Complete Recovery Guide to Same Day Discharge Total Hip Joint Replacement Surgery
You are about to embark on an important journey to improve your overall health and quality of life. You have chosen an outstanding institution to help you on this journey.
Our goals are the same as yours: to relieve your joint pain and return you back to a more active lifestyle rapidly, comfortably and safely.
The most important person on our team is you, the patient. Your active participation and willingness to recover is needed to make this possible and to ensure the best possible outcome.
We require that you establish one point person who will serve as your “coach” through this process.
You will find that you will need very little support within a short period of time following surgery as you achieve increasing independence and mobility.
We are all looking forward to helping with your recovery and planning for the best possible outcome.
Above all, remember you are never alone!
FAQ’s Before Surgery
Changes In Medical Status
If you develop any medical problems (i.e. sore throat, colds, fevers, infections, skin eruptions) or changes in your medical status, YOU MUST INFORM THE MEDICAL TEAM IMMEDIATELY
What if I need more help?
We can also provide you with information about private pay services for a home health aide, if you would like.
What arrangements should I make to go home? You will be discharged around approximately 6-8pm.
You are responsible for pre-arranging your transportation to and from the hospital.
Do I bring my medications?
No need to bring. The hospital has a list of all your medication when you provide this information in Pre-Testing.
What equipment do I purchase/need?
Your equipment needs will be determined in consult with the Physical and Occupational Therapists who see you in your peri-operative optimization information session and evaluate you after surgery. You are most likely to receive all of your equipment needed from the hospital vendor after your surgery before you return home.
Hip replacement patients usually leave the hospital with a walking aid of some sort (cane, forearm/Lofstrand crutch or walker).
Do I need to donate my own blood?
For your surgery you do not need to donate blood.
What meds do I take the morning of surgery?
If this applies to you: Please take your cardiac and blood pressure medication the morning of surgery with a sip of water!
Your surgery may be cancelled if you do not!
What meds do I stop 5-7 days prior to surgery?
In order to minimize the risk of bleeding or clotting complications at or immediately after surgery, the following medications should be discontinued or avoided for 7 days prior to your admission date.
If any medication was prescribed because of a life threatening past event such as a stroke or cancer, please advise your physician to make a possible exception to the rule in your specific case
If you take any anti-coagulant medication (blood thinner) such as Coumadin, Xarelto, Apixaban, etc. it is important to tell your doctor. This is to avoid any difficulty with blood clotting during the surgery.
Avoid these common medications affecting normal blood clotting:
- Davron Compound
- Pepto Bismol
- Vitamin E
- Avoid Estrogens:
- Female Hormones
- Hormonal Birth Control (pills, ring, patch, injection)
What meds can I take?
You can take:
- Tylenol or medications containing Tylenol like Datril and Enderin
- NSAIDs (Aleve, Motrin, Advil, Ibuprofen, Naproxen)
- All medications for high blood pressure, heart conditions, diabetes, and gout.
- If you take Coumadin it is important to tell your doctor
Your Preadmission Testing/Pre-Operative Information Session Visit:
Prior to your surgical date you will be required to have a Preadmission Testing (PAT) visit. All of your medical clearances must be completed prior to this appointment and be submitted to Dorothy, Dr. Vigdorchik’s Surgical Coordinator.
During your Preadmission Testing assessment, you will be seen by an Anesthesiologist, Physician Assistant and a Registered Nurse.
The Anesthesiologist will perform an examination with you and discuss the anesthetic in which you will receive as well as pain management options.
The Physician Assistants and Registered Nurses will complete a health history and initial patient assessment during your visit.
Please make sure to have breakfast on the morning of your Pre-Admission Testing visit.
Upon completion of your Pre-Admission Testing you will be provided with an after visit summary which will include information regarding which medications you should stop and when, along with patient education advising you on fall precautions and infection prevention. In maintaining the hospitals low incidence of infection, you will also receive antiseptic wipes to be used prior to your surgery
Same Day Discharge Pre-Operative Information Session
On the day of your Pre-Admission Testing appointment, you will also attend a pre-operative information session in which information will be provided by physical therapy, occupational therapy, and care management.
During the physical therapy information session, you will learn how to properly use an assistive device such as forearm crutches or walker, how to climb stairs after surgery and some home exercises that will be helpful in your recovery.
Your PAT and Pre-Operative session is interactive and we encourage you to ask questions. Because you are a Same Day Discharge patient, you will be scheduled for a specific date and time for these appointments
Following your pre-operative information session, your surgeon’s office will send over several prescriptions to your local pharmacy on file.
The medications will include:
- An Antibiotic (either Keflex/cephalexin 500mg or Cleocin/clyndamycin- take every 6 hours for first 24 hours after arriving home)
- Celebrex/celecoxib 200mg (used to prevent heterotopic ossification-once a day x 28 days)
- Zofran/ondansetron (for post-operative nausea- take as needed postoperatively)
- A narcotic pain medication (like Percocet/Norco and/or Oxycodone- take as needed for pain post operatively)
Also make sure you have the following over-the-counter medications on hand before your surgery – your doctor’s office may have requested them from your pharmacy as well:
- Ecotrin/aspirin 81mg twice a day for 28 days (to reduce risk of blood clots)
- Colace/docusate 50 mg three times daily (stool softener to reduce side effects of constipation postoperatively)
- Pepcid/famotidine 20mg once daily for 28 days (for stomach irritation with Aspirin)
FAQ’s After Your Surgery
A visiting nurse and physical therapist will visit your home the first day after discharge. The nurse is the first person to visit you as she will be responsible for “opening” the case. The physical therapist will likely visit you a number of times over the next 2 weeks.
