After a hip replacement, patients stay in the hospital for 3-5 days. After discharge from the hospital, most of them are sent home, where they undergo further rehabilitation. Naturally, people who have undergone surgery are interested in many questions. And the most important of them: how to sit correctly after hip replacement.
Before discharge.
The angle in the hip joint is at least 90 degrees
The main rule that must be followed in the postoperative period concerns the degree of flexion of the leg in the hip joint. According to doctors' recommendations, the leg in the operated joint is allowed to bend at least 90 degrees. Moreover, this applies to sitting both on a chair and on a bed, sofa, inside a car, etc.
Schematic representation of the angle.
Experts advise especially carefully monitoring the degree of limb flexion for 8-12 weeks after surgery. After all, during this period the muscles are not yet strong enough to properly support the bones of the pelvis and hips. Because of this, there is a high risk of postoperative fractures and displacement of the hip joint endoprosthesis.
Treatment of constipation after surgery
Restoring the function of the digestive system after abdominal surgery is aimed at solving several problems:
- normalization of intestinal motility;
- improvement of the condition and function of the mucous membranes of the stomach;
- prevention and treatment of dysbiosis associated with antibacterial therapy;
- prevention of postoperative complications;
- improving the patient's well-being.
Symptoms of constipation include stool retention for 1–2 days, bloating, increased gas formation, false urge to defecate, a feeling of fullness in the rectum, and abdominal pain. If you have regular bowel movements, constipation can be indicated by the dense consistency of stool, a feeling of incomplete bowel movement, as well as the need for strong straining during bowel movements.
The doctor will definitely tell you how to improve your bowel movements after surgery. This applies not only to patients who have undergone intestinal interventions, but also to people operated on for diseases of the pelvic organs. There are several methods for restoring bowel movements:
- Medication. The doctor will prescribe digestive enzymes, probiotics, and drugs to improve intestinal motility. It is advisable to resort to painkillers; they will help you better endure the early postoperative period. Complex treatment will help restore normal functions of the gastrointestinal tract, ensure better absorption of nutrients from food, as well as the removal of waste products. It is important to remember that this is a temporary measure to support the body weakened by the operation. If the problem returns after completing the course of therapy, you need to consult a specialist again.
- Dietary. After surgery, a special diet is required, which allows you to gradually activate the digestive system and prevent complications and constipation. As a rule, in a hospital a special table is organized for each patient. The principles of nutrition are frequent, fractional meals. The basis of the diet is cereal porridge with water, fish, steamed meat and poultry, and vegetables. In the first few days, depending on the type of operation, it may be recommended to consume only broths and pureed food. It is important to strictly follow the doctor’s instructions and avoid flour products, fatty, fried foods, marinades, sweets, coffee and strong tea.
The specialist will also suggest the optimal drinking regime. Much is determined by the specifics of the operation, but general recommendations include taking a sufficient volume of clean drinking water - up to 1.5–2 liters.
The volume of liquid consumed includes vegetable and meat broths and soups. The liquid will help maintain the normal consistency of stool, cope with intoxication and recover faster after surgery. A glass of water drunk in the morning on an empty stomach will trigger intestinal peristalsis and provoke the necessary reflexes.
- Herbal health. Herbal laxatives can help restore normal bowel function after surgery. Take medications with a mild effect to eliminate pain and spasms. In the postoperative period, it is important to exclude diarrhea, so it is better to use laxatives, which act delicately and help soften the stool and make it more comfortable for elimination.
One of these drugs is Fitomucil Norm. The composition of the English remedy includes the pulp of the fruits of domestic plums, as well as the shell of the seeds of the plantain Plantago Psyllium. The drug does not contain senna, is not addictive, acts gently and helps normalize stool.
Prebiotics play a special role in constipation after surgery. These food components are not digested or absorbed in the upper parts of the digestive system. But they are fermented by the microflora of the large intestine and serve as favorable soil for the colonization of beneficial bacteria. Prebiotics will help cope with dysbiosis, improve the state of microflora, and therefore effectively influence one of the mechanisms of constipation development - disturbance of the intestinal microbial balance.
In combination with probiotic bacteria - bifidobacteria and lactobacilli - this method of restoring intestinal function will give quick results. This is especially true in cases of antibacterial therapy and high risks of developing dysbacteriosis.
You can cope with constipation after intestinal surgery using an integrated approach. It is necessary to follow recommendations regarding physical activity - the attending physician will tell you when you can get up and walk. It is important to adhere to the recommended diet, take probiotics prescribed by your doctor to prevent dysbiosis and related disorders, and also not to restrain the urge to defecate. This will help improve bowel function faster.
High chair after endoprosthetics
To prevent excessive flexion of the hip joint, in the postoperative period it is recommended to sit on high bar stools. It is better to keep your legs close, distributing the weight so that most of the load falls on the healthy leg. In this case, the body can be supported with the help of hands, resting them on the edges of the chair.
Medical chair adjustable in height.
For greater comfort, the operated leg can be extended forward.
Of course, high bar stools are not found in every home. But it's not scary. After all, you can equip ordinary chairs for sitting by placing hard pillows on them. The recommended height of the sitting surface is 10 centimeters above the level of the knee joints .
Minimally invasive endoprosthetics in the Czech Republic: doctors, rehabilitation, terms and prices.
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How to sit in a chair, on a bed, on a toilet
In the first 8-12 weeks after endoprosthetics, you are allowed to sit only on hard surfaces. In this case, you need to ensure that when sitting, the pelvis is always above the level of the knees, and the angle in the hip joint is more than 90 degrees.
