on toilet or chair initially.

DO get up from toilet as directed by your therapist. Use the elevated toilet seat if we have given you one.

DO use a long-handled reacher to pull up sheets or blankets or do as directed by therapist.

DO NOT bend way over.

DO NOT turn your knee cap inward when sitting, standing, or lying down.

DO NOT try to put on your own shoes or stockings in the usual way. By doing this improperly you could bend or cross your operated leg too far.

DO NOT cross your operated leg across the midline of your body (in toward your other leg).

DO NOT lie without pillow between legs.

DO KEEP a pillow between your legs when you roll onto your “ good ” side. This is to keep your operated leg from crossing the midline

Activity

Continue to walk with crutches or a walker as directed by the doctor or physical therapist.

  • Your physician will determine how much weight you can place on your operated leg.
  • Walking is one of the better forms of physical therapy and for muscle strengthening.
  • However, walking does not replace the exercise program which you are taught in the hospital. The success of the operation depends to a great extent on how well you do the exercises and strengthen weakened muscles.
  • If excess muscle aching occurs, you should cut back on your exercises.

Place a smooth surface (card table, plywood sheet, etc.) under your legs. Begin with your legs together, and then spread them apart as far as you can. Hold them apart for 5 seconds. Return to the starting position. Progress to 20 repetitions 3 times a day.

Sitting

Avoid sitting more than 60 minutes at a time. DO NOT cross your legs. In fact, keep your knees 12 to 18 inches apart. Always sit in a chair with arms. The arms provide leverage to push yourself up to the standing position. A high kitchen or bar-type stool works well for kitchen activities. Avoid low chairs and overstuffed furniture because they require too much bending (flexion) in your hip in order to get up. Do not bend forward while sitting in a chair, causing more than a 90 degree bend in your hip. Use the toilet seat riser for the next eight weeks to avoid excessive bending of the hips.

Bending

For the first eight weeks, you should not bend over to pick up things from the floor. You may want to acquire a pair of slip-on shoes and a long-handled shoe horn to avoid excessive bending.

Other Considerations

It is recommended that you do not drive until six weeks following surgery. When getting into a car, back up to the seat of the car, sit and slide across the seat toward the middle of the car with your knees about 12 inches apart. A plastic bag on the seat will help you safely slide in/ out of the car. For the next 4-6 weeks avoid sexual intercourse. Sexual activity can usually be resumed after your two-month follow-up appointment. You can usually return to work within three to six months, or as instructed by your doctor.

Continue to wear elastic stockings until your return appointment. Don’t shower until after staples are removed. Showers may be taken two days after your staples are removed. Do not sit in a bathtub until your physician okays that activity.

Your incision

Keep the incision clean and dry. Also, upon returning home, be alert for certain warning signs. If any swelling, increased pain, drainage from the incision site, redness around the incision, or fever is noticed, report this immediately to the doctor. Generally, the staples are removed in three weeks.

Remember:

Your physician, physical therapist, and nurses are striving to make a painless, functional hip possible for you. The real success of your hip replacement, however, depends partly on you-especially how conscientiously you exercise and how diligently you apply the principles of home care and self-limitation.

Total knee Replacement

Contents

  • Introduction
  • Total knee replacement
  • Preparation for surgery
  • Pre- op Visit
  • After surgery
  • Physical therapy and Exercise program
  • Guidelines for care.

Introduction

The knee joint is among the strongest, largest and most complex joints of the body. When you walk, sit, squat, climb stairs up and down, play, jump and drive or do many other simple movements, you are depending on the knee for support and mobility.

When your knee is healthy, you may take it for granted, not giving a thought about the job it does for you. However, once it starts to become painful, stiff and you are forced to restrict certain activities, you may come to realise how much freedom of movement means for you.