Will I have sutures or staples/ when will they be removed?
- If you have a hip replacement, you likely have metallic staples or sutures.
- Invisible (woven) Sutures are dissolvable and do not need to be removed
- Staples are to be removed within 10-14 days by the visiting nurse.
- Nylon (black visible) Sutures are to be removed within 10-14 days by the visiting nurse
How much can I do after surgery?
Postoperatively, patients are encouraged to apply immediate full weight bearing. Many patients will have little need if any of assistive devices such as canes and walkers within 1 week for indoor ambulation and most can ambulate unassisted outdoors within 2-3 weeks.
A limp may persist for up to 3 months until muscle strength in the previously atrophied muscles is regained via regular therapy. Activities such as swimming and stationary bike are encouraged within a week of surgery, after the wound has been dry for at least three days.
High impact activities such as running, skiing or tennis however are restricted for a period of 2-3 months postoperatively in order to allow bone ingrowth into the prosthesis.
How much activity can I do?
You can bear as much weight as you tolerate on your operated leg unless specifically instructed otherwise by Dr. Vigdorchik. You may use the walking aid which you were discharged with and switch to a cane whenever you feel comfortable doing so. If you feel you can safely ambulate without any assist device you may do so. Keep in mind that every patient moves at their own speed of recovery so take your time. Your visiting therapist will assist you in the process.
A physical therapist will visit you at home. Please provide the therapist with the attached physical therapy instructions included in this packet.
If you have had a Hip Replacement or Resurfacing: Unless Dr. Vigdorchik or our office specifically provides instruction, you DO NOT have any movement precautions with regards to your operated leg, within reason. Although guarantees against a subluxation or rare dislocation do not exist, the joint was inspected at the time of surgery and found to be sufficiently stable as to avoid the need for substantial precautions. Your therapist will coach you as to any specific precautions.
High impact activity such as jumping, aerobics, tennis, and skiing are not permitted during the first 3 months after surgery.
When changing positions, please move slowly and deliberately. From a reclining position sit at the edge of the bed for a few minutes and get acclimated. If you feel dizzy or lightheaded take a deep breath and wait for the feeling to subside before standing. Stand in position a few minutes before starting to walk. Please use your assistive device when you first start walking and have your coach/partner with you. As you move about, these sensations will go away. Continue to move slowly when changing positions as long as you experience the feeling of dizziness and lightheadedness.
What if have a temperature or get a fever?
Check your temperature on a daily basis. Please note that a low-grade temp (below 101.5) is not uncommon in the first 3 days after surgery. Notify the office if your temperature rises above 101.5.
Is it normal to have leg swelling and bruising after surgery?
Many patients’ experience significant swelling and bruising (black and blue marks) in and around the operative site. This may extend to the thigh, below the knee and sometimes to the ankle. This generally progresses over the first week following your surgery. It typically begins to diminish over the second week and is largely resolved by 4-6 weeks from surgery. Provided you have been compliant with the prescribed anticoagulation regimen throughout the post-operative period (see below), the risk of a blood clot is low and this swelling is an expected part of recovery.
Warning: Should the lower leg be persistently very swollen, painful and hard to touch and if it does not soften with rest and elevation, you may be at risk of having suffered a deep vein thrombosis or blood clot. Because these can progress and trigger a pulmonary embolus, it is critically important to notify a physician so as to receive the appropriate diagnostic tests.
How do I care for my wound?
You may remove your Acquacel dressing 7 days following your surgery. You will have staples or surgical glue over your incision. If you have staples or nylon sutures, they will be removed by the visiting nurse 10-14 days after surgery.
If the wound is draining, simply tape a dry gauze pad on the wound until it stops (your visiting nurse can help with this). Please note that mild dark brown or yellow tinged drainage is considered normal for approximately 10 days following your surgery please let us know if you have a concern. If drainage persists past 10 days, please notify our office.
After removing the dressing on day 7 another dressing will be placed by the nurse. If it is clean, please keep it in place until your 2-week follow up visit. A light gauze can protect against abrasion from tight clothing.
Do not apply any creams or ointments to your surgical site.
You should examine your wound regularly for any signs of infection which include:
- Redness, swelling, tenderness, or warmth surrounding the incision
- Drainage of blood or pus from the wound, or any drainage that has a foul odor.
You may notice some redness, bruising and/or mild swelling surrounding the surgical site. This is a normal inflammatory process.
Can I take a shower or bath after my surgery?
You may shower after 48 hours from discharge, if the dressing is in place and has no leaking areas. After the dressing is removed (usually 7 days following surgery) please keep the wound dry even if a new gauze dressing has been placed. At your 2-week post-operative visit, Dr. Vigdorchik will give further instructions about getting the incision wet.
You should not scrub the incision. Be sure to pat the incision dry with a clean towel after showering.
If wound drainage is noted, you should contact Dr. Vigdorchik’s office.
Any submersion in water, including a bath, jacuzzi, or swimming is NOT permitted during the first 4 weeks.