Post operative instructions

Adam Freedhand, MD
707 968-0670
Post Operative Instructions
Total Hip Replacement- Direct anterior surgical approach

Incision Care
Dressings must be kept clean and dry. If there is no drainage it may be removed in 48 hours. For some patients the incision is sensitive and it is more comfortable covered. You may shower; it is alright if the wound gets slightly wet, but don’t soak it. Pat it dry when you are done. If the bandage becomes dirty or wet replace it with a clean bandage. You may not take a bath or go swimming until the incision is completely healed. Swelling and bruising
After surgery swelling and bruising of the operative leg is normal and will gradually decrease as the days pass. If activity and exercise worsens your swelling take time to lie down and elevate your leg above the level of your chest. Using an ACE wrap and ice machine will help relieve your symptoms. Ice machine
You will be discharged from the hospital with the unit and instructions for its use. Using the device 3 times a day for an hour at a time in conjunction with elevation will decrease pain and swelling and speed your recovery. You may use the machine more if you like. Relieving pain
It is normal to have some pain after surgery. Pain medications have been prescribed and enough pain pills have been given to cover you beyond your next office visit. It should be noted that pain medications take about one-half hour to start working, so take them prior to the pain becoming severe. DO NOT drink alcohol while taking prescribed pain medication. It is dangerous and illegal to drive while taking pain medicine. If you need a refill on pain medication before your first scheduled appointment, please call our office during regular office hours. DVT prophylaxis
You will be prescribed medication to lower your risk of forming blood clots. This medication is important to take until the prescription is finished. In addition, being active and performing your exercises properly can minimize your risk. Celebrex
You may be given a prescription for Celebrex after your total hip replacement. You must complete the prescription given. The purpose of this medication is to prevent abnormal bone formation and to help with pain management after joint replacement. If you are allergic another medication will be used. You may drive when you have good control over the operative leg and are no longer on pain medicine. Typically, with adequate protein intake for promotion of healing, there are no special diet restrictions. Make sure you eat a well-balanced meal, drink plenty of fluids and incorporate fiber into your diet as oral pain medications have a tendency to cause constipation. It is also a good idea to take a stool softener such as Colace or Citrucal daily until your system becomes regular after surgery. Activity
For the first few weeks after surgery, walk as much as possible without overdoing it. You are weight bearing as tolerated which means you are allowed to put as much weight on the operative leg as is comfortable. Let pain be a guide, keeping in mind that you just had surgery. You will be given home exercises to be done on a daily basis. After the initial post-operative phase, we will gradually progress your activities. However, initially, it is extremely important that you exercise your new joint by walking. Remember that exercise and activity is important to prevent the formation of blood clots. Assist devices
You will be discharged from the hospital with a walker, crutches or a cane depending on how well you walk with physical therapy as an inpatient. You will typically use these aids anywhere from a few days to a few weeks and stop using them when you are stable and strong on your feet. Some people who have used these devices for years may require prolonged use for reasons unrelated to the surgery. Hip precautions
There are none. The direct anterior approach leaves a hip inherently more stable than other surgical approaches. Though hip dislocation is still possible, it is rare. Therefore, you, and your physical therapist, don’t have to focus or worry about avoiding certain leg positions Dental work after joint replacement
Artificial joints can become infected after simple procedures such as dental cleaning. Preventative treatment is extremely important and should be followed prior to receiving any dental treatment. Please call us, or your dentist ahead of time so that an antibiotic can be prescribed before you have your dental work done. You should not have dental work performed for 3 months following your joint replacement due to the increased risk of infection. If a dental crisis occurs within this time period, please call our office for instructions. Post-operative office appointment
For patients that live in the area you will be seen 3 weeks, 8 weeks, 16 weeks and then 1 year after surgery. For those that live out of town the typical schedule is 6 weeks, 4 months and 1 year after surgery. Your first post operative visit should be set prior to your surgery. Post-operative Xrays
Xrays are obtained immediately after your surgery in the hospital. You will typically get additional Xrays at your subsequent visits to evaluate the hip replacement components for wear, loosening and other possible abnormalities. Call the office if you notice any of the following:
Persistent swelling, redness, or uncontrolled pain in the surgical area Persistent bleeding or drainage from the wound Call 911 if you have a sudden crisis such as symptoms of a heart attack,
stroke, dizziness or confusion, or chest discomfort or pain.


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