Dr JN Cakic

Specialist Orthopaedic surgeon
MD, FCS (SA) Orth, MMed (Orth) WITS, PhD(Med)WITS

Care before & after

Take the first steps towards the freedom from pain

Care AMIS

This programme is the general rule which has to be adjusted for each patient and condition individually. It is also adjusted specifically for the anterior surgical approach.

Pre-Operative Care

It is ideal to see a physiotherapist pre-operatively to release any muscle spasms and gain optimal flexibility and strength.

After admission, you will be seen by a physiotherapist who will guide you through the post-operative exercises and educate you on walking with crutches.

Post-Operative Care

You will be admitted in to hospital the night before your surgery. This is so that you can receive your blood thinner and also so that you can receive your enema to clean your bowels. Your anaesthetist will also see you before your surgery.

You will be in high care for one day/ night after your hip replacement. A drain will be placed in your thigh to drain out any excess blood from the surgery (the drain will stay in for 2-3 days). You will also have a brace (cold pack) on over the surgery site, so please ensure that you have loose, comfortable clothing. During this time, the physiotherapist will teach you how to do exercises in your bed to begin strengthening the muscles around the hips and pelvis. These exercises need to be continued at home after discharge.

The physiotherapist will assist you with mobilisation. You will be walking with the aid of crutches after the surgery. The amount of weight you will be allowed to place on your operated leg and the length of time that you need to use crutches will be determined by Dr Cakic after the surgery.

You will be taught how to climb stairs before you are discharged.

Walking is an important part of your rehabilitation, and once discharged from the hospital, you will be required to walk on a daily basis. Initially you should only walk on level ground and avoid obstacles.

You will need physiotherapy after you are discharged from the hospital to optimise healing and rehabilitation after the AMIS surgery. Following discharge you will have a programme of rehabilitation starting with physiotherapy. About 6 weeks to 3 months later, you will be referred to biokinetist for more active rehabilitation. Each patient is unique and rehabilitation will be adjusted individually.

One night before and then after the operation you will need to have blood thinners to decrease the risk of getting blood clots. In hospital you will get injections, then when you are discharged you will be changed over to tablets that you will take for 30 days from after the date of discharge.

Regarding your wound, you will have about a 10 cm cut, that will be dressed before you leave hospital. You will be given a pack that has extra dressings and a dressing pack in. This you will need to bring with you to the 3 week wound care follow-up. Leave your dressing in place until you see the wound care nurse at 3 weeks. Only change your dressing if necessary, if it gets wet or oozes through the dressing. You will also at 3 weeks need to go for a Doppler scan to rule out blood clots.

You will not see Dr Cakic at the 3 week follow up, but only at the 6 week follow-up. If there are any problems, Dr Cakic will be notified.

Dr Cakic will advise you as to when you may drive again.

Activities of daily living immediately after surgery:

  • When lying on your back, place a pillow under your knees.
  • When lying on your side, place a pillow between your knees.
  • Use a non-slip mat in the shower.
  • Take your body and hands down to your feet to put shoes/socks on.
  • To pick up an object off the floor, use the “safety position” and leave the operated leg behind.
  • Going up a flight of stairs, place your good leg on the first step, then your recovering leg, then your crutches.
  • Going down a flight of stairs, place your crutches down first, then the recovering leg and then the good leg.
  • In the car, push the seat back as far as possible and recline the back rest.

Pre-cautions and contraindications

The following movements are not allowed for the first 6 weeks:

  • Stretching your hip backwards
  • Rotating your leg outwards and bringing your foot up to your hands to put shoes and socks on/washing your foot in the shower
  • Rotating your leg outwards more than 45°
  • Deep squats
  • Slouching in a chair, sitting in a lazyboy chair or soft chair/couch

Related articles

Rehabilitation team

Barry Getz

Centre for Sports Medicine and Orthopaedics...

Paula Maclaurin

Fourways Life Clinic...

Boudine

Fourways Life Clinic...

Marlinde de Vries

Fourways Life Clinic...