Thank you for choosing Rutland Regional Medical Center for your upcoming medical procedure. In
this video, we will demonstrate what occurs once your total hip replacement is complete and once
you are fully awake after surgery. When having a hip replacement, you must avoid extreme ranges of
hip movement. Once your surgery is over, you will be introduced to the physical therapist
and trained therapy technician. They will come to your room and evaluate you either the day of your
surgery or the very next morning. Your therapist will ask questions about your pain level,
your level of activity, and any equipment needed before surgery. They are also available to answer
any questions you may have at any time, so ask them. It is important for you to let your
therapist know the details of your home, such as the number of steps inside and out, location of
handrails, and setup of bathrooms. Our goal is to make sure you are able to safely move around
your home. During the evaluation, the therapist may recommend the removal of tripping hazards,
like throw rugs. Depending on your mobility level and the setup in your home, your therapist
will recommend equipment, such as a rolling walker and/or crutches. At this point, your
surgeon has cleared you for some activity; and the physical therapist will get you out of bed. First,
the therapist will inspect your dressing, test for sensation, and assess your strength. You
will practice getting out of bed the same way you would as if you were home. Keep your toes pointed
to the ceiling when getting out of bed. It would be easiest for you to sit up towards the operative
leg, if possible. Continue until both heels are just off the mattress. At this point, you should
be able to sit yourself up with assistance from the therapist. Once seated at the edge of the bed,
a rolling walker will be placed in front of you. Prior to standing, the therapist will instruct you
to slide your operative leg slightly ahead of the other for comfort. Some important cues to
remember, use your arms to push off from a stable support surface; lean your body forward thinking
“nose over toes;” do not reach for the assistive device until fully standing. Once standing,
the therapist will adjust the rolling walker to fit you. The handles will line up with a bend in
your wrist allowing for the elbows to maintain a slight bend. At this point, you are allowed
to put as much weight as is comfortable on the operative leg, unless otherwise instructed by your
therapist. Next, your therapist will teach you the safest way to walk. There are three steps. Step 1,
slide the walker forward. Step 2, move the operative leg forward to the center of the walker.
Step 3, using the walker to support yourself, move your non-surgical leg forward to meet the
other leg. Next, your therapist will work with you to walk up and down stairs using either a crutch
or a cane. First. advance your non-surgical leg onto the first step. Next, use your arms and your
non-surgical leg to bring the operative leg onto the same step. As you do this, slightly bend the
knee of the operative leg to avoid catching your toe. Take your time as you repeat this pattern all
the way to the top. At the top, avoid twisting on your operative leg. Take small steps. During
this process, your therapist will be with you. Remember, your therapist is ready to answer any
questions you may have, so be sure to ask them. This process is reversed on the way down. Inch
close to the edge of the top step, use the railing to support your weight, and slowly lower the
operative leg to the first step. Be sure to have the foot fully supported on the step and not too
far forward. Again, using the railing for support, slowly lower the non-surgical leg. This pattern is
repeated all the way down to the bottom. Physical therapy will go over the basic therapeutic
exercises as seen in your surgical manual. These exercises should be completed 3 times
a day at home prior to surgery, unless otherwise instructed by your doctor. After surgery, you
will perform your exercise program as instructed by your physical therapist. For the first set of
exercises, you will lie on your back in a bed on a flat surface or in a fully reclined chair.
These exercises will help improve circulation and decrease the likelihood of blood clots. First,
are “ankle pumps.” Using your ankles bend your feet toward you and then away, using a controlled
motion. You may feel a slight stretch behind the leg, but no hold is required. Next, is the “quad
set.” With both legs straight, tighten the muscles at the front of your thighs as you press the back
of your knees down toward the bed. Hold for 3 to 5 seconds. Then the “gluteal set.” With your legs
straight, squeeze your buttocks tightly together. Your hips may rise slightly off the bed. Hold for
3 to 5 seconds. Next is the “active heel slide.” Start with both legs stretched out in front of
you. Slide your heels toward your buttocks as far as possible, while keeping your heel on the bed.
Hold for 3 to 5 seconds and slide it back. If you experience a cramp in your leg, lessen the
distance. Repeat this exercise with the other leg. These exercises are important for your recovery,
so if you have any questions, please ask your physical therapist. They are here to help. Your
physical therapist may recommend other exercises depending on your type of surgery. After surgery,
the use of ice is highly recommended. Ice is used to desensitize the surgical area,
as well as decrease pain and inflammation. Always use a barrier between you and ice,
such as a pillowcase. Apply the ice while you are sitting or lying down, and keep it in place for 20
minutes each time. Apply ice frequently throughout the day but especially after physical activity and
exercises. It's good to remember that ice is your friend. Your occupational therapist will help you
to be as independent as possible with activities of daily living, such as dressing, bathing, and
toileting. You may be given adaptive equipment to assist you with any dressing or bathing tasks that
were difficult either before or after surgery. If you can dress yourself without adaptive equipment,
your occupational therapist will encourage you to do so. If you are having difficulty,
equipment may include a reacher, a dressing stick, a long-handled sponge, a leg lifter,
or a sock aid. Depending on your mobility level and how your home is set up, you may want to
invest in additional equipment, such as a shower chair, a tub transfer bench, grab bars, a commode,
or an elevated toilet seat. It's time to leave the hospital. When you've been cleared to go home,
a hospital Volunteer will come to your room with a wheelchair to bring you to the hospital exit.
Your caregiver should pull the car up to the exit. They should adjust the passenger seat
for you so that it is pulled back away from the dashboard and with the back of the seat slightly
reclined. This will give you space to swing your legs into the car more easily. Using your walker,
move to the passenger side of the car. Slowly turn around using small steps so that your back
side faces the seat and is in contact with the seat. Move your operative leg slightly forward,
reach back for the seat, then lower yourself onto the seat. If you find it hard to move on to your
seat, use a plastic bag to make the surface slippery. While keeping your legs together,
carefully and slowly bring both legs into the car with as little movement as possible. Once
you are in the car and seated comfortably, take the seat back out of reclined position so it is in
the normal upright position and buckle yourself in. Please have someone at home to assist you
during the first two weeks of your recovery after your surgery. During your recovery at home, it
is very important that you always walk using your assistive device to prevent falls. This concludes
the video on post-operative recovery from your hip replacement. By doing the exercises recommended
before and after your surgery and following your doctor's instructions, you will be well on your
way to recovery. Thank you for choosing Rutland Regional Medical Center for your medical procedure
and for taking the time to view this video. All of us wish you a full and successful recovery.