How long does thigh pain last after hip replacement. What causes persistent thigh pain months after surgery. How to manage post-operative discomfort and when to seek medical attention. What are the risk factors for chronic pain following hip arthroplasty.

Understanding Femoral Stem Pain Following Hip Arthroplasty

Hip replacement surgery, also known as hip arthroplasty, is a common orthopedic procedure that can significantly improve quality of life for those suffering from severe hip joint damage. However, some patients experience lingering thigh pain in the months following surgery. This post-operative discomfort, medically termed “femoral stem pain,” can be a source of concern for patients and healthcare providers alike.

Femoral stem pain typically manifests as mild to moderate discomfort in the mid-front region of the thigh. Patients may describe it as an intermittent ache or even numbness. While most cases resolve on their own, persistent pain warrants medical attention to rule out complications.

Prevalence of Thigh Pain After Hip Replacement

Studies indicate that thigh pain is a relatively common occurrence following hip replacement surgery. A 2002 study found it to be a frequent post-operative symptom. More recent research suggests that the increasing use of cementless femoral stems has led to a higher incidence of thigh pain compared to traditional cemented implants.

Why Do Cementless Implants Increase the Risk of Thigh Pain?

Cementless hip implants rely on bone ingrowth for fixation, as opposed to being secured with bone cement. While this technique offers certain advantages, it also comes with a higher likelihood of femoral stem pain. The bone needs time to grow and attach to the implant, which can lead to micromotion and discomfort during the initial healing phase.

Timeline for Post-Hip Replacement Pain Resolution

Pain after hip replacement surgery is a normal part of the recovery process. The body needs time to heal from the significant trauma of joint replacement. For most patients, the pain and swelling gradually subside over the course of 3-6 months post-surgery.

Can thigh pain persist beyond the typical recovery period? In some cases, yes. According to a 2015 study, approximately 10% of total hip replacement patients develop chronic post-operative pain, defined as ongoing discomfort that lasts beyond the expected healing time.

When to Seek Medical Attention for Persistent Pain

If you experience any of the following, it’s advisable to consult your orthopedic surgeon:

• Pain that persists or worsens several months after surgery
• Discomfort that interferes with sleep or daily activities
• New or unusual pain that develops after an initial period of improvement
• Signs of infection, such as fever, redness, or increased swelling around the incision site

Managing Thigh Pain During Recovery: Effective Strategies

While some degree of discomfort is expected after hip replacement surgery, there are several strategies patients can employ to manage pain and promote optimal healing:

1. Home Preparation

Creating a safe and comfortable recovery environment is crucial. This may include:

• Removing tripping hazards
• Installing handrails in the bathroom
• Arranging furniture to accommodate mobility aids
• Setting up a comfortable sleeping area on the ground floor, if possible

2. Proper Wound Care

Meticulous attention to wound care is essential for preventing infection and minimizing pain. Follow your surgeon’s instructions carefully regarding:

• Keeping the incision site clean and dry
• Changing dressings as directed
• Monitoring for signs of infection
• Avoiding submerging the wound in water until it’s fully healed

3. Elevation and Ice Therapy

Elevating the affected leg and applying ice can help reduce swelling and alleviate pain. How should you properly elevate and ice your leg after hip replacement?

• Elevate the leg above heart level when resting
• Apply ice packs for 15-20 minutes at a time, several times a day
• Use a barrier (such as a thin towel) between the ice and your skin to prevent tissue damage
• Continue this regimen as recommended by your healthcare provider, typically for the first few weeks post-surgery

4. Pain Medication

Your orthopedic surgeon will likely prescribe or recommend appropriate pain medication to manage post-operative discomfort. This may include:

• Over-the-counter analgesics like acetaminophen or ibuprofen
• Prescription-strength NSAIDs
• Short-term use of opioid medications for severe pain
• Topical pain relievers

Always follow your doctor’s instructions regarding dosage and duration of pain medication use.

