Discharge Instructions: Anterior Approach
Total Hip Replacement Surgery

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Most of these instructions apply to the first 6-8 weeks after surgery.  These are general rules and you should always check with your surgeon if you have any questions.

Walking
§        Walk 4 - 5 times a day, increasing distance each time.  Walking is your most important exercise!  (Remember your rest periods in bed with leg elevation.  See “Blood Clot Prevention.”)

§        When walking or standing, you may bear full weight on your operated leg(s) unless told otherwise.

§        When going upstairs, lead with the unoperated leg and when coming down, lead with your operated leg.

§        Continue using a cane for all walking as long as there is a limp.

Exercises
§        Ten sets of the following exercise should be done each day while holding on to a table or using a crutch or cane on the operated side.  At least 10 repetitions of each exercise should be done during each set.

§        Bend knee and hip.  Lift up and down 10 times.

§        Keep knees straight. Lift leg out to the side.  Hold there for 5 seconds, then return to standing.  Repeat 10 times.

Your exercise program is not temporary, but continuous.  It is an important part of the ongoing management of your total hip replacement.

General Precautions
§        Do not force hip flexion beyond 90-100 degrees for the first 6 weeks.

§        When you sit down, slide your foot (on your operated side) out in front of you.

§        Do not lean forward when sitting in a chair.  If you must lean forward, be sure to spread your knees.

§        Always sit in a straight back chair (no couches, no low recliners, no soft chairs) for 6 weeks following surgery.

§        Do not cross your legs or extend your hip or leg backwards for 6 weeks.

§        Do not pivot on your operative leg.

§        Sleep with a pillow between your knees to keep legs from crossing for 4 weeks.

§        While sitting in a chair, have everything you need at arms length so you do not twist.

§        Use a regular toilet unless the toilet is unusually low.  Otherwise you may need a raised toilet seat.

Driving
§        You may go for short rides or to a restaurant 7-10 days after discharge from the hospital.

§        No extended car trips for 4 weeks.

§        Before driving in open traffic, test your driving skills in a large, empty parking lot.

§        You may drive approximately 2 weeks after discharge if you have good control of your right leg, if your family is not afraid of driving with you and if you do not have any other conditions that may prevent you from driving (check with your family physician).

Blood Clot Prevention
§        Take enteric coated aspirin, 325mg, 1 tablet, twice a day. (usually with breakfast and dinner) for one month after surgery to thin out your blood, or Lovenox as directed.

§        During the first 10 days after surgery, do not sit in a chair for long periods of time (no more than 30 minutes at a time, 3-4 times per day), then progress to longer periods if there is no swelling of the legs.

§        When not walking or exercising, you should be lying down in bed with legs elevated to prevent swelling, doing ankle pumps to prevent blood clots.  You should be decreasing the time in bed in a gradual manner.

Follow-up
§        Staples should be removed 2 weeks after surgery by the visiting nurse or rehab facility staff.

§        Call Your doctor to make an appointment for a 2-month check-up.

§        Ask for X-rays to be taken at this visit.

§        Call your doctor if there are any unusual symptoms such as severe pain, fever, chills, wound drainage, etc.