Bone-Sparing, Total Hip Resurfacing Arthroplasty Surgery (Metal-on-Metal Device)
Last updated Thursday, August 20, 2009
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Recovering from surgery
Pain and pain management
Hip-resurfacing
surgery is a major surgical procedure that involves cutting of skin,
preparation of bone, as well as suturing of tendons. The pain from this surgery
is managed by the anesthetic and by pain medications. Immediately after
surgery, strong medications (such as morphine or Demerol) may be given by
injection. Within a day or so, oral pain medications – strong painkillers and
non-narcotic painkillers such as Tylenol (acetaminophen) – are usually
sufficient.Use of medications
Initially
pain medication usually is administered intravenously or intramuscularly – and
sometimes patients are allowed to administer the medication as they need.
Hydrocodone or Tylenol with codeine are taken by mouth. Intravenous pain
medications are usually needed only for the first day or two after the
procedure. Oral pain medications are usually needed only for the first two
weeks after the procedure.Effectiveness of medications
Pain
medications can be very powerful and effective. Their proper use lies in
balancing their pain-relieving effect and their other, less desirable effects.
Good pain control is an important part of the postoperative management.Important side effects
Pain
medications can cause drowsiness, slowed breathing, difficulties in emptying
the bladder and bowel, nausea, vomiting and allergic reactions. Patients who
have taken substantial narcotic medications in the recent past may find that
usual doses of pain medication are less effective. For some patients, balancing
the benefit and the side effects of pain medication is challenging. Patients
should notify their surgeon if they have had previous difficulties with pain
medication or pain control.Hospital stay
After surgery the patient spends an
hour or so in the recovery room. A drainage tube may be used to remove excess
fluid from the surgical area. Such a drain would be removed on the first or
second day after surgery. Bandages cover the incision. They are usually changed
the second day after surgery.
Patients are discharged as soon as the incision
is dry, the hip’s pain is manageable with oral pain medications, the patient
can perform the range-of-motion exercises, and support systems are in place at
the patient’s home. Discharge is usually on the third day after surgery.Recovery and rehabilitation in the hospital
Early mobilization after total hip
resurfacing arthroplasty helps achieve the best possible hip function.
Arthritic hips are stiff, and one major goal of hip resurfacing is to relieve
much of this stiffness. However, after surgery scar tissue will tend to recur
and limit movement unless mobilization is started immediately. This early mobilization
is facilitated by the complete surgical release of the tight tissues.
The night of surgery, patients are
encouraged to get up to use a commode or walk to the bathroom with assistance.
During the hospitalization, the
patient learns a simple rehabilitation program that will help maintain mobility
at home after discharge. On the day of surgery or the day after, the physical
therapist teaches the patient gentle exercises. The patient usually is shown
how to prevent stiffness and adhesions.
Walking and strengthening exercises are
encouraged soon after surgery. Many patients return to leisure activities
within 3-6 months after surgery.Hospital discharge
At the time of discharge, the patient
should be relatively comfortable on oral medications, should have a dry
incision, should understand their exercises and should feel comfortable with
the plans for walking. For the first month or so after this procedure, the
operated leg may be less useful than it was immediately beforehand.
Limitations can be specified only by
the surgeon who performed the procedure. It is important that the repaired
tissues not be challenged until they have had a chance to heal.
The patient must plan to manage the activities
of daily living during the period of recovery.Convalescent assistance
Patients usually require assistance
with self-care, activities of daily living, shopping and driving for four to
six weeks after surgery. In the absence of home support, a convalescent
facility may provide a safe environment for recovery.
Recovery of comfort and function after hip
resurfacing continues for many months after the surgery. Improvement in some
activities may be evident as early as two weeks. With persistent effort,
patients make progress for as long as three to six months after surgery.Surgery for Total Hip Resurfacing Arthroplasty at the University of Washington, Department of Orthopaedics and Sports Medicine, Seattle, Washington
If you are interested in making an appointment to discuss this procedure in Seattle, you can request an appointment using our online referrals website. To request a referral online, please click here. You can also call 206-598-4288 to make an appointment. Our clinical center is located in Seattle Washington, USA
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