Causes of Persistent Thigh Pain After Hip Replacement

While most patients experience a significant reduction in pain following hip replacement, some may develop chronic thigh pain. Several factors can contribute to persistent discomfort:

1. Implant Loosening

If the bone fails to grow into the implant properly, it can result in micromotion and pain. This is more common with cementless implants during the initial healing phase.

2. Infection

Though rare, post-operative infections can cause persistent pain and require prompt medical attention.

3. Biomechanical Mismatch

In some cases, the stiffness of the implant stem may not match the flexibility of the surrounding bone, leading to stress and discomfort.

4. Periprosthetic Fracture

A fracture in the bone around the implant can cause pain and may require additional surgical intervention.

5. Bone Remodeling

As the body adapts to the new implant, the surrounding bone undergoes remodeling, which can sometimes cause temporary pain.

Impact of Implant Design on Post-Operative Pain

Research suggests that the design of the hip implant can influence the likelihood of experiencing chronic thigh pain. A 2019 study found that patients who received short-stem uncemented hip replacements were more prone to chronic thigh pain compared to those with wedge-shaped, straight-stem uncemented implants.

Role of Individual Anatomy in Pain Development

Interestingly, the same study identified a correlation between bow-leggedness and mid-thigh pain following hip replacement. This highlights the importance of considering individual patient anatomy when selecting and positioning hip implants.

Risk Factors for Chronic Pain After Hip Replacement

Contrary to common assumptions, factors such as age, weight, and overall health status may not significantly influence the likelihood of developing chronic pain after hip replacement. A 2020 study challenged these traditional beliefs, finding no strong correlation between these factors and post-operative pain outcomes.

Instead, the study identified several other potential risk factors for chronic pain:

• Pre-existing chronic pain conditions
• Psychological factors, such as anxiety or depression
• Genetic predisposition to pain sensitivity
• Surgical technique and implant selection
• Post-operative rehabilitation adherence

Importance of Proper Post-Operative Care and Activity Levels

The recovery process following a hip replacement, particularly with cementless implants, requires patience and adherence to post-operative instructions. Returning to high-impact activities too quickly can increase the risk of complications, including persistent thigh pain.

Guidelines for Safe Activity Progression

How can patients safely return to activities after hip replacement without risking implant loosening or chronic pain?

1. Follow your surgeon’s specific recommendations for activity restrictions
2. Engage in prescribed physical therapy exercises to strengthen supporting muscles
3. Gradually increase activity levels as approved by your healthcare team
4. Avoid high-impact activities (e.g., running, jumping) until cleared by your surgeon
5. Listen to your body and report any unusual pain or discomfort to your doctor

Advanced Treatment Options for Persistent Thigh Pain

When conservative measures fail to alleviate chronic thigh pain following hip replacement, additional interventions may be necessary. These can include:

1. Diagnostic Imaging

Advanced imaging techniques such as CT scans or bone scans can help identify the underlying cause of persistent pain.

2. Revision Surgery

In cases of implant loosening or misalignment, a revision surgery may be required to correct the issue and alleviate pain.

3. Pain Management Techniques

Specialized pain management strategies, such as nerve blocks or radiofrequency ablation, may be employed to target specific sources of pain.

4. Physical Therapy

Customized physical therapy programs can address muscle imbalances and gait abnormalities that may contribute to ongoing pain.

5. Pharmacological Interventions

In some cases, long-term pain management may involve the use of medications such as neuropathic pain modulators or low-dose antidepressants to address chronic pain syndromes.

While thigh pain following hip replacement can be concerning, it’s important to remember that the vast majority of patients experience significant improvements in pain and function after surgery. By understanding the potential causes of post-operative thigh pain, following proper recovery protocols, and maintaining open communication with your healthcare team, you can optimize your chances of a successful outcome and improved quality of life following hip replacement surgery.

Thigh pain after hip replacement: Treatment, causes, and more

Most people experience some pain after a hip replacement. Pain usually ranges from mild to moderate and may radiate to the thigh. Doctors call post-hip replacement surgery pain in the thigh femoral stem pain.

