Total Hip Replacement

  1. General information
    1. Replacement of both acetabulum and head of femur with prostheses
    2. Indications
      1. Rheumatoid arthritis or osteoarthritis causing severe disability and intolerable pain
      2. Fractured hip with nonunion
  2. Nursing interventions
    1. Provide routine pre-op care.
    2. In addition to routine post-op care for the client with hip surgery
      1. Maintain abduction of affected limb at all times with abductor splint or 2 pillows between legs
      2. Prevent external rotation (may vary depending on type of prosthesis and method of insertion) by placing trochanter rolls along leg.
      3. Prevent hip flexion.
        1. keep head of bed flat if ordered.
        2. may raise bed to 45° for meals if allowed.
      4. Turn only to unoperative side if ordered; use abductor splint or 2 pillows between knees while turning and when lying on side.
      5. Assist client in getting out of bed when ordered.
        1. usually on second post-op day.
        2. avoid weight bearing until allowed.
        3. avoid adduction and hip flexion; do not use low chair.
    3. Provide client teaching and discharge planning concerning
      1. Prevention of adduction of affected limb and hip flexion
        1. do not cross legs.
        2. use raised toilet set.
        3. do not bend down to put on shoes or socks.
        4. do not sit in low chairs.
      2. Signs of wound infection
      3. Exercise program as ordered
      4. Partial weight bearing only until full weight bearing allowed