pre and postoperative management required for hip replacement including investigation and

education

The knee or hip replacement is a significant surgical procedure that could, at times, be

psychologically and physically stressful for the patients. Studies indicate that education prior to

the conduction of surgery is beneficial since it aids in the minimization of anxiety as well as the

improvement of clinically crucial postoperative outcomes. Thus, both the preoperative and

postoperative management for the hip replacement is essential due to the improvement it has on

the postoperative outcomes related to function, pain, anxiety, the incidence of adverse events and

length of hospital stay. Also, from research, it can be deduced that the preoperative education is a

representation of a useful adjunct with minimal risk of undesirable effects, especially in

particular patients. However, other patients respond positively towards the preoperative

education since it is well stratified based on their social, physical and psychological needs. This

paper seeks to explain the pre and postoperative management required for hip replacement,

including investigation and education.

Overview of Hip Replacement

The hip replacement is also called the total hip replacement. It is a surgical procedure that

entails a replacement of the damaged parts of the hip joint with an artificial part. The

fundamental goal of a hip replacement is to aid in pain-relieving, increasing mobility, and

enhancing the function of the hip joint. One of the essential weight-bearing joints in the body is

usually the hip joint (Stambough et al., 2015). Generally, it is a ball and socket joint in which the

thighbone fits into a rounded socket in the pelvis. Osteoarthritis is the most common hip x-ray

Masterfile image that causes hip damage.

 Apart from the mentioned cause of hip damage, others include injury, rheumatoid

arthritis, bone tumor, and osteonecrosis among others. Since damage to the hip joint could result

in pain as well as interfering with daily life, particular techniques can be used in treatment. Such

methods could include medications, use of walking aids, and physical therapy.

Preoperative Management for Hip Replacement

Prior to the total hip replacement, it is usually necessary that all the patients undergo a

whole physical examination, various tests such as chest x-rays, urinalysis, and blood tests as well

as a dental assessment. During such a period, all the overweight patients could be advised to

reduce weight to help in the minimization of the risk for complications during and after surgical

operations. In particular times, blood is often donated by the patients before the surgery in the

event that it is necessary to transfuse blood during the procedure (Wainwright et al., 2015).

Additionally, all patients are usually expected to comply with the directions of the healthcare

providers before the surgery, and this is especially those relating to drinking, eating as well as

taking up of medication. From such directions, most of the patients are told neither drink nor eat

just after the mid night prior to the conduction of the procedure, and this forms the preoperative

procedures for hip replacement.

During the initial management, fast track triage systems are usually put in place because

of the large number of patient admission through the emergency department. Such a system

helps in the identification of the hip fracture especially using the diagnosis and radiography.

Also, the patients that could be having a certain clinical suspicion of hip fracture must have the

Big Six interventions prior to leaving the emergency department (Stambough et al., 2015). Such

treatments include the screening for delirium, early warning score system, provision of pain
relief, pressure area care, intravenous fluids therapy, and full blood investigation and

electrocardiogram, among others.

Postoperative Care after Hip Replacement Surgery

Prior to the hip replacement surgery, the recovery and rehabilitation plan will be

discussed by both the patients and the surgeon. Such a plan is beneficial because it helps in the

reduction of the risk of developing a post-surgical limp, leaving the hospital sooner, resumption

of an independent living sooner and regaining of hip strength, among others. Most of the

activities could be resumed by individuals usually after six weeks after the surgery. However, the

recovery period is often three months, and some people could take up to a whole year to recover

fully.