A hip replacement is a common procedure that replaces a hip joint that is no longer functional. Some people may need hip replacements as they age due to wear and tear on the joint. Others need them due to degenerative conditions such as osteoarthritis.

According to older data from 2002, thigh pain is a common symptom following hip replacement surgery.

More recent findings suggest that the rise in the use of cementless femoral stems has increased incidences of thigh pain. Historically, surgeons used bone cement to secure cemented hip joints. The new cementless joint allows the bone to grow and attach to it. Despite its benefits, cementless surgeries are more likely to cause femoral stem pain than cemented procedures.

However, while thigh pain is a possible complication, it does not usually persist over the long term. Most hip replacement surgeries result in a significant reduction in pain and improved quality of life.

Read more to learn about how long pain can last, how to cope with it, and more.

Pain after surgery is fairly typical, and a hip replacement is no exception. When a person has this procedure, their body has undergone significant trauma to replace the damaged joint. While this will reduce pain and discomfort in the long term, it can cause acute pain in the short term.

Most people can expect mild to moderate swelling and pain to subside in 3–6 months.

According to 2015 data, post-operative pain becomes chronic in about 10% of people who receive a total hip replacement. This means the pain is ongoing.

If a person experiences pain several months after they have healed from surgery or has pain that interferes with sleep or daily function, it may be a good idea to contact a doctor.

For some people, thigh pain after hip replacement surgery will go away on its own without treatment.

However, others may have pain that lingers for several weeks or months. Strategies for recovering well at home and reducing pain can include:

• Preparing the home: Making sure the home is a comfortable, safe place to recover is an important way to avoid unnecessary pain.
• Proper wound care: People should pay careful attention to wound care to avoid infection and additional pain.
• Elevation and ice: Elevating the affected leg and icing it can reduce swelling and pain.
• Pain medication: Most doctors will prescribe or recommend some form of pharmaceutical pain relief.

Others may experience chronic, or long-term, pain. When typical pain treatments and at-home remedies do not work, a doctor may recommend further options to fix the issue. If a person experiences ongoing pain, they should contact their doctor to discuss their options.

In most cases, thigh pain after a hip replacement is mild to moderate. This pain typically occurs in the mid-front of the thigh. It may feel as if an ache and come and go.

Some people may also experience discomfort that presents as numbness in the thigh.

Various factors can contribute to thigh pain after a hip replacement. The type of surgery, natural biomechanics, and type of hip replacement a person has are all factors. Several of the main causes of thigh pain are:

• a loose implant, meaning the bone cannot grow into the implant, causing small amounts of movement
• an infection
• the bone is more flexible than the stiff stem, causing the implant to painfully press into the cortical bone
• a thigh bone fracture
• bone remodeling, which occurs when new stresses make the bone remodel

According to a 2019 study, the hip joint design may affect a person’s pain following surgery. The study found that people who had short-stem uncemented hip replacements were more likely to experience chronic thigh pain than those who had wedge-shaped, straight-stem uncemented total hip replacement surgery.

In addition, the researchers found that bow-leggedness had links to mid-thigh pain.

Some people may be more likely to experience complications due to physical differences and biomechanics, such as being bow-legged. According to a 2020 retrospective study, physical differences in bone shape likely play a role.

Because it takes time for the bone to attach to a cementless hip joint, a person may need to avoid activity for several months. Returning to activity too quickly may increase their likelihood of complications such as thigh pain. Sometimes, the joint may loosen with activity, causing pain to radiate to the thigh.

Although some people think age, weight, and other factors influence postsurgery pain, this is likely not true. Results from a 2020 study suggest that the following are unlikely to cause thigh pain:

• sex
• age
• weight
• height
• bone density

A person should contact a doctor for mild to moderate pain lasting more than 6 months. Severe pain that makes it difficult to function may also be cause for concern.