Fortunately, today’s remarkable advances in medical technology and research makes it possible to replace the knee joint with long-lasting durable and fine-tuned artificial one that eliminates pain, corrects the deformity, strengthens your legs and improves your quality of life. This page provides information for you and your family regarding Total Knee Replacement surgery. The surgical procedure, pre-operative and post-operative Care, the risks and benefits of surgery, as well as rehabilitation, are explained.

Please read and discuss with your family before your total knee replacement surgery. The orthopedic surgeon’s goals are to restore your knee to a painless, functional status and to make your hospital stay as beneficial, informative and comfortable as possible. Please feel free to ask questions or share concerns with your consultant surgeon and physiotherapist.

Total Knee Replacement

Total knee replacement is a surgical procedure in which damaged components of the knee joint are replaced with artificial parts. The procedure is performed through a skin incision on the front of the knee; the muscular, ligamentous and bony components of the joint are exposed.

The worn out bony surfaces are shaved off with special instruments (resurfacing) and replaced with implants. Most common implant consists of three component the femoral, tibial and the patellar component.

Popular femoral component designs use highly specialized heavy metal alloys (Stainless steel, vanadium, titanium etc.) and are contoured more or less like the original bone.

The tibial component is a metal platform which holds a plastic tray (High density polyethylene) and this surface moves against the femur during joint motion. The patellar component is an all plastic button like implant which moves in the femoral notch simulating normal joint motion.

Who is a candidate for surgery ?

  • People suffering from severe arthritis of knee joints.
  • Daily knee pains from a very long time with swelling.
  • Debilitating pain restricting activities of daily living.
  • Severe deformity of the legs following knee pains (bent or bowlegs).
  • People suffering with rheumatoid arthritis.( young and old )
  • Arthritis or deformity following bony or ligamentous injuries around the knee joint

What can I expect from an artificial knee? Benefits of a Total Knee Replacement:-

An artificial knee is not a natural knee, so it is unfair to expect it to function as a normal free joint. But a near normal function of the new joint is an achievable target.

With the availability of technically advanced implants and well established surgical expertise in premier institutions such as Apollo group of hospitals the success rate of this surgery has been reported world wide approximately 97% at a 12 year follow up.

The average life of the implant for all age groups and indications has been found to be 15 years.

Relief from joint pain and stiffness.

Improve joint movement.

Ability for independent movement.

Improvement in the alignment of the deformed joints.

Independence to carry out functional activities of daily living like; walking, climbing stairs up and down, swimming, driving and social activities.

What are the risks of Total Knee Replacement ?

Total Knee Replacement is a major operation. In spite of all precautions some complications are encountered in clinical practice. The most common complications are

  • Blood clots in legs.
  • Blood clots in lungs.
  • Post operative blood loss may require transfusion.
  • Complications affecting the knee are less common, they are:-
  • Loosening of the prosthesis.
  • Knee Stiffness.
  • Infection in the knee

Preparation For Surgery

Maintaining good physical health before your operation is important. Activities that will increase your upper body strength will improve your ability to use walker or crutches after surgery. A blood transfusion may be needed after the operation. The Physician may order blood tests and urine analysis to rule out the presence of any infections. A review of your medical condition is necessary. Chest x-rays and an ECG may also be taken.

Pre-op visit

This visit would include an interview by your consultant or registrar about the past medical history and current medications and a chest x-ray will be taken. You may be instructed to stop taking Asprin,Ecosprin and warfarin group of medication four to seven days before surgery. Inform your doctor to drug and substance allergies.

  • You have to sign a written consent for surgery and rehabilitation.
  • Diet: you can take the regular diet before surgery. DO NOT EAT OR DRINK
  • AFTER MIDNIGHT before the day of surgery.
  • Bathing: A shower, bath or sponge bath should be taken the evening be-fore and morning of surgery. If you are allergic to iodine or soap, please inform the nurse.