Patients are usually taken to the post-anesthesia care unit just after the surgical

operations. They are monitored closely by the nursing staff in charge until they are coherent and

awake. After the wearing off of the anesthesia, there is a transfer of the patient to the hospital

room for further directions. Consequently, the patients remain in the hospital for about three to

seven days after the hip replacement surgery (Soffin & YaDeau, 2016) Moreover, there are

varying factors that help to determine the length of recoveries such as the success of

rehabilitation, overall health of the patient and the type of surgery conducted on the patient that

could be either minimally invasive or traditional. Another thing to note about the postoperative

care of hip replacement is that the patients ’movement is usually limited after the surgical

procedure, and this is to help to brace of the hip in the correct position.
 In order to brace the hip in the correct position, certain things could be done. For

instance, a drain could be inserted next to the incision site to drain excessive fluid as the patients

are allowed to continue receiving the intravenous fluids via a vein. In cases where particular

patients are faced with the challenge of urinating, a catheter could be used to help in draining of

the bladder (Lloret-Linares, 2016) The discomfort could also be reduced using the prescription

pain relievers. Furthermore, to minimize the risk of fluid getting into the lung, most of the

patients are usually expected to carry out simple coughing or breathing. Just after the surgery,

physical therapy usually begins, and this is typically a day afterward. Later patients typically can

sit up within two days after the surgery, and this also includes, walking with assistance and even

standing up (Sharma et al., 2016). After two weeks, the staples or stitches are removed.

Waking Up from Hip Replacement Surgery

Often a patient wakes up from anesthesia with a triangle-shaped pillow between his or

her legs, and this helps to keep the leg spread. The primary purpose of the pillow is to assist in

the stabilization of the hips. It is usually the doctor’s direction to the patient to always use the

pillow after the surgery (Kort et al., 2016). A patient is often in pain after hip replacement

surgery. However, such a pain could be treated using an integration of the certain pain relief

techniques that complement each other and thus reduce the side effects. Such a method is called

multimodal analgesia.

However, if the pain can be controlled, then the patients will be requested to carry out

certain gentle exercises in bed such as relaxing and contracting the gluteal muscles, bending and

flexing the ankle as well as contracting and relaxing the quadriceps muscles among others. Such

gentle exercises are usually done for just a few minutes every hour to help in blood flow (Kalson

et al., 2016). Another key thing that is done during the postoperative procedure among the
patients is the use of the aid of a physical therapist or even a walker to stand and thereafter take a

few steps. Studies indicate that the patients who are able to stand up and thus bear certain weight

are likely to recover faster than the others.

Amount of Weight on the New Hip

After the completion of the surgical operations, each of the patients is usually given

weight-bearing guidelines to comply with while at home and hospital. At the initial stages of the

weight placing on the new hip, the doctor would advise the patient to place just a small

percentage of weight on the new hip as he or she increases more weight over time. Several

factors are usually taken into consideration to determine the amount of pressure or weight to be

placed on the new hip (Chou et al., 2016). Such factors are the fixation of prostheses on the

natural bone, the nature, and type of prostheses and surgery applied as well as the natural bone's

condition of the patient involved. The patients, for example, with cementless prostheses usually

have to wait longer to place more weight on the hip due to the long-time needed for the growth

and bonding of the bone with the prostheses.

Time to Leave the Hospital

It usually takes about two to five days for the patients with hip replacement to leave the

hospital. Once pain is under control, the patient will be given a go head to perform particular

activities such as;

 Carrying out simple exercises

 Getting in and out of bed as well as walking short distances

 Eating meals while sitting up

 Adhering with various precautions for the avoidance of dislocation of a new hip

Before being discharged, the patients are usually required to go up and down stairs

possibly using an assistive device and handrail (Levy et al., 2017). Additionally, the patients that

have undergone through more than one joint replacement may be asked to stay in the hospital a

little bit longer.

Discharge to a Rehabilitation Centre

A rehabilitation center is usually necessary for particular patients whose homes have

many stairs and do not have caregivers at all. Such a facility often helps in the provision of

health care as well as both occupational and physical therapy, among others (Auyong et al.,

2015). However, the stays in the rehabilitation centers are usually covered by insurance based on

the circumstances surrounding the patient as well as the terms of the policy of the insurance

cover.

In conclusion, both the preoperative and the postoperative management care including

education is critical in a surgical procedure. They have a range of benefits such as pain-relieving,

reduction of the amount of time spent in the hospital, and the reduction of the amount of time

taken for a patient to recover from the hip replacement.

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