THR Anterior Approach Same Day Return Home

[AlanInAZ]

I am now 11 days post op left hip replacement. Anterior approach at a surgical center. Right hip was replaced 11 years ago by the same surgeon with the same approach but in a hospital and I was discharged the next day. This time I went home two hours after the surgery. I walked to the car and my wife drove home. A nerve block kept pain under control the first night. Home pain management relied on ibuprofen and Tylenol with a few narcotic pills for the first two days. I started the pain meds the first night in anticipation of the nerve block wearing off. Also started low dose aspirin for clot prevention. I rented a lay flat recliner for the first week that made exiting at night to pee much easier, a necessity at my age 77. There were no precautions other than don't fall and I was able to use the toilet at it's normal height. The biggest aggravation has been the thigh high compression stockings impossible to keep from bunching up and a major project taking them off and putting them on. I am supposed to wear these for three weeks when not sleeping. Luckily for me my spouse provided much needed support, especially around meal preparation. The first week a walker was used and I am now using a cane. I will continue with the cane for awhile to be safe. Outpatient PT started 5 days post opt with emphasis on rom and balance. Incision staples will come out in a few days. Overall a pretty smooth recovery up to now.

 

[mendogal]

Welcome back to BoneSmart!!!

It sounds like you remembered a lot of lessons learned from your first hip replacement.

Here's a quick "refresher course" just in case.

HIP RECOVERY GUIDELINES

1. Don’t worry: Your body will heal all by itself. Relax, let it, don't try and hurry it, don’t worry about any symptoms now, they are almost certainly temporary.

If you want to use something to assist with healing and scar management, BoneSmart recommends hypochlorous solution. Members in the US can purchase ACTIVE Antimicrobial Hydrogel through BoneSmart at a discount. Similar products should be available in the UK and other countries.

2. Control discomfort:
rest
elevate
ice
take your pain meds by prescription schedule (not when pain starts!)

3. Do what you want to do BUT
a. If it hurts, don't do it and don't allow anyone - especially a physical therapist - to do it to you
b. If your leg swells more or gets stiffer in the 24 hours after doing it, don't do it again.

4. PT or exercise can be useful BUT take note of these
BoneSmart philosophy for sensible post op therapy

5. At week 4 and after you should follow this
Activity progression for THRs

The recovery articles
Pain management and the pain chart
Healing: how long does it take?
Chart representation of THR recovery
Dislocation risk and 90 degree rule
Energy drain for THRs
Pain and swelling control: elevation is the key
Post op blues is a reality - be prepared for it
Myth busting: on getting addicted to pain meds
Sleep deprivation is pretty much inevitable - but what causes it?

BIG TIP: Hips actually don't need any exercise to get better. They do a pretty good job of it all on their own if given half a chance. Trouble is, people don't give them a chance and end up with all sorts of aches and pains and sore spots. All they need is the best therapy which is walking and even then not to excess.

We try to keep the forum a positive and safe place for our members to talk about their questions or concerns and to report successes with their joint replacement surgery. While members may create as many threads as they like in a majority of BoneSmart's forums, we ask that each member have only one recovery thread. This policy makes it easier to go back and review history before providing advice.

 

[mendogal]

If you provide the exact date of your L THR we can update your signature.

 

[AlanInAZ]

I have now had two anterior approach hip replacements, the most recent 5 weeks ago, the first 11 years ago. Both recoveries were pretty smooth as long as expectations are reasonable. Recovery takes times and don't rush things. The first week is the most uncomfortable in the sense that movement is most constrained by an unresponsive leg. Pain was well controlled with pills as needed. My most recent surgery was in a surgery center with same day release. The first few hours were uncomfortable, pain and shivering from the anesthesia but settled down by the time we got home. I rented a medical recliner for one week that made getting up to walk and visit the bathroom much easier. I used our standard height washlet toilet but had a second toilet setup with a higher seat just in case. There were no precautions and I could get up from a low seat without a problem, although I used my arms for assistance the first weeks. Progression from walker to cane to no cane is very individual and it is best to ignore the experiences of others.

I am now at 5 weeks post op and can walk distances I have not been able to cover pain free in several years.

Hope things go well

 

[Layla]

Happy One Month Anniversary…a couple days late. Thanks for the update!
Sounds like you’re doing really well!
Keep up the good work and stay in touch.
@AlanInAZ

 

[AlanInAZ]

My hip two replacements replacements are separated by 11 years, both done by the same surgeon with the same anterior approach using the Hana table. What is the difference, if any, in protocols. First the pain management changed. A nerve block was used this time to control recovery pain and allow same day discharge. Eleven years ago recovery pain was controlled in the hospital with an IV drip. Eleven years ago I relied on narcotics and now very little on narcotics with extensive use of NSAIDs and Acetaminophen. Another change is same day discharge versus one sleepless night in hospital. My first night at home was also sleepless but much more comfortable. Blood thinner changed to low dose aspirin (antiplatelet) from Xarelto (anticoagulant). Eleven years ago I had seven sessions of home PT and this time only 4 sessions of outpatient PT during first two weeks. I suffered with thigh high compression stockings for both surgeries. Stapled incision with staples removed at 14 days. I haven't yet received the cost but the various protocol changes all lead to lower cost.

 

[myglasshalffull]

Welcome & sounds like you are doing very good. Hope your recovery road continues to be smooth!