Additionally, if other symptoms accompany the pain, it may be a sign of infection. Symptoms that may indicate infection include:

• swelling
• redness
• discoloration
• high fever
• drainage or pus coming from the wound
• pain that worsens with activity or rest

A total hip replacement surgery can significantly improve a person’s quality of life, but it is a major surgery that takes time to heal. Thigh pain is a common complication after surgery. For most people, it will go away on its own, and a person can manage it with medication and home remedies.

Before a person undergoes hip replacement surgery, it is important to discuss potential risks and complications with a doctor.

Thigh pain after cementless total hip arthroplasty: evaluation and management

Review

. 2002 Nov-Dec;10(6):385-92.

doi: 10. 5435/00124635-200211000-00002.

Thomas E Brown 
¹
, Bryan Larson, Frank Shen, Joseph T Moskal

Affiliations

Affiliation

• ¹ Department of Orthopaedic Surgery, University of Virginia, Charlottesville, VA, USA.

• PMID:

  12470040

• DOI:

  10.5435/00124635-200211000-00002

Review

Thomas E Brown et al.

J Am Acad Orthop Surg.

2002 Nov-Dec.

. 2002 Nov-Dec;10(6):385-92.

doi: 10.5435/00124635-200211000-00002.

Authors

Thomas E Brown 
¹
, Bryan Larson, Frank Shen, Joseph T Moskal

Affiliation

• ¹ Department of Orthopaedic Surgery, University of Virginia, Charlottesville, VA, USA.

• PMID:

  12470040

• DOI:

  10.5435/00124635-200211000-00002

Abstract

Data from short- and long-term follow-up studies indicate that thigh pain is a significant complication after apparently successful cementless total hip arthroplasty. In most cases, reported symptoms are mild to moderate, resolve spontaneously or do not progress, and require little or no therapeutic intervention. However, persistent thigh pain may be a source of dissatisfaction or may present as severe, disabling pain. Possible causes include bone-prosthesis micromotion, excessive stress transfer to the femur, periosteal irritation, or a mismatch in Young’s modulus of elasticity that increases the structural rigidity of the prosthetic stem relative to the femur. Thorough diagnostic evaluation of thigh pain is essential to rule out prosthetic infection or loosening, stress fracture, or spinal pathology as the primary source. Treatment options in the aseptic, well-fixed femoral component include medical management, revision of the femoral component, or cortical strut grafting at the tip of the implant.

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Publication types

MeSH terms

Pain after arthroplasty [treatment, prevention]

Joint destruction is a big blow to health, but by no means an irreparable fact. Modern medicine makes it possible to replace the affected joint with an endoprosthesis, thereby restoring the patient’s mobility and the ability to lead a normal life. However, the period after arthroplasty may be accompanied by pain and discomfort. How to get rid of discomfort?

The need to replace the hip and knee joints can be caused by various reasons. The most common is arthritis. It can also be rheumatoid arthritis – a chronic disease in which the joint swells, hurts, and movement becomes difficult. Another reason is avascular necrosis, in which a section of bone is destroyed. In addition, the need for arthroplasty may arise with a fracture of the femoral neck and bone tumors. In these cases, the joints are also affected, and they need to be replaced. Endoprosthetics is a radical, but very productive method of treatment, since artificial joints made using the latest technologies are highly reliable and functional, they allow patients to get rid of severe pain, lameness, and fully return to independence in everyday life.

It should be borne in mind that both the successful operation and the postoperative period are of great importance for returning to the previous activity. The first 3-6 weeks after surgery are especially important, when the patient begins to restore motor skills – leaning on the operated limb, walking, self-care. During this period, physiotherapy and massage are usually prescribed, and the patient, under the supervision of a doctor, is engaged in physiotherapy exercises.

Reference

Approximately 1,500,000 total hip replacements are performed worldwide every year. According to statistics, in developed countries, there is one arthroplasty of large joints per thousand of the population. Recently, a joint replacement surgery was performed with a 3D-printed endoprosthesis.

