Hip replacement surgery restores motility and relieves pain. For example, in the United States alone, more than 285,000 operations are performed annually. However, the success of this procedure is highly dependent on the patient's post-operative care. One of the most complex daily activities is taking a shower, as motility is temporarily limited and it is not possible to distribute the weight on the "new" hip.
Steps
Part 1 of 4: Making Bathroom Changes Before Surgery
Step 1. Purchase a shower seat or commode chair at a sanitary ware store
In this way, you can remain seated while you wash making it much easier to do the operations with the sponge and soap. This support also prevents the operated joint from bending at a higher 90 ° angle, supports your butt and helps you get up effortlessly after a shower.
- Look for a product built in metal, non-slip and equipped with a backrest for greater stability; plastic chairs are not as strong.
- Choose a model with a seat 42-45 cm from the floor to prevent the hip from bending more than 90 °.
- Look for a chair with a footrest that will allow you to eventually shave your legs without forcing yourself to lean forward.
Step 2. Install a bidet near the toilet
This simple toilet allows you to wash after you have evacuated, as it sprays hot water directly on your butt; some models are also equipped with a flow of hot air to dry the private parts.
It is worth installing a mobile hand shower to control and direct the flow of water over the body as you prefer, especially if you have to wash from a sitting position
Step 3. Install vertical and horizontal support bars near the toilet
The horizontal ones help you sit on the toilet and get into the bathtub, while the vertical ones provide support when you need to get up from both the shower and the toilet.
Remember not to hold on to the towel bars, as they are not strong enough to withstand your weight and you may eventually fall
Step 4. Purchase a raised toilet seat
That way, you don't bend the joint beyond the 90 ° angle as you sit down after surgery. One of the precautions to be taken after this type of operation is to avoid excessive bending (greater than 90 °); consequently, you must avoid having the knee higher than the hip when you sit down.
You can buy a mobile riser or have a safety structure installed. During the preoperative interview ask the orthopedist where you can buy these items
Step 5. Place a non-slip rubber mat with suction cups or silicone decals on the bottom of the tub or on the floor surrounding the toilet
This way, you avoid slipping or falling when you are in the bathroom.
Remember to spread another similar mat outside the shower or tub to have a safe footing after washing
Step 6. Move all personal care products so they are close at hand
Put the shampoo, sponge, and soap a short distance from the shower seat so you don't tire trying to grab them while recovering.
If possible, switch from soap to liquid detergent. The bar of soap slips and falls easily from your hands forcing you to bend down or stretch to retrieve it; from this point of view, liquid soap is much easier to use
Step 7. Prepare a stack of clean towels in the bathroom
You can store them on the lowest shelf or in a nearby spot that you can easily reach; this little shrewdness saves you the trouble of having to get up and look for one to dry yourself.
Step 8. Remember that you cannot shower for 3-4 days after the surgery
At this stage, the cut and dressing should not get wet; the surgeon will be able to tell you when you can go back to washing normally.
- In the meantime, wash your upper body with your usual soap and water using the sink or a small tub. You can ask the hospital nurse to help you with intimate hygiene; this professional knows how to assist you.
- Since you don't have to do any activity other than recovering from the operation, you don't sweat a lot; so focus on rest and relax.
Step 9. Ask an occupational therapist to assess the condition of the home bathroom
If you do not know which changes are necessary or most suitable, ask the orthopedist or physiatrist to refer you to a qualified therapist who can inspect the area and suggest the safety precautions to be taken before the surgery.
Part 2 of 4: Shower after Surgery
Step 1. Protect the incision from water if a waterproof dressing has not been applied to you
In most cases water resistant gauze is used; as a result, your doctor may authorize you to take a shower but with some precautions. However, if regular gauze has been used, your surgeon warns you not to wet the area, as the moist dressing promotes the proliferation of dangerous microorganisms, which in turn can trigger an infection.
- To protect the cut without using waterproof gauze, take a plastic bag and cut it so that it just covers the dressing (it should be a few centimeters larger); prepare two such covers in case the first one has holes.
- Lay the two plastic sheets over the cut and tape them together. Check that the tape adheres to the skin to avoid water infiltration; if you can't do it yourself, ask someone to help you.
- You can also use medical or surgical tape, available from pharmacies.
Step 2. Use a wet cloth to remove the tape from the skin and water repellent dressing
Almost all types of tape cause some pain when peeled off the epidermis; using a damp towel you can facilitate operations and minimize suffering.
Do not reuse the plastic sheets as they may tear when you peel off the adhesive tape; make a new pair every time you shower
Step 3. Place both crutches on the floor followed by the sound leg and finally by the operated one
Typically, the orthopedist recommends using crutches after surgery to avoid transferring excessive weight to the new prosthesis.
Make sure they are within easy reach outside the shower enclosure so that you can easily grab them after washing
Step 4. Let someone assist you as you undress and prepare the shower seat for you
Having a family member, friend, spouse, or professional home care assistant makes it easier for you to work in the shower and prevent you from tripping or falling.
