Post-Operative Hip Instructions

Patients come back to Dr. Christoforetti’s clinic the day following their surgery for a follow-up, and on the same day, physical therapy is commenced (the first day after surgery).

In hip arthroscopy, small incisions are made in the skin, and slightly larger ones in the ligament capsule surrounding the hip joint. The postoperative leg positioners, hip brace, and Continuous Passive Motion machine (CPM) are intended to initiate proper healing of the deep incisions.

Dr. Christoforetti emphasizes the importance of early and expert physical therapy, coupled with the personalized involvement of a caregiver, to achieve optimal recovery.

Your dedication to assisting the patient with therapy and ensuring proper leg positioning will significantly enhance their recovery outcome in a positive manner!

All hip arthroscopy patients undergo pre-fitting for a hip brace by a representative in the office. The brace is configured to permit full hip extension and 90 degrees of hip flexion. It should be worn whenever the patient is not in the CPM device or during formal physical therapy sessions.

To apply the brace, wrap the padded waist strap around the torso just above the level of the pelvic brim. Attach the thigh straps to the surgical thigh loosely, ensuring the strap maintains contact around the entire thigh but with enough slack to comfortably slide one finger between the strap and the thigh.

The Continuous Passive Motion Machine (CPM) is crucial for preventing adhesion formation within the joint. Patients are required to use the CPM machine for six hours daily for the first two weeks postoperatively, although this duration may be extended at Dr. Christoforetti’s discretion.

During CPM use, the foot should be positioned in a toes-up orientation. The machine's settings should range from 0 to 90 degrees.

 All patients receive a Continuous Passive Motion Machine (CPM) delivered to their home prior to surgery.

The home caregiver will receive instructions on performing pendulums during a visit to Dr. Christoforetti’s office. This gentle passive circular exercise involves positioning the hip flexion between 30° to 70°. Both the patient and caregiver will be taught how to prevent hip flexor muscle firing and guarding. Pendulums should be carried out for 20 minutes continuously three times daily for the initial two weeks following surgery.

Hip arthroscopy patients are limited to 20 lbs. of foot-flat weight bearing with crutches during the initial two weeks following surgery.

Postoperative medications are prescribed and dispensed before surgery for hip arthroscopy patients. The typical regimen comprises a pain medication, a sleep aid, a nausea medication, and a nonsteroidal anti-inflammatory drug (NSAID) such as Indocin, naproxen, or Celebrex to prevent the bone formation in the soft tissues of the hip post-surgery. While in the hospital, medication specifics may vary, but it is essential to include an NSAID.

Patients are advised to take all medications as prescribed on an as-needed basis, EXCEPT for the NSAID pill, which must be taken as prescribed on a scheduled dose with food.

On the first night after surgery, the bulky postoperative dressing may show signs of drainage. Simply reinforce the dressing as necessary.

The following morning, the bulky dressing will be removed, and the skin will be cleansed. A small adhesive OpSite Dressing will then be applied. For the first week, whenever the dressing becomes wet or soiled, it is important to remove the dressing, clean the skin gently with a soft cloth and water, and reapply a fresh OpSite Dressing.

Typically, for outpatient procedures, patients will follow up with Dr. Christoforetti or his staff the DAY after surgery and then proceed to physical therapy on the same day. It is essential to preschedule this visit before the surgery.

If the patient is staying overnight, they will undergo a session of physical therapy that must involve the primary caregiver's participation. Additionally, they will have a follow-up session scheduled with a preselected outpatient therapist, as well as a 2-week postoperative visit scheduled with Dr. Christoforetti.

Patients are permitted to shower 48 hours after surgery. However, bathing, hot tubs, or swimming pools are not allowed. Additionally, patients should refrain from scrubbing or vigorously drying the incisions.

Patients are prohibited from driving until they have ceased all sedating medications and are no longer dependent on crutches. For surgeries on the right hip or standard transmission driving, the earliest allowable driving time is 6 weeks postoperatively. For surgeries on the left hip, driving may resume as early as 2 weeks postoperatively.

Return to school or work will differ for each patient, but typically, the first two weeks postoperatively are dedicated solely to recovery. It is advisable to make arrangements in advance so that students can receive school assignments during this period.