1. Consequences of arthroplasty

2. Treatment of pain after arthroplasty

3. Preventive measures after arthroplasty

Consequences of arthroplasty

It should be noted that the process of implantation of a hip or knee endoprosthesis cannot be completely painless. In the postoperative period, the patient may experience pain and discomfort.

This is usually expressed as follows:

• aching pain in the area of ​​the implanted endoprosthesis;
• pain in areas adjacent to the implant;
• pain syndrome after exercise;
• Drawing or aching pain in the evening.

Similar symptoms occur even during the successful course of the postoperative period, when there are no defects associated with the prosthesis itself and its installation, and when infectious and inflammatory processes are excluded. Such pains are usually caused by irritation of the nerve fibers in the area of ​​the implanted endoprosthesis and tissue healing, because any operation is an intervention in the subtle and complex world of the human body, and therefore such unpleasant sensations are a natural reaction to the operation.

Treatment of pain after arthroplasty

Before prescribing treatment, the doctor refers the patient to computed tomography and laboratory blood tests. If everything is in order with the endoprosthesis and there is no infection in the body, then the doctor prescribes treatment for the pain syndrome itself. As a rule, this is a complex treatment, including a number of methods.

• Taking pain medication.
• Physiotherapy (baths, electrophoresis, UHF, etc.).
• Reflexology (point impact on certain parts of the body).
• Therapeutic massage.
• Swimming to strengthen adjacent muscles improves implant performance.
• Shock Wave Therapy (SWT) is an impulse impact with the help of a special device on a disturbing area with shock acoustic waves of a given frequency. As a result, the pain decreases, inflammation and swelling are gradually removed, and the functioning of the lymphatic system improves. The nutrition of tissues improves, thanks to which the recovery processes are accelerated. This method is successfully used in medical clinics “Zdorovye Plus” for the treatment of pain after endoprosthetics of the knee and femoral joints.

Taking into account the patient’s condition, his age, individual characteristics of the body and the clinical picture, the doctor prescribes a certain course of certain procedures.

Preventive measures after arthroplasty

In order for the rehabilitation period after arthroplasty to be successful, all doctor’s instructions must be strictly followed. First of all, return to physical activity as soon as possible. Gradually begin to sit down, then get up, go up and down the stairs. Feasible physical activity will avoid swelling and congestion, as well as the formation of blood clots. Yes, it is not so easy to overcome postoperative weakness, but if it is reasonable to distribute the load, follow the prescribed diet during this period, take vitamins, then the recovery will be painless.

If drugs are prescribed, they must be taken strictly according to the schedule, without missing the time of taking. The same applies to medical procedures.

SWT will help speed up the process of rehabilitation after arthroplasty. In the Health Plus network of clinics, this procedure is carried out by highly professional doctors using the latest Swiss equipment, which allows you to perform the prescribed technique as accurately as possible. At the same time, the prices for UVT therapy in the Zdorovye Plus clinics are quite affordable, which makes this method of treatment affordable for almost all segments of the population. If you care about your health, consider visiting our medical center.

Recommendations for patients undergoing total hip replacement

The first days after the operation are the most critical. Your body is weakened by the operation, you have not yet fully recovered from anesthesia, but already in the first hours after waking up, try to remember the operated leg more often, monitor its position. As a rule, immediately after the operation, the operated leg is placed in the allotted position. A special pillow is placed between the patient’s legs, ensuring their moderate dilution. You need to remember that:

• during the first days after the operation it is necessary to sleep only on the back.
• you can only turn on the “non-operated” side, and then not earlier than 3 days after the operation. Turning to a healthy side must be performed very carefully, with the help of relatives or medical staff, who constantly keep the operated leg in a state of abduction. For insurance against dislocation, we recommend putting a special pillow between the legs.
• you can sleep on your “non-operated” side no earlier than 2 weeks after surgery,
• In the first days, a large range of motion in the operated joint, sharp turns of the leg, and rotation in the hip joint should be avoided.
• Sitting in bed or going to the toilet in the first days after surgery, you must strictly monitor that there is no excessive flexion in the operated joint (more than 90 degrees). When you sit on a chair, it should be high. A pillow should be placed on a regular chair to increase its height. Low, soft seats (armchairs) should be avoided.
• it is strictly forbidden to squat down, sit cross-legged, “throw” the operated leg over the leg after the operation.
• try to devote all your free time to physiotherapy exercises.