Care after surgery

After surgery, the patients are monitored in the intensive care unit until post op stabilization and are transferred to the ward. It is important that any numb-ness, tingling or sudden severe pain in your feet and legs should be reported to the nurse immediately during this period. These are some of the things you would find after your surgery:

Dressing is applied to the surgical area. (Changed 2-3 days after the surgery)

  • A suction drain that has tubes leading directly into the surgical area.
  • An IV line that will continue till you are capable of taking adequate amounts of fluid by mouth.
  • Post-operative nausea or vomiting that can be reduced by anti-nausea medication.

Elastic stockings:

You may be fitted with suitable elastic surgical stockings that help prevent blood clots and improve circulation. You may wear these stockings every day for six to eight weeks following surgery.

Physical Therapy and Exercise program

When muscles are not used, they become weak and do not perform well in supporting and moving the body. Your leg muscles are probably weak because you have not used them much due to your knee problems. The surgery can correct the knee problem, but the muscles will remain weak and will be strengthened through regular exercise. You will be assisted and advised how to do this under therapist supervision.

Instituted in the immediate post operative period

  • Elevation and positioning of the leg.
  • Thigh muscles tightening- loosening for both legs
  • Movements of the Ankle and Toes to prevent blood clots.
  • Straight lifting of the legs.
  • Coughing and deep breathing exercises to help prevent complications.
  • Mobility in bed – Turning to normal side and lifting the buttocks helps to prevent bedsores.
  • Once the dressing is reduced your doctor may advice you to under go venous doppler study. (checking of blood clots in legs)
  • After that your doctor will decide when to make you walk and start knee bending exercises. Ambulatory activity like walking with the help of a walking aid, bearing as much weight as indicated by your doctor or physiotherapist, and often a support is applied to operated leg to pro-vide stability if your muscles are weak.

In case of both knees replacement, ambulation is done with supports for few days.

Getting discharged

Your consultant doctor will decide when to discharge once he ensures wound healing is good and your walking with the walker is satisfactory. He will review prescription for medication, home exercise and follow up date for staple removal. Your physical therapy will continue till you become more independent in your exercises, transfer from bed to chair, staircase climbing and other activities your therapist has designed for you.

Guidelines for care

Your knee replacement should give you years of service. You can protect it by taking a few simple tips for safety and greater efficiency

Do’s

  • Exercise to maintain knee movement.
  • Cold application.
  • Weight reduction program if obese.
  • Bathroom modifications.
  • Prevent infection, urinary ,dental etc, because your new knee is sensitive to infection.
  • Swimming, driving, normal family life and social activities.
  • In case of injury to your new knee apply ice and consult your doctor immediately.

Don’ ts

  • Hot fomentation.
  • Forceful bending of artificial knee.
  • Bending beyond 120 degrees.
  • Massage over the artificial knee.
  • Squatting and low sitting.
  • Sudden jerky and rotating movements.
  • Crossed leg sitting.
  • Cycling.
  • Activities that over load the artificial knee must be avoided.

Follow-up care:

When you leave the hospital, you will be given a schedule of follow-up visits. These visits will ensure the long-term success of your operatio.

Total Hip Replacement

Introduction

This page is designed to provide information about total hip replacements and what to expect before and after this surgical procedure. Instructions are provided to help you prepare for surgery, recovery and rehabilitation. It is recommended that you read this booklet before your surgery and write down any questions you may have. If you have questions, please feel free to ask your consultant doctor. The doctor’s goals are to restore your hip to a painless, near functional status and to make your hospital stay as beneficial, informative, and comfortable as possible

Contents

  • Total Hip Replacement
  • Preparing for Surgery
  • Pre-op Visit
  • Day of Surgery
  • After Surgery
  • Home Exercises

Total Hip Replacement

Total hip replacement is a surgical procedure for replacing the hip joint. This joint is composed of two parts–the hip socket (acetabulum, a cup-shaped bone in the pelvis) and the ” ball „ or head of the thigh bone (femur). During the surgical procedure, these two parts of the hip joint are removed and replaced with smooth artificial surfaces. The artificial socket is made of high-density plastic, while the artificial ball with its stem is made of a strong stainless metal. These artificial pieces are implanted into healthy portions of the pelvis and thigh bones and affixed with a bone cement (methyl methacrylate).

