Hip surgery pre op precautions and post op care

Prof. Dr. Maximilian Rudert, Medical Director of the Orthopedic Hospital König-Ludwig-Haus in Würzburg, Germany, talks about hip surgery and pre op and post op instructions that patients undergoing the operation should follow.

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If you are about to undergo hip surgery or suffer from limited hip mobility and are considering the operation as an option, this exclusive interview is just for you.

With years of expertise in the field of Orthopedics, Prof. Dr. med. Maximilian Rudert offers tips and guidelines to help you understand the process better.

What is the average time of rehabilitation after a hip surgery?

The rehabilitation time differs a little bit from country to country and is, of course, age dependent. In our hospital we keep the patient as an inpatient for about one week. Younger patients recover faster. The patient is ambulating with crutches from the day after the operation on. After one week in Germany the patient would be advised to enter a 3 weeks rehab program. This can be on an in- or outpatient basis. After these 4 weeks the patient should be able to walk without crutches and to carry out all activities of daily living. Active sports should be started not earlier than 5 to 6 month after surgery.

What degree of mobility can patients expect after a hip surgery?

Degenerative arthritis and destruction of the hip joint leads to restricted mobility primarily due to pain and as a sequel to capsular shrinking and bone apposition (osteophytes) around the joint. Mobility of the joint should be regained because parts of the capsule and osteophytes are resected and the damaged joint itself is replaced. After the first few month movements of the hip should be painless. This increases general mobility of the patient and - what is even more important and one of the major goals of the surgery in our view - dramatically improves quality of life.

What postoperative instructions should patients follow after a hip surgery?

While in the hospital, the patient receives instructions which movements are allowed and which are restricted in the early postoperative period. These instructions are mainly presented by and trained with the physical therapist. It is crucial to follow these instructions because they are dependent on the surgical approach and the implant that was used by the surgeon. We use the minimally invasive direct anterior approach (DAA) that enters in-between muscle groups and allows for fast recovery because muscle origins are not detached. During the first month forced external rotation of the straight leg (Charly Chaplin) and hyper flexion of the hip (happens while rising from a deep chair with drive). If the patients wants to lie on the side, the operated side is recommended. Dislocation of the hip is almost impossible in this position. A pillow between the knees is helpful.

What can patients expect before undergoing a hip surgery? Is there an specific preparation or diet they should follow?

It is positive to get an impression on what to expect after surgery. Special sports groups for arthritis patients or patients with joint replacements do help to get the best insight into the perioperative events. We do not recommend a certain physical training although it is reasonable to enter surgery as fit as you can. For elderly people it can be helpful to train the use of crutches before they are needed. In general it is good to loose overweight because perioperative risks (cardiac, infection, thrombosis etc.) are decreasing with kilos. Starvation diets are NOT recommended.
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