TOTAL HIP REPLACEMENT PRE AND POSTOPERATIVE CARE

The condition being a degenerative condition gradually may deteriorate becoming unbearable and the non-operative interventions may fail to be effective. Operative management of osteoarthritis of the hip involves surgical replacement of the hip joint. The total hip replacement surgery is a major surgical operation that requires effective pre and post-operative care for the patient to ensure positive patient outcomes. Pre-operative Care for Hip Replacement The initial and one of the critical preoperative preparations for the hip replacement surgery is the patient’s psychological preparations. Evidence has shown that patients who are well counselled and understand what to expect in surgery have better recovery post-surgery and also have reduced pain levels as well as mental health concerns post-surgery (Edwards, Mears & Lowry Barnes, 2017).

The patients also ought to be assessed for any infections such as skin, urinary dental among other infections which would increase the risk of hematogenous seeding, any underlying infections must be treated by antibiotics prior to the patient undergoing the surgical intervention. Dental assessment for the patient is critical to identify any dental infections which could lead to infections of the prosthesis leading to post=operative complications. Any dental procedures should be done two weeks prior to the surgery A methicillin-resistant Staphylococcal aureus screening should be completed as part of the patient assessment for infections and managed before surgery. Admission of the patient for the surgery should be done to prepare the patient before her surgery. Among the essential preoperative preparations include a reassessment of the patient to confirm that their health status has not changed.

The prophylactic antibiotic administration is essential to prevent the risk of infection. The preferred prophylactic medication of choice is Cefuroxime or Clindamycin for patients allergic to beta-lactam (Hickson et al. The day prior to surgery the patient should be prepared psychologically for the surgery, dentures removed as well as any other clothing or jewellery. The patient will be advised to remain nil per oral for the 12 hours preceding the surgery and informed of his or her premedication schedules. The patient should then sign an informed consent for the surgery having understood the risks of the surgery and the procedures involved in the surgery. A hip X-ray will be done to confirm the location and position of the prosthesis. Ambulation is encouraged early to promote recovery and prevent pressure sores as well as the occurrence of lung congestion or infections which are common post-operatively (Lemmey & Okoro, 2013).

Depending on the patient’s condition, the physiotherapist can initiate simple bed exercises or stand the patient out of bed taking a few assisted steps if they are able and is safe to do so. Foot pumps or ant embolic stockings are applied to prevent the occurrence of thrombosis. The second day following surgery blood levels and X-rays are repeated and if the blood levels are within normal, the drains are removed and antibiotic infusion is stopped with the removal of infusions. A home visit by the nurses is important to monitor progress on discharge. Patient education prior to discharge is critical to ensure that the patient understands the correct care and positioning during their recuperation period at home. References Aresti, N.