After Surgery Care for Total Hip Replacement (Direct Anterior Approach)

The aim of care after your surgery is to allow you to return to your daily activities. The team will advise you regarding the daily activities and the physiotherapy sessions.

You are cared by a multidisciplinary team comprising of the Surgeon / Doctors / Advanced Practice Nurses/ Resident Nurses/ Nurses/ Physiotherapist/ Occupational Therapist / Medical Social Worker / Dietician.

Preparation of Home Environment

• Choose a chair with a firm back rest
• Avoid low chairs
• Position chair against a wall or at a corner
• Place a chair in the toilet for seated showering
• Consider installation of grab bars and non-slip mats
• Install grab bar(s) at the shower area, as well as next to the toilet seat
• Place non slip mats in the shower and toilet 

Plan ahead

• Prepare and place daily necessities within reach
  
• Place daily necessities needed, such as clothes, within safe reaching distance
  
• Avoid placing items at low (floor) level or overhead
  
• Make prior arrangement for other daily needs post-discharge, such as meal arrangement
  

​Physiotherapy 

The goal of physiotherapy is to:

• Restore movement and strength of the operated hip(s) 
  
• Aid in return to normal activity as soon as possible 
  

Occupational Therapy

The role of occupational therapy is to:

• Ensure independence in self care
• Provide equipment recommendation and home safety advice
  

Care after Surgery

Special Instructions Post Surgery Hip Precautions

DO NOT…

• Sit on the floor, squat, jump and run for the first 6 weeks
• Apply heat on your operated hip as this may worsen swelling and pain
• Perform deep massage on the operated leg

• Change the height of the walking aid without consulting your therapist

Swelling and pain management

Swelling following surgery is expected. You should ice the affected area following each set of exercises. Wrap an ice-pack in a layer of towel and apply over the affected area for 20 minutes each time. You should check the integrity of your skin during this process. If you experience severe pain, numbness, discolouration or new bleeding, inform your nurse or doctor.

Wound Care

Your incision may be closed by adhesive stitches, surgical tape, staples or topical skin adhesive. The wound should be covered with adhesive bandages otherwise explained by your doctor or nurse. Upon discharge, nurse will provide information to you on managing your wound.

Going up and down the stairs 

Climbing up stairs

It is important to know how to use stairs regardless of whether you have them at home as you may encounter them outdoors. You may or may not need someone to help you perform this safely. 

• Use a handrail if available 
• Lead with the unoperated leg followed by your operated leg and your walking aid
  

Going down stairs

• To go down the stairs, it is done in reverse.
• Again, use a handrail if available
• Lead with your walking aid, followed by your operated leg and subsequently, your walking aid
  

Exercises

Your physiotherapist will guide you on the following exercises to improve the range and strength of the operated hip. You might not need to do all of them. It is important to perform these exercises only as directed by your therapist to aid in your return to your daily activities as soon as possible. Generally, they should be performed, 5-10 times each time with 5-10s holds each, 3 times a day.

Heel slides   

1. Bend both your hip and knee on the operated side
2. Use a towel if necessary to assist you with this movement

 Straight leg raise

1. Bend your non-operated leg,
2. Straighten your operated leg by tightening the thigh muscles and lift your leg 20cm off the bed. If you are unable to perform independently you may use a towel to help lift up the  foot.
   

Static quadriceps 

Straighten your knee by tightening your thigh muscles and maintain the contraction

Inner range quadriceps 

1. Keep the back of your knee on a rolled up pillow/towel/blanket
2. Tighten your thigh muscles and lift only the lower leg off the bed

Hip abduction in supine

1. Squeeze your buttocks together
2. Slide the operated leg outwards and inwards

Bridging

1. Bend both legs up and keep your feet on the bed
2. Squeeze your buttocks together
3. Gently lift your buttocks off the bed
   
   

Managing self-care

Lower body dressing

• Choose loose fitting clothing
  
• Dress in sitting, especially if you require a walking aid
  
• When wearing pants, dress operated leg first
  
• When taking off pants, undress non-operated leg first
  

• Avoid sitting on low chairs. Choose chairs with arm rests, so that it will be easier to stand up from a sitting position
  
• Avoid bending down while standing to pick up items from the floor. Consider moving a chair closer to object, sit on the chair before bending down to pick it up. Alternatively, use a long handled reacher
  

Transferring into a car

• Choose the front seat if possible
• When getting in the car, sit by the edge of the car seat first, before swivelling both legs into the seat
• When getting out, shift both legs out of the car to sit by the edge of the seat.  Hold onto stable fixtures or onto your walking aid before standing up.
  

On the Day of Discharge

• You will be given a Patient Education Information pamphlet on how to care for yourself at home.
• You may receive an implant card if you had metallic implant inserted during your surgery.
• You would have been assessed by a physiotherapist before returning home. You may or may not need a walking aid. Do not rush to buy a walking aid.
• An outpatient physiotherapy appointment will be given to you and you will also need an ice pack.  
  
• You can call us if any enquires. A hotline number will be given to you.