Activity

It takes about 2 months for your hip prosthesis to heal in place. During these first 2 months:

• Be extra careful not to fall.
• Avoid strengthening exercises, stretching, or heavy lifting (above 25 pounds or so). Avoid any high impact or jar¬ring activities (jumping, jogging, sports, etc).
• Outpatient Physical Therapy is not routinely prescribed unless you have a specific issue that requires it. We can discuss the need for therapy at your next visit.

Gentle motion of the hip can be helpful for your recovery. There are 3 activities that we encourage:

• Walking—You can walk as much as your pain will allow. Avoid overdoing it; try not to walk to the point of fatigue or soreness. Watch for uneven surfaces. It’s a good idea to begin with level ground before progressing to hills.
• Stationary bike (recumbent is fine) – Begin with zero or low resistance. Start with a few minutes at a time, and progress slowly.
• Pool activities — Wait 2 weeks before using the pool. Practice gentle walking, side-stepping, or marching in place. Avoid kicking or lap-swimming for the first 2 months

You may transition from your walker or crutches at your own pace. Try to increase your weight bearing by practicing a normal gait every day. As a rule of thumb, continue to use a cane or crutch until you can walk without a limp.

Wound Care

You may shower 24 hours after your sutures have been removed. Please leave steri-strips in place until they begin to fall off. Call the office if you notice ongoing drainage or increasing redness near the incision. Keep the incision dry until there is no drainage.

Pain control

You may continue to ice and elevate as long as it is helpful. Over the counter anti-inflammatory medication, and Tylenol, are recommended. Narcotics may be necessary for uncontrollable pain, but try to wean from them as soon as possible.

Preventing blood clots

Continue to take Aspirin for the first month after surgery to decrease the risk of blood clots (unless otherwise instructed). Avoid long periods of immobility (for example, long trips in a car or plane).

You may stop using TED compression stockings, unless otherwise instructed.

Driving

Avoid driving while on narcotic medication. Otherwise you may drive when it is not painful to do so, and your strength, stamina, and reflexes have improved

Dentist

Antibiotics are recommended prior to certain dental procedures for the first 2 years after joint replacement. Call the of¬fice for a prescription. If possible, avoid elective dental procedures for the first 3 months after surgery.

Follow Up Appointment
Please follow up with Dr. Downer 8 weeks after surgery unless otherwise instructed.

1. You may shower tonight, letting soapy water run over your incision(s) and patting them dry with a towel. You should avoid submerging the leg (bath, pool, hot tub, etc.) for at least one week.
2. You will continue strict non-weightbearing in the boot for 2 more weeks. After 2 weeks, you will start progressive weight bearing in boot. Please refer to the separate handout.
3. Use an ace bandage or a thick sock to prevent the boot from rubbing on the incision(s).
4. You will wear the boot at all times (including sleeping), except for the following:
   • Bathing, showering
   • Exercises
   • In a completely controlled environment, for the purpose of icing
5. You will start doing exercises for the ankle to maximize your post-op flexibility. You will do these twice daily, once in the morning and once in the evening:
   • Write the alphabet with your foot. Do two repetitions.
   • Stretch the Achilles by placing a towel across the ball of your foot and pulling up. Hold each stretch for a five-count and do five repetitions.
6. You will continue to ice and elevate the leg as much as possible. Elevating the leg above the level of the heart will reduce the amount of time required to bring down the swelling.
7. You should continue taking the blood clot prevention medication (aspirin or equivalent) as prescribed until you are at least 4 weeks post-op.
8. Formal physical therapy will begin at 4 weeks post-op. A referral will be provided today in clinic.
9. I would like to see you back in 2 weeks for an incision check.

1. You may shower tonight, letting soapy water run over your incision(s) and patting them dry with a towel. You should avoid submerging the leg (bath, pool, hot tub, etc.) for at least one week.
2. You may begin progressive weightbearing in the walking boot. Please refer to the separate handout.
3. Use an ace bandage or a thick sock to prevent the boot from rubbing on the incision(s).
4. You should come out of the walking boot/brace and perform exercises to maximize your post-op ankle flexibility. You should perform the following exercises twice per day, once in the morning and once in the evening:
   • You should work on 3 sets of 15 reps of dorsiflexion (up), eversion (out) but avoid plantarflexion (down) and inversion (in) for now.
   • Stretch the Achilles by placing a towel across the ball of your foot and pulling up. Hold each stretch for a five-count and do five repetitions.
   • Plantarflexion (down) and inversion (in) may begin at 4 weeks post-op.
5. You should continue taking the blood clot prevention medication (aspirin or equivalent) as prescribed until you are at least 4 weeks post-op.
6. Physical therapy may begin at 4 weeks post-op. A referral will be provided today.
7. I would like to see you back in 4 weeks for your next follow-up appointment. We will obtain new x-rays at that time. If there is appropriate evidence of healing, we will likely have you begin progressive weightbearing in the boot.

1. You will begin progressive weightbearing in the boot and continue this until your next follow-up. Please refer to the separate handout.
2. You may now remove the boot for sleeping and driving.
3. You should continue to perform the following exercises to maximize your post-op ankle flexibility. You will do these twice daily, once in the morning and once in the evening:
   • Write the alphabet with your foot. Do two repetitions.
   • Stretch the Achilles by placing a towel across the ball of your foot and pulling up. Hold each stretch for a five-count and do five repetitions.
4. You will continue to ice and elevate the leg as much as possible. Elevating the leg above the level of the heart will reduce the amount of time required to bring down the swelling.
5. I would like to see you back in 4 weeks for your next follow-up appointment. We will obtain new x-rays at that time. If there is appropriate evidence of healing, we will likely have you begin transitioning out of the walking boot and into regular shoes.

1. You may shower tonight, letting soapy water run over you incision(s) and patting them dry with a towel. You should avoid submerging the leg (bath, pool, hot tub, etc.) for at least one week.
2. You will be strict non-weightbearing in the walking boot.
3. Use an ace bandage or a thick sock to prevent the boot from rubbing on the incision(s).
4. You will wear the boot at all times (including sleeping), except for the following:
   • Bathing/showering
   • Exercises
   • In a completely controlled environment, for the purpose of icing
5. In order to maximize your post-op ankle flexibility, you should come out of the walking boot and preform the following exercises, twice per day:
   • Write the alphabet with your foot. Do two repetitions.
   • Stretch the Achilles by placing a towel across the ball of your foot and pulling up. Hold each stretch for a five-count and do five repetitions.
6. You will continue to ice and elevate the leg as much as possible. Elevating the leg above the level of the heart will reduce the amount of time required to bring down the swelling.
7. You should continue taking the blood clot prevention medication (aspirin or equivalent) as prescribed until you are at least 4 weeks post-op.
8. I would like to see you back in 4 weeks for your next follow-up appointment. We will obtain new x-rays at that time. If there is appropriate evidence of healing, we will likely have you begin progressive weightbearing in the boot.