The first goal of physical therapy is to improve blood circulation in the operated leg. This is very important to prevent blood stasis, reduce swelling, and speed up the healing of a postoperative wound. The next important task of physical therapy is to restore the strength of the muscles of the operated limb and restore the normal range of motion in the joints and support of the entire leg. Remember that in the operated joint, the friction force is minimal. It is a swivel with perfect sliding, so all problems with limiting the range of motion in the joint are solved not with the help of its passive development by the type of rocking, but by actively training the muscles surrounding the joint.

In the first 2-3 weeks after the operation, physiotherapy exercises are carried out lying in bed. All exercises should be performed smoothly, slowly, avoiding sudden movements and excessive muscle tension. During physiotherapy exercises, proper breathing is also of great importance – inhalation usually coincides with muscle tension, exhalation – with their relaxation.

First day: the first exercise is for the calf muscles. Reject with a slight tension your feet on yourself and away from you. The exercise should be performed with both legs for several minutes up to 5 times per hour. You can start this exercise immediately after waking up after anesthesia.

The following exercises are added on the second day after the operation.

The second exercise is for the thigh muscles. Press the back of the knee joint against the bed and hold this tension for 5-6 seconds, then slowly relax.

The third exercise – sliding the foot along the surface of the bed, raise the thigh towards you, bending the leg at the hip and knee joints. Then slowly slide your foot back to the starting position. When doing this exercise, at the beginning you can help yourself with a towel or an elastic tourniquet. Remember that the angle of flexion in the hip and knee joints should not exceed 120 degrees!

The fourth exercise – putting a small pillow under the knee (no higher than 10-12 centimeters), try to slowly strain the thigh muscles and straighten the leg at the knee joint. Hold the straightened leg for 5-6 seconds, and then also slowly lower it to its original position.

All of these exercises must be done throughout the day for several minutes 5-6 times per hour.

On the 2nd day after the operation, in the absence of any complications, you can sit up in bed, leaning on your hands. On the third day, you need to start sitting up in bed, lowering your legs from the bed under the supervision of the staff. This should be done in the direction of the non-operated leg, gradually moving the healthy leg and pulling the operated leg towards it. In this case, it is necessary to maintain a moderately spread position of the legs (use a special pillow). When moving the operated leg to the side, keep the body straight and make sure that there is no outward rotation of the foot. Not earlier than 4-5 days it is allowed to get up by the bed under the supervision of medical personnel. Sit on the edge of the bed with your operated leg straight and in front. Slowly place both feet on the floor.

FIRST STEPS

The goal of this rehabilitation period is to learn how to get out of bed, stand, sit and walk so that you can do it safely yourself.

At this time, you still feel weak, so in the early days, someone must help you by supporting you (you may feel slightly dizzy). Remember, the faster you get up, the faster you can walk on your own. The medical staff can only help you, but no more. Progress is entirely up to you. So, you should get out of bed in the direction of the unoperated leg. Sit on the edge of the bed with your operated leg straight and in front. Before you get up, check if the floor is slippery and there are no rugs on it! Place both feet on the floor. Leaning on crutches and on an unoperated leg, try to stand up. Caring relatives or medical staff in the early days should help you. Leaning on a healthy leg, push the two crutches forward. Then transfer the operated leg to the level of the crutches, slightly bending in all joints. Leaning on crutches and transferring body weight to them, move your healthy leg forward. Repeat all movements in the same order.

