Orthopaedics  |  Osteo Knee & Hip Pathway - Post Discharge Care




Orthopaedics

Osteo Knee & Hip Pathway - Post Discharge Care

After hip joint replacement surgery, notify the Orthopaedic Registrar on call or the operating Consultant if one of the following complications occur:

1. Thromboembolism

  • Suspected DVT should be diagnosed and managed in the community via CPO where available.
  • Please advise the orthopaedic team preferably using the referral for advice option in eReferrals that a DVT has occurred and is being managed in the community.
  •  If the patient is at high risk for PE or there are other issues precluding community management please refer to the Medical Registrar on call.

2. Infection

  • If there is any suggestion of deep infection requiring antibiotics the patient should be referred for review by the Orthopaedic registrar on call or the Consultant concerned.
  • Distant cellulitis including on the limb distal to the replacement can be managed by the GP.
  • CRP is not considered a useful diagnostic tool to exclude infection in the 6 weeks post-operatively.

 

Post Discharge care for Hip and Knee Joint surgical patients

Analgesia:

  • Patients are discharged from hospital with advice to continue with Regular Paracetamol and with a short term opiate such as Oxynorm/Oxycontin for 3 -4 days.

 

Wound Care:

  • Patients being discharged with staples in their wound will have these removed by the District Nurse, or at the GP.
  • If the patient has dissolvable sutures, the wound is left covered with an occlusive dressing. The patient is given instruction to remove the dressing after 7 days.
  • The patient is advised to see their GP if there is any bleeding, redness or heat at the wound site, severe pain, increased wound ooze or increased swelling at the wound site.

 

District Nurse:

  • A patient is only referred to a District Nurse for wound care, or if they are having input into home help or personal cares.
  • If after 6 weeks ongoing support is required regards home and personal assistance, the DN advises Support Net who will provide an assessment and if the patient qualities, this will be provided and funded by Support Net.

 

Physiotherapy:

  • Physiotherapy post THJR is case dependent rather than routine as most do not require.

 

Consultant follow-up:

  • Some patients will be called back at 2 - 3 weeks by the Consultant but those are progressing as expected will be sent an appointment for a follow-up clinic visit 6 weeks post-operatively.

 

Longer term follow-up:

  • Following the 6 week clinic appointment, patients are recalled at one year post-op for a check with an x-ray. After 5 years they are sent a scoring sheet to complete and depending on these results they will be discharged or recalled for consultation.

 



Last updated : Friday, September 11, 2015
Next review date : Saturday, September 10,2016


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