What to Expect After a Hip Replacement Surgery ? 

Have you undergone a hip replacement surgery recently and are looking for a perfect rehabilitation plan? If yes, you’re at the right place. We, here at Yashoda Hospital & Research centre, Nehru Nagar, Ghaziabad will guide you throughout the recovery and rehabilitation process. We shall suggest to you the possible DO’S and DON’TS so that you may benefit from it at the comfort of your home.

Not to mention that hip replacement or any other joint replacement surgery is not an easy choice to make. And it is even harder to take care of yourself after the surgery if you are doing it on your own. You would want to recover as soon as possible and avoid any chances of getting any complications after the surgery.

Usually, your rehabilitation begins within 24 hours after the surgery. Patients who have undergone hip replacement surgery should use crutches or a cane in order to be able to walk after a day or two after the surgery. This is to make sure that you don’t put too much stress on your implant or the area of the surgery.

At first, you should walk short distances with the help of crutches or a cane. Keep increasing the walking distance with time.

Rehabilitation and recovery post-surgery

If you have undergone a THR (Total Hip Replacement) surgery at Yashoda Hospital & Research Centre, Nehru Nagar, Ghaziabad:

• Your recovery will begin right after the surgery and our medical team will manage your pain and monitor your vital signs.
• You will likely have a dressing on your hip which may be removed after a day or two from the surgery, based on your progress.
• The pain management team will assess your medication and provide you with necessary assistance to ensure your comfort and mobility during the rehabilitation process.
• Post-surgery, our physical therapists will start your rehabilitation plan and will assist you in tasks like sitting, getting out of bed, walking, climbing stairs, etc. using available props.
• After you are discharged from the hospital, you must continue with the physical therapy at your home for around 7-8 weeks. You should immediately consult the physical therapist or your surgeon if you experience any complications (which we will address later in this blog). Usually, patients are able to return to a normal active life after this period.

What to keep track of after the surgery?

After the surgery, you may experience some complications. To treat it, you should keep an eye on your progress and check for the following:

• Swelling around the implant.
• Redness around the wound outside the replaced part or any kind of fungal or other infection around the wound.
• Blood clotting.
• Difference in the length of your legs.
• Dislocation of the implant balls from the socket.
• Numbness in the area around the implant.
• Heavy/severe pain around the area where you have received the implant. If you experience any of the following, you are advised to consult your doctor without any delay to avoid any further worsening of the condition. Your surgeon knows everything about your surgery and medical history, so he will be able to prescribe the right treatment for you. We, at Yashoda Hospital & Research Center Nehru Nagar, Ghaziabad, always wish for your good health and well-being. And we are always available at your service, just a phone call away.

What is Revision surgery?

Total hip replacement surgery involves implanting a mechanical device on the hip joint. And sometimes such implants may fail mechanically or biologically. If this happens, you will need to undergo a reoperation of the hip to figure out the cause of the failure and treatment of the same. Such a reoperation is called revision surgery.

Why do you need a revision surgery?

Keeping your well-being in mind, it is advised to always follow the procedure and protocol prescribed by your surgeon and physiotherapist. Most of the elderly patients who have received a THR are able to retain the prosthesis for around 18-20 years and sometimes even for lifetime. However, some patients might need revisions in hip replacement if the patient wants to have an active physical lifestyle or because of any mechanical or biological failure of the implant.

The possible reasons for a revision may include the following:

• Repetitive dislocation of the implant
• Mechanical failure
• Infection

Repetitive dislocation

Dislocation of a hip implant may happen due to many reasons. A hip replacement will function properly if the ball remains inside the socket at all times. If the ball and socket are aligned properly and the forces of strong muscles and ligaments around the hip joint are strong, the ball will stay inside the socket. Hip replacements are designed such that they can support a large range of motions. However, in some cases, the ball may get out of the socket because of a certain hip position. Such a condition is termed as hip dislocation.

For patients who follow proper precautions, hip dislocations are rare. Yet, some elderly patients or patients who get THR because of a fracture, may be prone to hip dislocation. If you are exposed to frequent dislocations, your surgeon will recommend a revision surgery. A revision surgery helps in preventing new dislocations. Such a surgery might need reorientation or complete exchange of the replacement. Your surgeon may use a device to capture the ball inside the socket, if necessary. It is important that the tissues around the replacement heal properly, so your surgeon may recommend wearing a brace for some time. You should always stick to the advice of your surgeon to avoid such complications in future.

