Hip replacement surgery is a key clinical treatment for hip joint diseases, including total hip replacement and hemi-hip replacement. Total hip arthroplasty is applicable to osteoarthritis, rheumatoid arthritis, traumatic arthritis, aseptic necrosis of the femoral head, and partial hip fractures, mainly for patients with high activity levels and long life expectancy. Hemi-hip replacement is mainly for patients with normal or mild acetabular disease, elderly, with low activity levels, and unable to withstand long-term and major surgical treatments.

With the increasing trend of population aging in our country, the number of medical cases for hip replacement surgery is increasing. With the development of medical technology, surgical methods are constantly evolving, and total hip joint replacement has long played a key role in improving joint function, relieving pain, and improving the quality of life of patients.

What is hip replacement surgery?

Hip replacement surgery is a surgical method that replaces the human hip joint surface, femoral head, and acetabulum damaged by disease or injury. Its purpose is to remove the disease, relieve pain, and restore the activity and function of the joint. Total hip replacement includes the replacement of the acetabulum and femoral head, while hemi-hip replacement preserves the acetabulum and only replaces the femoral head.

What are the complications after hip replacement surgery?

1. Pulmonary embolism: Sudden chest pain resembling pleurisy, shortness of breath, blue lips, tachycardia, and blood in sputum.

2. Deep vein thrombosis: Pain and swelling on the affected side, weakened or diminished dorsalis pedis artery, abnormal color and temperature of the lower limb skin, subjective sensation of numbness, and increased circumference of the calf.

3. Infection: High fever after surgery, swelling and severe pain on the affected joint, limited joint movement, and abnormal white blood cell count.

4. Nerve injury: Numbness and muscle weakness on the affected side.

5. Dislocation: Pain on the affected side, limited activity, and reduction in strength. X-ray examination is the gold standard for confirming dislocation. The key reasons for dislocation after hip replacement surgery include: long-term bed rest leading to reduced hip joint tissue function, loss of strong joint maintenance, poor posture management, incorrect rehabilitation treatment, and excessive joint movement.

Three, how to prevent dislocation after hip replacement surgery?

1. Before surgery: Improve the assessment, assess the consistency of the acetabular structure, and properly estimate the size of the prosthesis needed and the amount of muscle to be cut.

2. During surgery: Select an effective surgical approach, ensure that the anterior tilt angle and abduction angle are within the effective range, maintain the support of the surrounding soft tissues of the hip bone after replacement, and reconstruct the external rotation muscle group.

3. After surgery: Implement an initial rehabilitation plan and carry out appropriate rehabilitation training.

3.1 Postoperative posture: (Lying flat) separate the patient’s lower limbs, the affected side is in external rotation and neutral position, a thin soft pillow is placed vertically between the calf and knee, raise the affected side to prevent swelling.

When lying on the side, if the affected limb is on top, place a pillow between the two legs; if the affected limb is on the bottom, do not place a pillow.

3.2 Initial rehabilitation exercise:

Ankle pump exercise: After the anesthetic effect of surgery wears off, instruct the patient to perform ankle pump exercises as soon as possible, which is beneficial for venous return and relieves swelling and discomfort.

Gluteal muscle contraction and leg extension exercises: involuntarily tighten the gluteal muscles, hold for 5 seconds, and then relax. Do 10 times each time, 3-4 times a day.

Straight leg raising exercise: After muscle tension is restored.

Load hip flexion, hip flexion knee flexion: Training starts on the first day after surgery.

Initial bed activities: Assess the patient’s muscle tension, cognition, and pain score, and use a walker to help get out of bed as soon as possible after surgery. Within one month after surgery, do not overextend the body when standing or sitting, slightly extend the affected side, and maintain the angle between the affected side and the body greater than 90°.

3.3 Specific guidance for daily living behavior:

Seating posture: Choose a suitable high stool, commode, and prevent crossing legs or sitting in a circle within one month.

Sitting posture: Prevent crossing legs and pigeon toes from standing up, and do not turn around quickly within one month after surgery. When turning around, rotate the body and the affected side separately.

Walking: Hold your head up and chest out, look straight ahead, lift the walker with both hands, move one step, and support the body with both arms, first step on the affected side and then on the healthy limb, with moderate steps, not exceeding the walker.

Wearing socks and picking up items: within 6-8 weeks after surgery, do not bend down or squat to wear shoes, and can rely on sock aids, when sitting, the affected side bends backward, and the healthy side is in front to wear socks. When picking up items on the ground, you can use auxiliary equipment to prevent bending down.

Four, do you need to remove the suture and have a follow-up examination after surgery?

With the development of intelligent technology, after hip replacement surgery, cosmetic skincare suture thread is used, which does not require suture removal. After hospitalization, follow the specific instructions of the doctor and nurse to change the dressing, generally once every 2 days. Remember to change it immediately if the medical dressing outside the wound bleeds or gets wet accidentally. Generally, re-examination is carried out one week, one month, and half a year after hospitalization, the specific time is decided by the condition of the disease.

Five, What should be prepared at home before hospitalization?

1. Walker, 2. Commode

3. Seat height stool, 4. Pillow core or ladder-shaped pillow