When walking in the first 10-14 days, you can only touch the floor with the operated leg. Then slightly increase the load on the leg, trying to step on it with a force equal to the weight of your leg. You can walk for as long as your well-being, the condition of your leg allows, without reducing the time of therapeutic exercises. If you do not do enough gymnastics, incorrectly, abuse walking, the swelling of your legs will increase by the end of the day. In this case, seek clarification from your doctor. Concomitant diseases can support swelling of the legs.

After you have learned to stand and walk confidently without assistance, exercise therapy should be expanded with the following exercises performed in a standing position.

Knee lift

Slowly bend the operated leg at the hip and knee joints to an angle not exceeding 90 degrees, while raising the foot above the floor to a height of 20-30 cm. Try to hold the raised leg for a few seconds, then also slowly lower the foot to the floor.

Leg abduction

Standing on your healthy leg and holding securely on the back of the bed, slowly move your operated leg to the side. Make sure your hip, knee, and foot are pointing inward. Maintaining the same posture, slowly return the leg to its original position.

Leg retraction

Leaning on your healthy leg, slowly move the operated leg back, placing one hand behind the lower back and making sure that the lower back does not bend. Slowly return to the starting position.

We recommend doing the exercises listed above up to 10 times a day for several minutes. They will help you significantly speed up the rehabilitation period and start walking faster without assistance.

Almost every patient has a need to walk up the stairs. Let’s try to give some advice: when moving up, you should start lifting with the non-operated leg. Using crutches, move your unoperated leg to the next step. Shift your body weight to the non-operated leg on the step above. Then the operated leg moves – lift and put it on the same step. The crutches move last or at the same time as the operated leg. When descending the stairs, first place the crutches and the operated leg on the underlying step, and then the non-operated one. Leaning on crutches, bend the non-operated leg at the joints and, maintaining balance, place it next to the operated leg.

If possible, use a railing instead of one crutch. So, once again we repeat the general rules for moving up the stairs – a healthy leg is always on a higher step, a diseased leg is always below, on a lower step. Crutches remain for support on the same step with a sore leg.

EXTRACT HOME

You will be discharged for outpatient treatment under the supervision of a specialist at the place of residence on the 14-15th day, when all the sutures are removed, there is no inflammation of the operated joint, when you perform all the required movements well enough, after X-ray control of the operated joint. The attending physician will tell you the recommendations necessary for discharge.

HOUSES

While at home, it is necessary to continue therapeutic exercises and follow the recommendations of the attending physician. It is also necessary to monitor your health, since exacerbation of chronic diseases, acute infections, hypothermia, overwork can lead to inflammation of the operated joint. With an increase in body temperature, swelling of the operated joint, redness of the skin over it, increased pain in the joint, you should immediately consult a doctor.

Also, take some simple precautions at home. Walk in low-heeled shoes, remove movable rugs and wires from the floor for a while, walk carefully on a damp surface, try not to let pets get under your feet. Do your best homework. Alternate the time of work, rest, gymnastics. Try to walk with the help of relatives and friends.

SHOWING AND BATHING

For the first six weeks after the operation, it is advisable to avoid taking a bath and it is better to wash yourself in a warm shower. At the same time, it is desirable to have someone nearby until you feel confident. If the bath cannot be avoided, then we advise you to follow some simple rules that make it as safe as possible. First, avoid hot baths for up to 6-8 weeks – this is not at all related to the possible heating of your new joint, as patients mistakenly think. Rather, it is caused by the dangerous effect of hot water on the possibility of blood clots in the operated leg. Secondly, when entering the bathroom, always sit on the edge, firmly holding onto the tub with your hands. The legs are transferred in turn to the bathroom, while the entire load should be transferred to the hands with which you must hold firmly. After that, you can carefully dive into the water, while the entire load should be transferred to a slightly bent healthy leg, and it is better to keep the patient straight.

You should also carefully exit the bath, again focusing all the load on the arms and healthy leg. The sore leg moves smoothly out of the bath, remaining in a straightened position.