Make sure you have a clean towel handy, which you can leave on the rubber mat on the floor, for example, just outside the tub or near the shower seat
Step 5. Sit in the car seat with someone's help
If you think you can wash yourself, ask your caregiver to stay out of the bathroom where they can hear you in case you need them.
Step 6. Turn on the tap and start washing
Use a sponge with a long handle to wash your feet and legs; then switch to a normal sponge for the rest of the body.
You can get up from the seat once or twice while washing, as long as you first take care to dry your hands with a towel placed near you and grab the vertical support bars
Step 7. When finished, turn off the tap and slowly lift yourself out of the seat
Make sure your hands are dry when you place them on the horizontal or vertical support structure to avoid losing your grip; you can also ask an assistant to help you.
Step 8. Pat your skin dry with a clean cloth
At this stage, remember not to bend the torso more than 90 ° with respect to the legs; also avoid turning your feet excessively outward or inward when standing and do not twist your body.
Hold on to the horizontal bars and gently pat your feet on the towel on the ground to dry them
Part 3 of 4: Recovering after the Surgery
Step 1. Play an active role in the healing and recovery phase
This means taking advantage of the advice and guidance of the medical staff made up of orthopedic surgeon, physiatrist and their collaborators, as well as your loved ones to support the recovery phase.
It takes some time to get back to daily activities, and some lifestyle changes may need to be made in the meantime. Washing, walking, running, using the bathroom, and sexual intercourse all need to undergo changes that take into account your new hip
Step 2. Do not cross your legs for eight weeks after the operation
This gesture can cause dislocation of the prosthesis.
Step 3. Do not bend the joint beyond 90 ° and do not lean forward when sitting down
Do not bring your knees higher than your pelvis and always keep your back straight when sitting.
Step 4. Ask someone to pick up items that fell on the floor while you are in the chair
This precaution is especially important when you wash yourself. If the bar of soap slips from your hands while you are in the shower, the automatic reflex is to bend down to pick it up.
- To minimize the risk of this happening, replace the soap bars with liquid detergent;
- Do not pick up any objects that have fallen on the bathroom floor. Dry off, get out of the shower or tub, and ask a family member or caregiver for help.
Part 4 of 4: Read up on the Intervention
Step 1. Learn the anatomy and physiology of the hips
These joints are similar to ball joints. The spherical structure is none other than the head of the femur, the long bone of the thigh, while the concave portion (acetabulum) is present on the iliac bone (the pelvis); when you move your legs, the sphere rotates inside the concavity.
- When the hip is healthy, the femoral head slides smoothly in all directions within the acetabulum. This phenomenon is possible thanks to the smooth cartilage, a flexible tissue that covers the ends of the bones and acts as a shock absorber.
- If the cartilage wears or is damaged due to a fall or an accident, the movement of the "ball joint" becomes more difficult, with more friction; all this causes damage to the bone structure and reduces the motility of the legs.
Step 2. Be aware of the factors, such as age and disability, that can lead to the need for hip replacement surgery
Although there are no absolute weight or age criteria for establishing complete hip replacement surgery, it has been found that most patients are between the ages of 50 and 80. Orthopedic surgeons evaluate the condition of the joint on a case-by-case basis, but recommend the procedure if:
- Complaints of joint pain that severely limits the ability to carry out daily and elementary activities;
- Report that pain is present both at rest and during movement, during the night and day;
- You suffer from joint stiffness which limits the normal range of motion of the hip, especially when you have to lift your limbs while walking or running
- You have a degenerative pathology of the hip, such as osteoarthritis, rheumatoid arthritis, osteonecrosis, fractures or, in very few cases, childhood joint diseases;
- You get no benefit or pain relief with drug treatment, conservative treatments, and orthopedic aids (cane or walker).
Step 3. Ask your doctor if you need a full or partial hip replacement
During a partial surgery, only the head of the femur is replaced with a metal ball that flows smoothly inside the acetabulum; in a complete surgery the acetabulum itself is also replaced.
- Full implant (or hip arthroplasty) is a surgical procedure in which cartilage and damaged bone are removed and replaced with prostheses.
- The acetabulum is replaced with a concavity made of durable plastic and stabilized with a substance similar to cement. The surgeon may also decide to simply insert it and allow new bone material to grow to stabilize the prosthesis.
- This procedure eliminates debilitating joint pain and allows you to resume normal daily activities (washing, walking, running, driving, and so on), which had become nearly impossible due to preoperative hip conditions.
Step 4. Try non-invasive therapies before resorting to surgery
Not all patients complain of severe enough pain that they are good candidates for surgery. Also, even if you were, the orthopedist almost always suggests noninvasive treatments first to manage pain, such as medications, exercises, and lifestyle changes (such as weight loss and physical therapy).
