I had a patient who had a total hip replacement performed in 2001. According to the patient the operation was a success. Well, someone told me that this patient should ALWAYS keep a pillow between her legs when she repositions herself in bed (i.e., turns left to right) to prevent possible dislocation. Is this information accurate?
Jun 1, '04
No. My understanding is that after it is healed one can function fairly normally without the abductor pillows. But I'm no expert in ortho.
Jun 2, '04
Tweety is right on this one (at least per all of the orthopedic surgeons in this neck of the woods).
We teach our patients that after 1 year, they should basically just "live their life", and no longer need to maintain abduction with bed positioning.
It isn't a bad idea to place the abductor pillow between the legs when manually moving a patient - it's more comfortable, for sure. Unless there are complications related to the replaced hip, no pillow is necessary after about a year. You'd probably be safe even at 6 months, but it never hurts to be cautions and wait a full year.
Additionally:with the anterolateral approach most commonly used for THA, it is generally considered safe to roll the new total hip patient involved side DOWN (i.e. a Right Total Hip rolls onto their Right side) without a pillow. The biggest problem is adducting (especially with female patients) when you roll then with involved side UP. The precautions are: 1)No hip flexion past 90 degrees (don't put the butt below the knees. Be careful with that bedpan, and any toilet seat that is too low) 2) No adduction past midline, and 3) no Internal rotation. Safest position is slightly extended, slightly abducted, and slightly externally rotated. Worst possible is combinations of 1, 2 and 3 (internal rotation with adduction, etc.)
Hope this isn't TMI, and that it helps with the question.
Jun 2, '04
I just had to post that on Tues we had an ambulance call to the local Dunkin Donuts for an unable to ambulate party.
Well 79 yo m who had hip surgery 5/27,,sat down and went to extend his left leg and hear his hip POP. :uhoh21: Needless to say I am sure he will be going in for a hip repair again!!
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