SURGERY

DAY 1

On the day after the surgery, exercises are begun. These exercises help in improving body circulation and the circulation of the operated limb. This helps in reducing the swelling and prepares you for early walking.

The exercises also help in reducing the incidence of calf clots (deep vein thrombosis) and lung complications (pulmonary embolism) secondary to calf clots.

• Deep breathing exercises: This is done with a machine called triflometer. To be done in set of 10, twice a day.
• Static Quadriceps exercises: In this exercise, you tighten your kneecap till the count of 3 seconds and loosen it for another count of 3 seconds. To be done in the set of 5, every hour.

• Calf pumps: Moving the foot up and down, at the ankle joint to its maximum This exercise reduces the incidence of calf vein clots.
• Buttocks: Try to lengthen and shorten the operated leg from the hip. This develops your buttock muscles. To be done in set of 5, every hour.
• Upper limb exercises: Done either in sitting or propped up in bed.

• Raising the arms by the side.
• Spreading the arms by the side.
• Bringing the arms together in front
• Elbow bending and straightening.
  
• Spring dumbell.

All to be done in set of 5, twice a day.

Today the nursing staff will help you turn on your side. You may turn on either side. That is, if you wish, you may lie on the operated side as well. While turning on the side it is important to keep the legs spread apart with pillows in between the legs. Keeping the hip and the knee straight.

DAY 2

• Dressing is done and drainage tube is removed.
• The same set of exercises you did yesterday are done today.
• The Epidural medication is continued in reduced dosage. You will be given mild pain relieving tablets.
• Today is the last day of antibiotic course. After the last dose, your intravenous line will be removed.

DAY 3 & 4

• The Epidural tube is removed.
• The urinary catheter is removed.
• Your exercise program will continue.
• You are made to stand up with the help of a walker and may be allowed to walk few steps if your condition permits.
  

In hip replacement surgery, standing and walking start before you start sitting.

• Getting out of the bed.
• Avoid bending the knee and the hip on the operated side.
• With help of sling provided to you, lift your operated leg off the bed.
• Get out the bed on the side closer to your non-operated side.
• Get the non-operated leg on the ground, pivot your body, keeping your non operated leg straight and out.
• Sit at the edge of the bed with operated leg straight out in front.
• Stand with the help of the walker.
• You may put full weight on the operated leg, if cemented hip is used.
• You are allowed to put only 10% of your body weight on the operated leg, if uncemented hip is used.

DAY 5

Onwards, if you have adequate balance, you may be allowed to walk and sit on the chair.

Walking:

• Use walker initially.
• Walk halfway into the walker, keeping the hip straight. Avoid rotating the foot.
• Lift the walker straight up and place it ahead of you by six inches and walk into the walker.

Sitting:

• Use high chair or put a thick pillow on regular chair. Use chair with armrest.
• Back up till you feel the chair touching you.
• Reach for armrest, keep operated leg straight out in front, lower yourself without leaning over.
• Sit and slide back in the chair.
• Reverse this method to stand.
• Never sit on a low stool, chair or sofa.
• Minimum recommended sitting height is 20 inches.
• Avoid very soft surface, as getting up becomes difficult.
• Never cross the operated leg on the other leg.