Cement less total hip replacement

An alternative hip prosthesis has been developed that does not require cement. This hip has the potential to allow bone to grow into it, this is an important consideration for the younger patient. In some cases, only one of the two components (socket or stem) may be fixed with cement and the other is cement less. This would be called a ”Hybrid„ hip prosthesis.

When do we consider total hip replacements?

Total hip replacements are usually performed for severe arthritic conditions. The operation is sometimes performed for other problems such as hip fractures or aseptic necrosis (a condition in which the bone of the hip ball dies). Most patients who have artificial hips are over 55 years of age, but the operation is occasionally performed on younger persons. Circumstances vary, but generally patients are considered for total hip replacements if:

Pain is severe enough to restrict not only work and recreation, but also the ordinary activities of daily living

  • Pain is not relieved by arthritis (anti-inflammatory) medicine, the use of a cane, and restricting activities
  • Significant stiffness of the hip
  • X-rays show advanced arthritis, or other problems

What can be expected of a total hip replacement ?

A total hip replacement will provide complete or nearly complete pain relief in 90 to 95 percent of patients. It will allow patients to carry out many normal activities of daily living. The artificial hip may allow you to return to active sports or heavy labor under your physician’ s instructions. Most patients with stiff hips before surgery will regain near-normal motion, and nearly all have improved motion.

What are the risks of total hip replacement ?

Total hip replacement is a major operation. The effect of most complications is simply that the patient stays in the hospital longer. The most common complications are not directly related to the hip and do not usually affect the result of the operation. These include:

  • Blood clots in the leg
  • Blood clots in the lung
  • Urinary infections or difficulty in urinating
  • Complications that affect the hip are very un common, but in these cases, the operation may not be as successful:
  • Difference in leg length
  • Stiffness
  • Dislocation of hip (ball pops out of socket)
  • Infection in hip

A few of the complications, such as infection or dislocation, may require re–operation.

How do artificial hips stand up over time?

As we noted earlier, 90 to 95 percent of hip replacements are successful up to 10 years. The major long-term problems are loosening or wear. Loosening occurs either because the cement crumbles (as old mortar in brick building) or because the bone melts away (reabsorbs) from the cement. By 10 years, 25 percent of all artificial hips will look loose on an X-ray. Somewhat less than half of these (about 5% to 10% of all artificial hips) will be painful and require revision.

Wear can occur in the plastic socket after some years. Small wear particles can cause inflammation resulting in thinning of the bone and risk of fracture. Loosening and wear are in part related to how heavy and how active you are. It is for this reason we do not operate on very obese patients or young, active patients. Loose, painful artificial hips can usually, but not always, be replaced. The results of a second operation are not as good as the first, and the risks of complications are higher.

Preparing for Surgery

Maintaining good physical health before your operation is important. Activities which will increase upper body strength will improve your ability to use a walker or crutches after the operation.

Pre-operative Visit

The day begins in the clinic, where an interview by the Doctor concerning past medical history and current medications will be taken. You may be instructed to stop taking your anti-inflammatory medications (ibuprofen, Naprosyn, Relafen, DayPro, aspirin) one week before surgery. You will be attending a teaching session which will include the following topics and other information about your surgery. There will also be time for discussion and questions. Bring a written list of past surgeries and of the medications and dosages that you normally take at home.

Diet

You should follow your regular diet on the day before your surgery. DO NOT EAT OR DRINK AFTER MIDNIGHT. The day of surgery you may brush your teeth and rinse your mouth without swallowing any water.

Bathing

A shower, bath or sponge bath should be taken the evening before and morning of surgery

Deep Breathing Exercises

You will be instructed in deep breathing exercises to minimize the risk of lung complications after surgery. These exercises are necessary to remove any excess secretions that may settle in your lungs while you are asleep during surgery. These exercises are to be done every one or two hours after surgery. An incentive spirometer may be demonstrated. This bedside device assists you in deep breathing exercises.