It is strictly not allowed during the first 1.5 – 3 months to visit a bath or sauna (due to thromboembolic complications).

Once again, we remind you that during this period:

• it is advisable to sleep on a high bed.
• After the operation, you must sit on high chairs (like bar chairs). A pillow should be placed on a regular chair to increase its height. Low, soft seats (chairs) should be avoided. All of the above is important to observe when visiting the toilet,
• it is strictly forbidden to squat down, sit cross-legged, “throw” the operated leg over the leg.
• get rid of the habit of picking up fallen objects from the floor – you should do this with the help of any devices that exclude bending and squatting.

MONITORING

An endoprosthesis is a rather complex structure. Therefore, we strongly recommend that you do not abandon the scheme for monitoring the behavior of a new artificial joint. Before each follow-up visit to the doctor, it is necessary to take an x-ray of the operated joint, it is advisable to take blood and urine tests (especially if you had some kind of inflammation or problems with wound healing after the operation). The first follow-up visit usually takes place 3 months after the operation. During this visit, it is important to find out how the joint “costs”, whether it is possible to start a full load on the leg. The next control is after 6 months. At this moment, as a rule, you are already walking quite confidently, fully loading the operated leg. To determine what and how has changed in the state of the bones and muscles surrounding the joint after a normal load, whether you have osteoporosis or some other bone tissue pathology is the purpose of this examination. Finally, the 3rd control was one year after the joint replacement. At this time, the doctor notes how the joint has “grown”, whether there is a reaction from the bone tissue, how the surrounding bones and soft tissues, muscles have changed in the process of your new, better life. In the future, visits to your doctor should be done as needed, but at least once every 2 years.

REMEMBER! If pain, swelling, redness and an increase in skin temperature appear in the joint area, if the body temperature has increased, you need to URGENTLY contact your doctor!

TIPS FOR THE FUTURE

Avoid colds, chronic infections, hypothermia – your artificial joint can become the very “weak spot” that will become inflamed.

Watch your weight – every extra kilogram will accelerate the wear and tear of your joint. Remember that there are no special diets for hip replacement patients. Your food should be rich in vitamins, all the necessary proteins, mineral salts.

The term of “fail-safe” service of your new joint largely depends on the strength of its fixation in the bone. And it, in turn, is determined by the quality of the bone tissue surrounding the joint. Unfortunately, in many patients who have undergone arthroplasty, the quality of bone tissue leaves much to be desired due to existing osteoporosis. Osteoporosis refers to the loss of mechanical strength of the bone. In many ways, the development of osteoporosis depends on the age, sex of the patient, diet and lifestyle. Women over 50 are especially susceptible to this disease. But regardless of gender and age, it is advisable to avoid the so-called risk factors for osteoporosis. These include a sedentary lifestyle, the use of steroid hormones, smoking, and alcohol abuse. To prevent the development of osteoporosis, we recommend that patients give up highly carbonated drinks, be sure to include calcium-rich foods in their diet, such as dairy products, fish, and vegetables.

Avoid lifting and carrying heavy weights, sudden movements, jumping on the operated leg. Walking, swimming and easy skiing are recommended. Usually, with full restoration of limb function, patients have a desire to continue playing their favorite sport. But, taking into account the peculiarities of the biomechanics of the artificial joint, it is desirable to avoid those types of sports activity that are associated with lifting or carrying heavy weights, sharp blows to the operated limb. Therefore, we do not recommend sports such as horse riding, running, jumping, weightlifting, etc.

Normal sex is allowed 1.5-2 months after the operation. This period is required for the healing of the muscles and ligaments surrounding the operated joint.

We advise you to make some simple devices to make your daily life easier. So, to avoid excessive hip flexion when bathing, use a sponge or washcloth with a long handle and a flexible shower. Try to buy shoes without laces. Wear shoes with a long-handled horn. Wash the floor with a long-handled mop. When traveling in a car, try to move the seat back as much as possible, taking a semi-reclined position.