The muscles and ligaments around your total hip replacement hold the ball in the socket. These take time to heal after surgery. Therefore, positions that will stress these muscles and ligaments are restricted following surgery. The object of these restrictions is to prevent the hip from dislocating.

It is important to avoid two basic positions:

*extreme bending at the hip
*crossing your legs

For the first 6 weeks you must:

• use an elevated toilet seat
• avoid sleeping on your stomach
• avoid sleeping on the operated side
• place pillows between your legs when sleeping on your back or unoperative side
• avoid crossing your legs at any time
• avoid sitting on low chairs or couches- sit only in chairs with arms where your knees remain lower than your hips
• avoid leaning forward while sitting
• avoid flexing your hips more than 90 degrees or rotating your foot and leg inward
• avoid picking up objects from the floor or bending to put on your socks and shoes

Medications

Take prescription medication(s) only as directed. Do not take any over the counter medication unless you have discussed it with your physician.

Diet

Eat a well balanced diet.
A multi-vitamin capsule each morning for 1 month is advisable.
Pain medication may be constipating - we encourage you to drink lots of fluids and increase your intake of fruits and fiber.

Incision Line Care

Your staples will be removed 2 to 3 weeks after surgery, either at home by a visiting nurse or at your doctor's office. You do not need to keep the incision covered by a bandage - leaving the incision open to the air facilitates healing.

If you notice any of the following symptoms of infection, please call the office immediately:

• drainage from the incision
• the incision becomes red and very hot
• you develop a fever over 100 degrees

Showers

You are usually allowed to shower 5 to 7 days after your surgery. You should pat the incision dry - do not rub it or apply creams or lotions. If you are unsteady standing, you may use a stool or chair.

Support Stockings (T.E.D. Hose)

Continue wearing your support stockings 24 hours a day or as instructed by your physician. The length of time that you will have to wear them depends on your activity level and the amount of swelling. Most patients wear the stockings for 4 to 6 weeks after surgery.

You may get ankle swelling for about 3 months, but it should be down in the morning. If you lie down during the day and elevate your leg so your foot and ankle are higher than your heart, the swelling should go away.

Remember not to bend more than 90 degrees at the hip. If the swelling continues or if you have swelling in both legs, you should call your doctor.

The following symptoms may indicate the formation of a clot. If you notice any of these symptoms, please call your doctor immediately:

• calf is painful and feels warm to the touch
• persistent swelling of the foot, ankle, or calf that does not go away with elevation of the leg
• chest pain or shortness of breath (if this chest pain or shortness of breath is sudden or severe, seek emergency care immediately)

Walkers/Crutches

It is important that you use your walker or crutches as directed by your therapist/doctor. If your hip replacement is cemented, you may progress from a walker or crutches to a cane when you feel safe and comfortable. If your hip replacement is uncemented, you will need to continue using the crutches for at least 6 weeks per your doctor's instructions.

Daily Activity

Walking is very important for the success of your hip surgery - but you must avoid the extremes of too little or too much.

1) Do not sit for longer than 30 to 45 minutes at a time. Use chairs with arms. You may nap if you are tired, but DO NOT stay in bed all day. Frequent short walks, either indoors or outdoors, are the key to a successful recovery.

2) You may experience discomfort in your operated hip and you may have difficulty sleeping at night. This is part of the recovery process. Getting up and moving around often alleviates some of the discomfort.

3) You should do stairs with support. Do one step at a time - "good: leg up - "bad" leg down. Use a railing if available.

4) You may be a passenger in a car, but you should sit on a firm cushion or folded blanket to avoid sitting too low. Be careful to avoid excessive bending of the operated hip getting in and out of the car.

5) You may drive a car with an automatic shift when you are walking independently with a cane.