Blood Clot Prevention

You may be fitted with elastic support stockings. The morning of surgery, you will receive these stockings to aid in the circulation of your legs and feet to reduce the risk of blood clots.

Examination

he physician will also review your medical history and the medications that you take. He will listen to your heart and lungs, and do a general physical exam. He will check for any type of infection. Any blisters, cuts, or boils should be reported. If infection is found, surgery is generally delayed until the infection is cleared. During your pre-op visit, blood will be drawn and lab tests one to insure that you are in good general health. X-rays are taken if necessary (an ECG is obtained if you have not had one taken for six months or if otherwise indicated).

After all of these tests and exams are completed, an anesthesiologist will talk with you to determine the type of anesthesia that is best suited for you. After you see the anesthesiologist, your pre-op evaluation is usually over. Before you leave the hospital make sure your questions are answered. If at any time you become ill, such as with a cold or flu, you need to call your physician. Remember we want you to be in your best possible health!.

Care after Surgery

After surgery you will be taken to the Recovery Room for a period of close observation, usually one to three hours. Your blood pressure, pulse, respiration and temperature will be checked frequently. Although circumstances vary from patient to patient, you will likely have some or all of the following after surgery

You will find that a large dressing has been applied to the surgical area to maintain cleanliness and absorb any fluid. This dressing is usually changed 2 to 4 days after surgery by the surgeon.

A hemovac suction container with tubes leading directly into the surgical area following surgery. The hemovac is usually removed by your doctor two to three days after surgery.

Post-operatively you may have temporary nausea and vomiting due to anesthesia or medications. Anti-nausea medication may be given to minimize the nausea and vomiting.

Diet: You will be allowed to progress your diet as your condition permits; starting with ice chips and clear liquids to diet as tolerated.

Coughing and Deep Breathing: To help prevent complications, such as congestion or pneumonia, deep breathing and coughing exercises are important. Inhale deeply through your nose; then slowly exhale through your mouth. Repeat this three times and then cough two times.

You will be encouraged to use your incentive spirometer.

Activity

Some patients experience back discomfort after surgery. This is caused by the general soreness of the hip area and partly by the prolonged lack of movement required before, during, and after surgery. Periodic change of position helps to relieve discomfort and prevents skin breakdown. The head of your hospital bed should not be elevated more than 70 degrees during the first few days after surgery. Sitting up may allow the artificial ball to dislocate from the hip socket. There will be some precautions, mostly to prevent dislocation, which is more likely to occur the first six to eight weeks after surgery. These precautions include:

  • Using 2-3 pillows between your legs and not crossing your legs
  • Not bending forward 90 degrees
  • Using a high-rise toilet seat

Initial rehabilitation

The first day after surgery you will be assisted to a reclining chair, and physical therapy may begin. You will gradually begin to take steps, walk, and learn to climb stairs with the aid of a walker or crutches. This initial rehabilitation generally takes 4-6 days. During this time, discomfort may be experienced while walking and exercising. Pain medication will be ordered by the doctor as needed. Most patients are relieved of their painful pre-surgical hip condition.

Therapy and rehabilitation program

Following surgery, you will work with a physical therapist to become independent in walking, going up and down stairs, getting in and out of bed, and doing exercises to improve the range of motion and strength of your hip. You will be instructed by your physical therapist in a specific home exercise program to meet your needs.

Do the home exercises two to three times a day (see home exercises section). Do your exercises indefinitely. Walking is not a substitute for exercise. If an exercise is causing pain that is lasting, reduce your intensity. If it continues to cause pain, contact your physical therapist or physician.

Home Exercises

Here is a list of potential exercises you may be asked to complete. Please refer to the exercises given in Articular resurfacing these exercises are sometimes done before surgery to help maintain the strength and range of motion of your hip.