perioperative care

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The patient undergoing total hip replacement should be informed of the general risks of the general anaesthetic and of major surgery.

The effects of infection in a prosthetic hip are disastrous. Prophylactic antibiotic cover is given about half an hour prior to surgery and continued for 24-48 hours afterwards until the drains are removed.

A hip replacement is a major operation and prophylactic anticoagulant therapy is recommended. Usually, subcutaneous heparin or one of the newer low molecular weight heparins are prescribed. In some series, fatal pulmonary embolism occurs in 1-2% of total hip replacements not covered pre-operatively by suitable anticoagulant therapy.

Post-operatively, weight bearing should be gradually introduced. Some recommend that the patient should remain on crutches for 6-10 weeks until osteointegration is advanced.

Patients should be informed that the new hip may dislocate so certain positions such as sitting in a low chair are to be avoided. Activities which involve repetitive impact such as tennis and jogging are out of the question but more gentle exercise such as swimming, cycling and golf are to be encouraged.

The patient should also be aware that the hip may loosen and require replacement. They will be encouraged that they will have complete relief from hip pain.

Last reviewed 01/2018

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