Concerns of Patients with Total Hip Arthroplasty
Surgery is a stressful procedure for all patients. This is completely normal. Many people for no reason think that by asking questions they are naïve. This is not true. It is completely normal to want to know as many things as possible about the operation you are about to undergo or have already undergone. It is the surgeon’s job to answer all your questions in the clearest way. Some common questions and concerns may be the following:
Why this particular design?
There are countless prosthetic designs available for total hip arthroplasties. The important thing is that any design chosen has a proven good survival. Some arthroplasty designs made their appearance with a lot of fanfare and then disappeared due to poor results. The important thing is that your surgeon is happy and experienced in the type of total arthroplasty he has chosen. Ask about the short-term and long-term effects of this design. Do not be carried away by publications in the non-specialist press, such as newspapers, which say that this type of arthroplasty is the answer to all questions. It may indeed be happening, but it may be withdrawn after a while, which you will never read about in the newspapers. There are countless examples of arthroplasties that were presented, applied to many patients and due to their poor results they had to be withdrawn after some time. This was sometimes the result of their design and other times of the material from which they were made. For this reason, you should always listen to and consult your surgeon who is aware of global developments and the latest data.
My wound is hot. Is this normal ?
The healing that takes place after surgery is related to inflammatory processes. It is therefore completely normal for a wound to be hot for a period. Increased heat can sometimes be a problem, however, and you should consult your surgeon.
I feel numb my skin around the scar. Is this a problem?
No problem at all. Some patients after total hip arthroplasty feel numb their skin in a small area around the wound. These observations are generally of no significance at all.
Is it a problem that my leg is swollen after surgery?
Sometimes yes, sometimes not. Until a person walks fully and normally, the muscle pump does not return blood back to the heart as efficiently as it did before. Therefore, it is normal for an operated leg to be swollen. However, swelling of the leg can sometimes be a sign of deep vein thrombosis. If the swelling is associated with discomfort, is hard and painful, mainly in the calf, you should consult your surgeon. The swelling of the leg will logically have disappeared 3 months after the operation.
My total arthroplasty is still painful. Should I be worried?
It is very common for a total hip arthroplasty to hurt after surgery. This pain is completely different from the intense agonizing pain of arthritis before surgery. However, the discomfort should be mild and should not increase. If it grows, you should consult your surgeon. There is a possibility, even if very small, that the arthroplasty will loosen or that there is an infection.
My joint doesn’t bend as well as before. Is this a problem?
Usually not. After a total hip arthroplasty, we advise patients not to bend their joint more than 90o, i.e. right angle. This is to prevent hip dislocation. Rarely, there may be severe stiffness after a total hip arthroplasty and in this case you should consult your surgeon.
My total arthroplasty produces various sounds. Should I be worried?
Noises produced by the hip are not common. They usually reflect a looseness of the joint and should also disappear when the musculature is strengthened after surgery. Rarely, it may reflect an instability of the hip and may pose a risk of dislocation. You should therefore consult your surgeon. It should be noted that the newer types of arthroplasties with an articulated surface of ceramic in ceramic mainly, and less metal in metal, can sometimes produce squeaking sounds which are not related to instability or possible dislocation, it is the sound caused by these hard metal surfaces when they move on top of each other. This sound has not been associated with any problem in arthroplasty, but it causes dissatisfaction to the patient.
Will I need to make a modification to my home?
Probably not. However, it would be useful to have a handrail on the stairs or handles in the bathroom or other places. You should have a high chair with a straight back and handles, which will help you sit and get up easily and it should be a chair that will be around 50 cm high in its seat so that you do not sit low. This applies to total hip arthroplasties where there is a risk of dislocation, and makes physiotherapy and your exercises easier but also easier to sit and stand up. Beds should usually be raised with chokes in the period after total hip replacement to avoid low sitting. It is preferable to raise the bed than to buy a new bed because this modification is temporary for the first 6-8 weeks. Lifting the bed with a second mattress is usually not a good option because it makes the seat too soft and does not help with getting up.