Post-operative Instructions for Hip Arthroscopy

Wound Care

  • You will have a sterile gauze dressing covered with tape. Please keep the dressing clean and dry. You may take a sponge bath, or shower with waterproof plastic wrap over the surgical area (use tape at the edges to prevent leaks).
  • Remove the dressing 3 days after surgery to inspect the incisions. Some clear, yellow, or bloody drainage from the incision is normal. If this happens, keep the incision covered with gauze and change the dressing daily until there is no further drainage. If there is no drainage you may leave the hip open to air. You may get the incision wet 5 days after surgery, but do not submerge in water. Sutures will be removed at your follow up appointment.
  • Occasionally there is excessive bloody drainage; please change the dressing when it becomes completely saturated. Sterile gauze is available at the pharmacy. If you continue to have saturated dressings beyond the first few dressing changes, please call the office.
  • If the incisions are draining pus (opaque, thick, white fluid), or if there is redness that worsens over the next 1-2 days, call the office immediately. Do not apply any ointments or creams.

Activity

You may be weight bearing as tolerated with the use of crutches to assist your operative leg. Please continue to use both crutches at all times for the first 2-4 weeks after surgery. You may gradually increase the amount of time you spend standing and walking. Formal outpatient physical therapy is typically not required.

Avoid heavy lifting, exercising, stretching, running, climbing, squatting, and any jarring activities. Please use pain as your guide; any activity that causes severe pain should be avoided.

Controlling your pain and inflammation

Some pain, swelling, and bruising is expected after surgery. It is usually most severe for the first 2-3 days. The following strategies are especially important during this time.

  • Rest — Take things easy for the first few days, try to rest and avoid prolonged walking or standing.
  • Ice – Apply an ice pack (or a cold therapy machine if you have one) to your operative hip to reduce pain and inflammation. Take care not to put ice directly on the skin. Ice for 30 minutes at a time, and remove for 30 minutes in between sessions. You should continue this for the first 2-3 days or longer if you still have pain and swelling.
  • Elevate – Put pillows under your operative leg, or lie on your opposite hip to elevate. This will help to drain fluid from the leg and reduce swelling.
  • Medication — You may have received a prescription for narcotic and/or anti-inflammatory medication. Please take them as instructed. The medication is most helpful if taken 30-45 minutes prior to any planned activity.

Follow up appointment
If an appointment has not already been scheduled, please call the office at 206-633-8100 and schedule an appointment for 7-10 days after your surgery. During this visit we will examine the surgical incisions, remove sutures if necessary, and take xrays.

Returning to work
You may return to work when it is safe to do so within the above activity restrictions. Please note that your employer may prohibit narcotics while at work. Please continue to rest and ice while at work. You may need to ask for frequent breaks in order to avoid prolonged standing or walking. A doctor’s note or a Duty Status form can be provided during your follow up appointment.

Driving
For those who had LEFT hip surgery, you may drive an automatic transmission once it is comfortable to do so and you are no longer taking narcotic medication. For the RIGHT hip, or those with manual transmission, it may take anywhere from 2-4 weeks depending on your pain level, strength, etc. Please wait to drive until after your follow up appointment so that we can assess your progress.

Medications and common side effects:

  • Narcotics (oxycodone, hydrocodone, etc.) – prescription medication for reducing pain. They may cause drowsiness, confusion, nausea, and constipation. To avoid constipation, increase your intake of fiber, fruits, and vegetables, and stay hydrated. Over the counter laxatives can be taken to treat constipation while on narcotics; please see separate handout or ask your pharmacist.
  • Anti-inflammatories (Ibuprofen, Naproxen, etc.) – available over-the-counter to reduce pain and inflammation. Avoid them if you have diagnosed kidney disease or active ulcers. This medication can cause upset stomach; please take them with food. To treat an upset stomach, take an over-the-counter antacid or proton-pump inhibitor (ask your pharmacist for assistance).
  • Acetaminophen (Tylenol) – Used to reduce pain and decrease fever. Avoid taking this medication if you have liver dis-ease. Taking more than the recommended dose can lead to liver damage. For an adult, it is safe to take up to 3-4,000 milligrams each day (24 hour period). Avoid taking with Percocet, Vicodin, Norco; these prescription narcotics already have acetaminophen in them. It is safe to take Tylenol and an anti-inflammatory at the same time.
  • Antihistamines (e.g., benadryl, hydroxyzine) – Used to treat some side effects from narcotic use, such as itching and nausea. Can cause drowsiness and confusion.

Please call the office if you have the following:

  • Fever above 101°, pus draining from wound, worsening redness or rash
  • Difficulty breathing
  • Continuous bleeding from wound (see “wound care” above)
  • Numbness or weakness of the leg
  • Intolerable pain when the above strategies for pain control have failed.
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About Philip Downer

Phil Downer, MD Dr. Downer is a board-certified orthopedic surgeon with a special interest in hip preservation surgery. Dr. Downer enjoys seeing patients of all ages, but his special interest in joint preservation has led him to treat many younger patients with hip problems, such as hip dysplasia or hip impingement.