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Minimally Invasive Total Hip Replacement
WHAT YOU SHOULD KNOW:
- Minimally invasive total hip replacement is surgery to replace a hip joint damaged by wear, injury, or disease. It is a type of hip replacement surgery done to treat hip pain and problems with walking. The hip joint is a "ball and socket" joint, and is your largest weight-bearing joint. The ball-shaped top of the femur (thigh bone) sits in the acetabulum socket (hollow area) of the pelvic bone. The joint is held together by ligaments and muscles. The socket is lined with cartilage (firm, flexible tissue) that can become damaged or worn away, causing pain. Arthritis, infection, injury, or loss of blood supply to the ball of the femur can damage the joint. You may need to have one or both of your hip joints replaced.
- Your caregiver may do a modified version of a regular total hip replacement procedure. Instead of a large 8 to 10 inch (20 to 25 centimeters) incision (cut), you may have a 3 to 6 inch (8 to 15 centimeter) incision. It may be made on the front, side, or back of your hip. Your caregiver may choose to do another version of this surgery with two smaller incisions. One incision is made on the front and one on the back of your hip. Using incisions smaller than what is used in regular hip replacement surgery may decrease blood loss and tissue trauma. During surgery, the damaged parts of your hip joint are removed and replaced with artificial implants (man-made parts). The implants may be made of metal or ceramic materials. Having this surgery may ease your pain, make your hip joint more stable, and improve movement of your legs.
Take your medicine as directed:
Call your primary healthcare provider if you think your medicine is not helping or if you have side effects. Tell him if you are allergic to any medicine. Keep a list of the medicines, vitamins, and herbs you take. Include the amounts, and when and why you take them. Bring the list or the pill bottles to follow-up visits. Carry your medicine list with you in case of an emergency.
- Antibiotics: This medicine is given to fight or prevent an infection caused by bacteria. Always take your antibiotics exactly as ordered by your primary healthcare provider. Do not stop taking your medicine unless directed by your primary healthcare provider. Never save antibiotics or take leftover antibiotics that were given to you for another illness.
- Anticlotting medicines: These medicines are given to help prevent blood clots from forming in your blood vessels. You may be given any of the following:
- Aspirin to stop blood clots: Aspirin helps thin the blood to keep blood clots from forming. If you are told to take aspirin, do not take acetaminophen or ibuprofen instead. Do not take more or less aspirin than directed. This medicine makes it more likely for you to bleed or bruise.
- Warfarin: Warfarin is a type of medicine that helps prevent clots from forming in the blood. Clots can cause strokes, heart attacks, and death. Using warfarin may cause you to bleed or bruise more easily. If you are taking warfarin:
- Watch for bleeding from your gums or nose. Watch for blood in your urine and bowel movements. Use a soft washcloth on your skin, and a soft toothbrush to brush your teeth. Doing this can keep your skin and gums from bleeding. If you shave, use an electric shaver. Do not play contact sports.
- Many medicines cannot be used when taking warfarin. Talk to your caregiver about all of the other medicines that you use. Tell your dentist and other caregivers that you take warfarin. Wear a bracelet or necklace that says you are taking this medicine.
- You will need to have regular blood tests while taking warfarin. Your caregiver uses these tests to decide how much medicine is right for you to take. Take warfarin exactly how your caregiver tells you to. Tell your caregiver right away if you forget to take the medicine, or if you take too much.
- Talk to your caregiver about your diet. Warfarin works best when you eat about the same amount of Vitamin K every day. Vitamin K is found in green leafy vegetables and certain other foods.
- Blood thinners: This medicine helps prevent clots from forming in the blood. Blood thinners may be given before, during, and after a surgery or procedure. Blood thinners make it more likely for you to bleed or bruise. Use an electric razor and soft toothbrush to help prevent bleeding.
- Pain medicines: These groups of medicines are given to decrease your pain after your surgery. You may need any of the following:
- Acetaminophen: This medicine is used to decrease pain and lower a high body temperature (fever). Taking too much acetaminophen can hurt your liver. Read labels so that you know the active ingredients in each medicine that you take. Talk to your caregiver before taking more than one medicine that contains acetaminophen. Ask your caregiver before taking over-the-counter medicine if you are also taking pain medicine prescribed (ordered) for you.