Mechanical failure

Mechanical failure of an implant involves wearing, loosening or breaking of the parts of the mechanism. The parts of the implant that move against each other usually wear out or break due to continual or repetitive movement. Tiny particles produced in such a process may invoke strong immune responses from your body as these particles are foreign to the immune system.

Such a reaction may result in destruction of the bone around the implant (osteolysis). This in turn, leads to the loosening of the parts of the implant.

Your surgeon will remove the worn/loosened/broken part during the revision surgery. You may need a bone graft from a deceased donor in order to rebuild the lost bone content. You may also be advised to not bear full weight on the operated leg if your bone stock is of poor quality or a large amount of bone graft has been used to treat your condition.

Infection

Infection of an operated body part is inevitable if precautions are not taken after the surgery. During the first 6 weeks of the surgery, there are more chances of getting infected. Sometimes, infections from other body parts may spread to the hip replacement through the bloodstream causing hip pain and fever.

Your surgeon will diagnose the infection and treat it with the available options. Such options may include a course of antibiotics targeting the bacteria as well as surgery. The choice of treatment is based on the type of infection causing microorganism (bacteria), your general health, duration of the infection, etc.

Infections may be treated using the following:

• Surgical cleaning of the prosthesis/implant is recommended in the early stage of the infection. Intravenous antibiotics and oral antibiotics may be prescribed by your surgeon to treat the condition.
• Exchange of a hip replacement may be another option. The surgeon may either completely replace the prosthesis which involves the removal of the old replacement bone cleaning and implanting a cement spacer. This is followed by intravenous doses of antibiotics and finally reimplantation of a definitive hip replacement.

How to prevent the need for a revision surgery?

After a THR, you will never want to have a revision surgery. However, it just happens. Don’t worry; we have some advice for you so that you can avoid this uncomfortable and painful experience.

If you follow these rules, you may have a healthy life:

• Always keep a close track of your progress, any complications during the rehabilitation and even after the recovery post-surgery.
• Follow your surgeon’s instructions to prevent dislocations. And never let yourself get infected by taking proper antibiotics.
• Get your hip replacement regularly checked for any complications.

Our specialists at Yashoda Hospital & Research Centre, Nehru Nagar, Ghaziabad

Dr. Vipin Tyagi, who has earned his M.B.B.S. and M.S. in Orthopedics from King George’s Medical College in 1983, is an experienced surgeon at Yashoda Hospital & Research Centre, Nehru Nagar, Ghaziabad. He served as Registrar in the Department of Orthopedics at the renowned Sir Ganga Ram Hospital, New Delhi from 1984 to 1985. After that he trained himself rigorously abroad under the supervision of acclaimed orthopedic surgeons such as Dr. Ranawat and Prof. Dr. Tria in the USA, Canada, Germany, Switzerland, South Korea and Libya. Dr. Tyagi joined Yashoda Hospital & Research Centre as a Senior Consultant and Head of the Orthopedic Trauma & Joint Replacement Department in 1992. He has performed over 20,000 surgeries successfully as of now.

Dr. Ajay Panwar, senior consultant and surgeon at Yashoda Hospital & Research Centre Nehru Nagar, Ghaziabad, specializes in orthopedic trauma, hip & knee arthroplasty, sports injuries and arthroscopy. He holds expertise in hip and knee replacement surgery. Dr. Panwar holds the reputation of being one of the most proficient orthopedic doctors in Ghaziabad. Along with being well-equipped with the expert level knowledge of M.S. and M.Ch. in Orthopedics, he owns fellowships in joint replacement and spine surgery and has an experience of over 30 years in this field.

Dr. Rahul Kakran is one of the best orthopedic doctors in Yashoda Hospital & Research Centre, Ghaziabad. He has been working for over 11 years in the field of orthopedics and holds experience in treating fractures, dislocated joints and spinal joints. As an experienced expert, Dr. Kakran, performs minimally invasive spine surgeries such as percutaneous pedicle screw fixation, TLIF, balloon kyphoplasty and micro-endoscopic discectomy with outstanding results. As of date, he has performed over 500 successful surgeries.