Total hip replacement – for those following hip precautions

This leaflet is designed to give patients, their family and carers, information about occupational therapy and how this will help with recovery following a total hip replacement surgery.

What is occupational therapy?

Occupational therapy provides practical support to help people recover and overcome barriers preventing them from doing the occupations or daily activities that matter to them. Occupations may include day-to-day self-care such as getting dressed, preparing and eating meals and going to the toilet, being productive at work, studying or caring for others as well as general leisure activities. An occupational therapist will consider all of the patient’s needs – physical, psychological, social and environmental. Further information can be found on the Royal College of Occupational Therapists website (opens in a new tab).

What will the hospital occupational therapist do?

Sometimes people find that they are unable to or have difficulty carrying out their occupations, which is the clinical term for their everyday activities, following an operation.

Based on our assessment in your pre-operative clinic, the occupational therapist may provide:

• Education and advice on how to continue to complete your occupations (everyday activities) following your operation.
• Suggestions of minor changes to your home environment for you or your family to put in place on discharge.
• Equipment for your home to support you after your operation.
• Rehabilitation whilst in hospital to help and support you to work on your agreed treatment goals.
• Working with the multidisciplinary team to coordinate your discharge from hospital including onward referrals to community services if required.

Your occupational therapist is:

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Occupational therapy team contact information (use this number to provide us with furniture heights or if you have any further queries): 01223 216880.

Total hip replacement pre-operative clinic (to be completed with your Occupational Therapist): . . . . . . . . . . . . . . . .

Your popliteal measurement (this is the measurement from the floor to the back of your knee): . . . . . . . . . . . . . . . . . .

“Transfers” means getting on and off of your furniture. When you have a hip replacement, you need to make sure your knee does not come above you hip when you are sat down on the edge of the bed, in your chair or on the toilet.

In order for you to complete safe transfers following your operation, the recommended heights of your furniture should be:

Chair: . . . . . . . . . . . . . . . . . . .

Toilet: . . . . . . . . . . . . . . . . . . .

Bed: . . . . . . . . . . . . . . . . . . .

Other: . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

In order to meet these heights, you may require additional equipment such as chair or toilet seat raisers that will be recommended to you by your occupational therapist. The provision of any equipment will be discussed with you by your occupational therapist.

Recommendations made during your pre-operative clinic appointment:

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Hip precautions

After having a hip replacement there are certain precautions that you must keep to in order to help to protect and prolong the life of your new hip.

For 6 weeks:

• Do not bend your hip more than 90 degrees for example having your knee higher than your hip
• Do not bend over for example, to put on socks or to pick up an item from the floor
• Do not cross your legs or ankles when lying, sitting or standing
• Avoid twisting for example to reach the TV remote or a cup
• Avoid heavy lifting
• Avoid high impact exercise or jumping
• Do not drive.

Activities of daily living (ADL)

Getting on / off furniture

It is recommended to get out of bed towards the side of your operated leg.

Avoid sitting on low chairs / toilets; to reduce the risk of bending too far at your hip. You will be advised during what height your furniture will need to be after your operation and if required, your Occupational Therapist will discuss equipment with you.

Washing

It is recommended that you strip wash standing up or sitting on a chair or toilet that is an appropriate height. A long handled sponge could be helpful to wash your lower half or have someone assist you.

Return to showering when you feel able to get in and out safely and stand for the duration (unless you have a seat). Have a practice first without running water.

Dressing

When dressing, do not bend to reach to your lower body. You are advised to sit down while you are dressing. You will need either to use dressing aids (such as a helping hand grabber, a long-handled shoehorn, and a sock aid) or have someone assist you with dressing your lower half. If you wish to purchase dressing aids before you come in to hospital, they can be bought online or in pharmacy stores. Alternatively these are available to purchase on the ward after your surgery.

Dress your operated side first; you can practice this before the surgery.

Loose fitting clothes will be easier to put on. Bring your own clothes to the ward to practice dressing after your operation.

Sleeping

Sleep on your back for two weeks after the surgery with a pillow between your legs. After these two weeks, you may sleep on your operated side with a pillow between your legs.

Household tasks

You should avoid heavy housework such as vacuuming or changing bed sheets. As you feel able, you can complete light tasks, for example, dusting.

Rearrange your living areas so that items are easy to reach such as your TV remote, to avoid bending and twisting.

You may wish to consider how you will do your shopping initially following discharge as you will be unable to drive – perhaps family can support you with this or you could do the shopping online).

Cooking / preparing meals

• Cook simple meals; consider using ready meals and pre chopped vegetables.
• Before your surgery, if possible, batch cook and stock up your cupboards and freezer.
• Reorganise your kitchen so items are easy to access for example placing items closer together and at counter height to avoid bending to low cupboards.
• You will use a mobility aid after your surgery, and this will make carrying items difficult. You can slide items along kitchen surfaces or carry food in Tupperware or drinks in a flask in a bag over your shoulder.
• You may wish to consider keeping a chair in the kitchen, if there is space, to reduce need to carry things between rooms. If required consider eating at the kitchen worktop or a table.
• Initially, having a friend / relative to give you a helping hand with these tasks, can be very useful, while you can focus on getting used to your new routine and ensuring you adhere to your hip precautions (as mentioned above).

If you have any questions / concerns about managing your daily activities, speak to your occupational therapist on the ward after your surgery for additional advice.