Discharge Protocol for Hip Replacement & Resurfacing

Timothy J Jackson, MD

Discharge Protocol for Hip Replacement and Resurfacing

If Discharged to Home

• Take 10 deep breaths each hour
• Get up and walk every hour. Walk as much as possible.
• Use walker only as needed. Progress to full weight-bearing as quickly as possible, unless instructed otherwise.
• Keep incision dry until 10 days after surgery. Then may begin showering.
• Do not bathe or swim until incision completely healed.
• Home health nurse, if applicable, will visit you in your home. Please share instructions below.
• Home physical therapist will also visit you in your home for the first 2 weeks post-op. As soon as possible, you should transition to therapy in an outpatient physical therapy center.
• Keep your post-op visit with Dr. Jackson at 10-14 days post-op.

Instructions for Home Health Nurse:

• See patient once daily for 3 days, then 3x/week for 2 week. Check vital signs at each visit.
• If on Lovenox in hospital, discharge on Lovenox for 2 weeks, then convert to aspirin for additional 4 weeks.
• If normally on Coumadin at home, discharge on Lovenox and regular dose of Coumadin, discontinue Lovenox when therapeutic on Coumadin. PLEASE REQUEST PRIMARY CARE PHYSICIAN TO MANAGE COUMADIN.
• Instruct on incision care, pain management, and hip precautions (posterior THAs only)
• May get incision wet in shower 10 days after your surgery. No baths or swimming until incision closed completely.
• Silver dressing may stay on for 10 days. Only remove if need for incision checks.
• Let steri-strips fall off on their own.
• Patient should return to Dr. Jackson’s office for incision check at day 10-14 after surgery.
• Anti – embolism stockings to be worn for 4 weeks.

Instructions for Home Physical Therapy

• See patient for 3x per week until able to transition to outpatient PT center. Please encourage transition to outpatient PT center as soon as possible.
• Weight bear as tolerate, unless otherwise stated.
• May obtain a rolling walker, raised toilet seat and /or any other assistive device if needed.
• Instruct on hip precautions (posterior THA only) and on home safety.
• Increase mobility with gait training, transfers, and stair climbing.
• DO NOT DRIVE UNTIL CLEARED BY MD.

If Discharged to Skilled Nursing Facility or Rehabilitation Facility

• Physical therapy twice daily & Occupational therapy to evaluate.
• If on Lovenox in hospital, discharge on Lovenox for 2 weeks, then convert to aspirin for additional 4 weeks.
• If normally on Coumadin at home, discharge on Lovenox and regular dose of Coumadin, discontinue Lovenox when therapeutic on Coumadin. PLEASE REQUEST PRIMARY CARE PHYSICIAN TO MANAGE COUMADIN.
• Instruct pt on incision care, pain management, and hip or knee precautions.
• May get incision wet in shower day 5 after surgery. No baths or swimming until incision closed completely.
• Silver dressing may stay on for 10 days. Only remove if need for incision checks.
• Let steri-strips fall off on their own. If patient is discharged to home before 14 days,
• Patient should return to Dr. Jackson’s office for incision check at day 10-14 after surgery.
• Also patient should follow up with Dr. Jackson at 8 weeks post-op.
• Anti – embolism stocking to be worn for 4 weeks.