- NSAIDs: Nonsteroidal anti-inflammatory (NSAID) medicine may decrease swelling and pain or fever. This medicine can be bought with or without a doctor's order. This medicine can cause stomach bleeding or kidney problems in certain people. Always read the medicine label and follow the directions on it before using this medicine.
- Pain medicine: You may need medicine to take away or decrease pain.
- Learn how to take your medicine. Ask what medicine and how much you should take. Be sure you know how, when, and how often to take it.
- Do not wait until the pain is severe before you take your medicine. Tell caregivers if your pain does not decrease.
- Pain medicine can make you dizzy or sleepy. Prevent falls by calling someone when you get out of bed or if you need help.
Ask for information about where and when to go for follow-up visits:
For continuing care, treatments, or home services, ask for more information.
- Ask your caregiver when you need to return to have your wound checked and the stitches or staples removed. You may also need to have blood tests.
Activities, exercises, and assistive devices:
- Using a cane, walker, or crutches: You may be asked to start walking or moving soon after your surgery. You may need to use a cane, walker, or crutches. This may help you get around, and decrease your chance of falling or being hurt. It is important to use your crutches, cane, or walker correctly. Ask your caregiver for more information about how to choose and use crutches, a cane, or a walker.
- Exercises: You may be taught or have been taught before your surgery about exercises you should do. These exercises will help strengthen the muscles around your hip joint and speed up your recovery. You may want to apply ice to your hip before doing these exercises to reduce your discomfort.
- Physical therapy: You may need to see a physical therapist to teach you special exercises. These exercises help improve movement and decrease pain. Physical therapy can also help improve strength and decrease your risk for loss of function.
- Preventing implant dislocation: Your implants may get out of place when you start going back to your daily activities. Do the following to help prevent this from happening:
- Avoid leaning forward as you lie down on bed.
- Avoid sitting on a low chair. Use armrests when rising from a sitting position to decrease the force and pressure on your hips.
- Do not bend forward with your legs crossed. Lift objects with your knees bent rather than straight.
- Do not walk too fast and avoid walking on soft floors to prevent pressure on your hips.
- Sports: Start on low-impact sports when you can bear the pain. Low-impact sports may include stationary cycling, dancing, golf, swimming, and walking. You may be asked to start on low-impact activities such as golf, swimming, or low-impact aerobics. Basketball, running, or racquet sports may not be good for you and should be avoided at first. You may be allowed to return to normal sports activities after six months. Ask your caregiver for more information on what sports or exercises may be right for you.
Preventing deep vein thrombosis:
Deep vein thrombosis (DVT) is a condition where blood clots form inside your blood vessels. This can easily happen after having a major bone surgery. Ask your caregiver for more information about deep vein thrombosis. The following can help prevent clots from forming inside your veins:
- Early mobilization: You may be asked to start moving your legs, standing, and walking soon after your surgery. This prevents blood from pooling in your legs and causing clots to form inside your veins.
- Compression stockings: Your caregiver may advise you to wear compression stockings. These are tight elastic stockings that put pressure on your legs after your surgery. The pressure is highest in the toe and decreases as it goes towards the thighs. Wearing pressure stockings help push blood back up to the heart and keeps clots from forming. Ask your caregiver for more information on using compression stockings.
CONTACT A CAREGIVER IF:
- You get a fever.
- You have chills, a cough, or feel weak and achy.
- You have more pain and swelling in your hip joint, even after taking pain medicines.
- Your skin is itchy, swollen, or has a rash.
- You have questions or concerns about your recovery, medicine, or care.
SEEK CARE IMMEDIATELY IF:
- You have nausea (upset stomach), vomiting (throwing up), and stomach distention.
- You have seizures (convulsions), cannot think clearly, and have rashes on the head, neck and chest.
- Your bandages become soaked with blood.
- Your incision is swollen, red, has pus coming from it, or it has come apart.
- You have trouble urinating with little or no urine, or have pain while urinating.
- Your arm or leg feels warm, tender, and painful. It may look swollen and red.
- You have chest pain or trouble breathing that is getting worse over time.
- You suddenly feel lightheaded and have trouble breathing.
- You have new and sudden chest pain. You may have more pain when you take deep breaths or cough. You may cough up blood.
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The above information is an educational aid only. It is not intended as medical advice for individual conditions or treatments. Talk to your doctor, nurse or pharmacist before following any medical regimen to see if it is safe and effective for you.