The next stage of pre-operation preparation has been undertaken: the Joint Replacement Education Group. A large part of modern surgery is self help and active recover and this meeting was all about that.
Not too long ago the mantra for recovery from surgery or injury was "rest". When I was run over some twenty years ago and gained a broken leg for my troubles this was the case. As it happened it was a good summer (apart from the broken leg) and after the initial ten days to a fortnight when my body really didn't want to know about doing anything I'd be out as much as possible, some days walking four miles to meet Cath for lunch then back again. I don't think the hospital was too pleased when I returned their fancy articulated cast in an unrepairable state!
Back to the present day and my ignoring of medical advice is now the norm: active rest and recovery has been shown to improve the post-operative outcome. After all it doesn't look good on the hospital and surgeon's stats if you have to come back for a refit. I was the youngest attending the group, by far! One or two of the others were coming in for their second hip replacement, obviously keen for punishment :-)
The first part of the session was going through the pre-op and post-op procedures. The ward sister also passed round an example of the implant we were going to get - the tang and neck are titanium, the ball is ceramic and the socket is plastic. A bit of Googling reveals that the average femoral head (the ball) is 40-50mm or just a little bigger than a golf ball whereas the ball we looked at was 22mm or so in size. This gives a good basis for the restrictions placed on hip movement in the first three months post-op as there'll be much higher stresses on the smaller joint surface so displacement would be more likely. Some newer replacements are starting to use larger balls to reduce this risk, I'm not sure what I'll be getting.
As part of the active recovery, the ward staff will be looking to have me walking as soon as I get back from the operating theatre and potentially through the night as well. Once I'm able to perform basic
tasks like dressing myself; going to the loo; getting up and down stairs then providing there are no medical complications I'll be discharged. This is usually two to three days after the operation but could be as little as one.
The rest of the session was taken up by physio and occupational therapy and finally the handing out of the various tools we need so that we don't have to bend down - the hip-body angle mustn't go past 90deg, again this is to prevent displacement occurring.
I also had a visit from the occupational therapist to ensure that the house is suitable for me to be discharged to. Again it was making sure that the chairs, toilet etc aren't too low to avoid over-flexing the hip.
Just a week to go now.