As for soft chairs, sofas and beds, it is better not to sit on them at all. After all, under the weight of the body, they will certainly “fail”, and the pelvis will drop below the permissible level. And this can have extremely unpleasant consequences.
One of the toilet nozzle options.
During the rehabilitation period, it is necessary to equip a toilet room. Namely, purchase and attach a special elevation to the toilet seat. It will allow you to sit on the toilet in such a way that the permissible angle in the hip joint is maintained. To make it easier to get up from the toilet, grab bars can be attached to the walls in the toilet, which will be easy to grasp with your hands.
How to normalize bowel movements after surgery
To prevent complications and restore normal stool frequency, you must follow a diet. On the first day after surgery, the list of permitted products is limited to apple juice, weak tea, and a small amount of chicken broth. On the second or third day, the diet includes pumpkin and zucchini, natural yogurt without starch.
If in the first three days the body reacts normally to food, the following products are gradually included in the diet:
- vegetables and fruits high in fiber,
- buckwheat porridge and whole grain oat flakes,
- boiled lean meat and fish,
- fermented milk products with low fat content,
- grapefruits and red apples.
Pickles, smoked meats, baked goods, legumes, chocolate, carbonated water and all products that stimulate gas formation in the intestines are prohibited.
To facilitate the elimination of feces after surgery, the following rules must be followed.
- For breakfast there is porridge made from coarse cereals, boiled in water with the addition of milk. For taste and benefit, you can add some dried fruits: figs, prunes or dried apricots.
- Eat at least 5-6 times a day at regular intervals, eat at the same time every day.
- Include in the menu puree soups with vegetable or meat broth, salads with fresh vegetables and fruits. If the patient has undergone surgery on the intestines, you should not eat cabbage, bell peppers, eggplants and legumes, because they cause gas formation.
- Meat and fish dishes should be boiled or steamed. Salt should be used in moderation, and if possible, avoid it altogether.
- Drink at least one and a half liters of water daily. After surgery, carbonated water and sugary drinks are contraindicated. It is better to give preference to weak black or green tea.
How to get there without harming your sore leg?
In fact, you can get home from the hospital in a regular car, sitting in the front seat next to the driver. Before sitting down, the chair should be pushed back as far as possible and its back reclined. You can put a hard cushion on the seat itself, which will make it taller. You must get into the car backwards, keeping your lower limbs straight outward. Leaning on the back of the seat and keeping your legs together, they should be slowly placed in the cabin.
Image of the correct landing using the example of a driver. The passenger must adhere to the same parameters.
As for driving a car independently, you can think about it no earlier than 6-8 weeks after surgery.
What happens after hip replacement surgery?
You will likely be in the hospital for 4-6 days, during which time you will lie in a bed with a wedge-shaped pillow between your legs to help position your new hip joint correctly. Bladder drainage will help you go to the toilet without getting out of bed. Physical therapy begins just one day after surgery, and within a few days the patient will be able to walk with a walker, crutches or cane. Physical therapy should continue for several weeks to months after surgery.
What are the consequences of an angle of less than 90 degrees?
Sitting in an inappropriate position can lead to dangerous complications in the postoperative period. For example, to dislocation of the endoprosthesis, that is, displacement of its head in relation to the acetabular component. In this case, the patient will need closed or open reduction of the dislocation. And if he does not seek help in time, then there is a high probability that the patient will need to have a second operation.
Dislocation on x-ray.
If you sit incorrectly, another, even more dangerous consequence is possible - a periprosthetic fracture of the femur. Most patients with postoperative fractures undergo a second operation, during which the bone is strengthened with bone plates or even the endoprosthesis is changed.
Prohibited sitting positions
While sitting, it is strictly forbidden to tilt your body forward, much less rest your elbows on your knees (especially while sitting on the toilet). You should also not cross your legs, squat, cross your legs, or lounge in chairs and sofas that are too soft. As we have already said, neglecting precautions can have dire consequences.
Let's sum it up
- In the first 8-12 weeks after hip replacement, you should sit only in high, hard chairs. The angle at the hip joints should not be less than 90 degrees.
- In the postoperative period, it is forbidden to cross your legs, squat, lean forward, and especially rest your elbows on your knees. You should also not sit in low soft chairs, on sofas or beds with a “sagging” mattress.
- When returning home from the hospital, you should sit in the front seat of the car, first moving it as far back as possible. First you need to sit in a chair with your back forward, and then carefully place your legs in the cabin, keeping them straight together.
- When preparing your home for the return of a person who has undergone surgery, you should purchase and install a raised toilet seat. It will allow the patient to sit on the toilet without the risk of hurting his leg.
- Incorrect sitting in the postoperative period can lead to dangerous consequences: periprosthetic fractures and displacement of endoprosthetic components.
What should you avoid after hip replacement surgery?
You should not turn or twist on your operated leg for approximately 6 to 12 months. Also, you should not lift the operated leg above the waist or bend it under you. You should avoid bending your leg at the hip more than 90 degrees. This applies to both leg lifts and squats.
Your physical therapist should teach you the necessary techniques and equipment so that you can live a normal life while meeting all of the above requirements. It must be remembered that failure to comply with the instructions of the physiotherapist may lead to the dislocation of the newly installed hip prosthesis, which will require a new operation.
Even after your hip joint has fully healed, some sports or activities may not be possible for you. The endoprosthesis is designed to withstand the load associated with walking and normal daily activity. In case of increased load, sudden jerking movements and overstrain, the prosthesis may fail prematurely.
