How soon can you drive after hip replacement surgery?

Please read this carefully...

Q: When do I see the doctor after surgery?

A: 3 weeks after surgery.

Q: When can I shower?

A: Immediately. NO BATHS or soaking. Your dressing is waterproof. Dab dry after shower.

Q: When can I drive?

A: Usually you can resume driving after you are off your pain medication and feel strong enough and safe enough to drive. If surgery was performed on your left leg, assuming you don't drive a manual transmission vehicle you can start driving once off narcotic pain medication. If surgery was performed on your right leg, you can typically resume driving between 3-4 weeks after surgery.

Q: Will I have bruising after surgery?

A: Yes. You will have some degree of bruising after surgery but everyone is different. Some will only experience redness around the incision. Others will have bruising down the entire leg. Both are considered normal and will typically resolve over 10-14 days.

Q: Do I need to clean the incision?

A: No. Please call us if you notice any significant drainage on the dressing.

Q: When can I stop taking the blood thinner (aspirin, coumadin, Xarelto, lovenox)?

A: The usual length of time is 4 weeks post-operatively.

Q: How long do I have to follow hip precautions for my hip replacement?

A: 6 weeks. When you feel like you have returned to your normal activity level, are off pain medications and comfortable you may typically remove the precautions.

Q: How much weight can I put through my leg after surgery?

A: You can put as much weight as you can tolerate on your surgical leg immediately after surgery. Most patients are walking with or without a cane/walker/crutches on the day of surgery. Your therapist will instruct you on how to properly use these devices.

Q: Can I go up and down stairs?

A: Yes. You will be able to negotiate stairs immediately after surgery and instructed by physical therapy on the appropriate way to do so. Be aware that excessive use of stairs may increase the swelling and discomfort around the knee and as such, try to limit the number of stairs you use initially.

Q: What is my activity level expected to be after surgery?

A: Every patient is different. You should be increasing your activity level daily, but let pain be your guide. The majority of your recovery will take place in the first 4-6 weeks after surgery and the remainder will come over the next year. Most people will overdue it at some point! If/when you do, you will experience increased pain and swelling. If you cannot control this with rest and your pain medications, or if you have difficulty putting weight on your surgical leg, contact our office for further instructions.

Q: How long do I have to wear the stockings?

A: These should be worn on both legs after surgery for at least 48 hours. You may remove when walking regularly.

Q: What positions can I sleep in?

A: You may sleep on your back or on either side. If you choose to sleep on your side, make sure you place a pillow between your legs for the first 3 weeks. Your physical therapist will assist you initially into this position and give you proper instructions. Do not do it on your own the first time!

Q: When should I call your office?

A: If you experience any of the following:

• Fever above 101.5˚ consistently
• Increased drainage or swelling
• Pain not controlled by pain medication
• Inability to bear weight on your operative leg
• Severe insomnia
• Swelling in foot or calf that is accompanied by coolness or decreased sensation in the foot
• Confusion/disorientation

Important things to remember in the first six weeks after hip replacement surgery.

• Sleep on your back, or on the un-operated side with a pillow between your legs
• Resurfacing hip replacement patients should use a walking stick for the full six weeks after surgery to minimize any risk of fracture while the joint is settling down.
• Patients should sit in chairs, which are at knee height or higher, with arm rests to enable you to get out of it easily. Deep lounge chairs should not be used.
• Do your best to keep your knees apart when bending to reach between your legs, rather than reaching to the outside of your leg.
• Don’t bend over to pick up and don’t lean forward to put on your stockings/socks and shoes
• Your hip should not be flexed more than 90 degrees (ie. pull up your leg to your body)
• It is advisable to avoid lifting or carrying anything heavy
• Do not cross your legs when you are sitting down, standing up or lying down.

Wound care

Generally, a wound from hip replacement surgery requires very little care. Most people have sutures that dissolve themselves and do not require removal. Before leaving the hospital, your dressing will be changed. It is important to keep the wound dry.

Patients who have the anterior approach hip replacement must take extra care with wound care. They must not allow the wound to become moist in the hip crease, as this can make superficial infection more likely.  In some cases, if the wound is inflamed or oozing, oral antibiotics may be required for a short period of time. If this occurs, you should contact Professor Walter’s rooms, the Mater hospital or your GP immediately.  The wound should be covered until it has healed.

Hydrotherapy

Patients can proceed with hydrotherapy 4 weeks after surgery if they meet the following criteria:

• The wound is clean and dry with no scabs, drainage or blisters
• The wound is reviewed by rehabilitation physician prior to doing hydrotherapy.

Please contact the office if you are at all concerned about participating in hydrotherapy.

TED Stockings

Professor Walter is up-to-date with recent research and does not require routine wearing of TED stockings. However, if there is swelling or a history of DVT (deep venous thrombosis) or pulmonary embolism you will be asked to wear them for a period of time.

Pain medication

Patients generally only need Panadol or Panadeine after discharge from hospital. Professor Bill Walter will ask you to see your GP if stronger pain medication is needed. Your GP is in the best position to manage your overall health and all your medications. Professor Bill Walter does not prescribe narcotics to patients after they leave hospital.

Activities

During the first six weeks after your surgery, we recommend limiting your activities to walking with support, gentle swimming in the shallow end once you have been given permission to get the wound wet. We recommend you refrain from exercises such as pilates, golf and social tennis until three months after the date of your surgery. High impact activities such as running and jogging and activities which put your body into extreme poses, such as yoga, are not recommended at any time after hip replacement. If you are enthusiastic about a particular sport, please seek instructions from Dr Bill Walter, as there are often ways you can modify your movement to keep your hip safe.

Sex

You can have sex whenever you feel ready, although you are advised to be the “passive” partner during the first six weeks and remember to avoid positions which involve internal rotation of the hip or leg. Professor Walter has done some interesting research, which shows improvement in sexual function in women after hip replacement surgery. Read about this study.

Driving

The Roads & Traffic Authority recommends you should generally not drive for six weeks following a hip replacement.  In order to be safe driving a car after a hip replacement, you must be able to control the pedals properly and you must not be taking strong pain medications that could impair your judgement or reaction time. As you get to the six-week mark, ask yourself if you would be able to stop quickly if a pedestrian ran in front of your vehicle. If you feel you could not react quickly enough, wait a little longer.

Travel

It is usually safe to take a short flight a week after surgery as long as you do not have blood clots in your legs. Long flights are best avoided during the first few months after surgery. There is a risk of deep vein thrombosis (blood clots in the legs). If you must travel, we recommend you wear TED stockings and mobilise throughout the flight as much as possible. If possible keep your legs elevated when seated during the flight. If it is necessary to travel long distances, then speak to your GP or Dr Walter prior to doing so.

Infections (and a special note about your teeth)

After joint replacement, (even years after your surgery) pay particular attention to infections anywhere on the body. You must deal with them immediately. Pay special attention to tooth decay and mouth infections, as these may be a cause of infection in joint replacement.  If you need to visit your dentist, tell them you have had a joint replacement. Also give them a copy of the current advice from the Arthroplasty Society of Australia, which outlines recommendations for mouth care after joint replacement surgery.