Hip Replacement for NOF

This document provides information about hip replacement surgery for femoral neck fractures, including pre-operative and post-operative requirements, recovery, and rehabilitation. It discusses the impact of femoral neck fractures on health insurance costs and the different types of hip arthroplasty procedures. The document also covers the importance of pre-operative evaluations, post-operative care, and potential complications. Overall, it offers a comprehensive overview of hip replacement for NOF.

Running head: HIP REPLACEMENT FOR NOF
Hip Replacement for NOF
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Introduction
Femoral neck fractures or fracture in the neck of femur generally occurs in the old age
people. It represents a crucial health issue and has a substantial impact on health insurance costs
(Li et al., 2013). The fractures can be repaired by hip arthroplasty, which comprises of unipolar
or bipolar hemiarthroplasty (HA), and total hip arthroplasty (THA) (Rogmark&Leonardsson,
2016). Surgery is the mainstay of care for the fractured femoral neck. The femoral neck fracture
is a kind of hip fracture. When an older person undergoes a femoral neck fracture, the damage
occurs just below the ball of the ball-and-socket hip joint; that portion of the thigh bone is known
as the femoral neck. As a femoral neck fracture happens, the ball is detached from the rest of the
thigh bone (the femur). The most substantial damage in this kind of split is that the blood flow is
restricted in the fractured area, which leads to disruption in the blood flow at the time of
injury(Li et al., 2013). Since blood flow is disturbed, this limits the healing process of the
fracture.

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Pre-Operative Requirements
Before any hip-replacement surgery takes place for the improvement of the fractured
neck of femur, the doctor or the nurse will discuss about a recovery and rehabilitation plan which
will aim for the patient’s hospital duration of stay, to help the patient regain their hip strength
and function more quickly, and the surgeons will also aim at reducing any danger of developing
any kind of post-operational limp.
Elderly patients receive a full medical examination, a dental assessment, and a range of
exams such as blood tests, hip x-ray, EKG, urinalysis before total hip replacement operation. In
several instances, patients donate blood before the operation, for blood transfusion, when
essential throughout the operation. In other cases, patients who are obese may donate blood prior
to the surgery. Before the surgical procedure, patients should take medicine, eat, drink and take
medicines from their healthcare providers. In several instances, after midnight on the night of
before the procedure, patients should not eat or drink.
An orthopaedic surgeon will recommend that the standard treatment doctor conduct a full
physical evaluation before the operation. This is necessary to ensure the safety of the patient is
sufficiently adequate for surgery and regeneration. A professional like a cardiologist can also
evaluate many patients with severe medical circumstances before the procedure, like heart
disease. Before the operation, the patient's skin must not be infected or inflamed. If either one is
present, consult the orthopaedic surgeon before the surgery for therapy to enhance the skin. The
elderly patient or their caregiver should discuss with orthopaedic surgeon about the medications
they take. The orthopaedic surgeon or primary care doctor will advise the patient about which
medications will be continued and which will not be continued before surgery.

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If the person is overweight, the physician may request for a loss of weight before the
operation so that pressure is minimized on the new knee and the risk of operation may reduce.
Although diseases are not prevalent after hip replacement, an infection may happen if
bacteria reach the blood system, as during dental processes bacteria can enter the blood system.
Before a hip replacement operation, major dental procedures (such as tooth extractions and
periodontal operate) should be finished. Routine teeth washing should be postponed for several
days following the operation. Participants with a record of latest or regular urinary disorders
should perform a urological assessment before the operation. Older prostate males should
consider finishing the necessary therapy prior to surgery.
After the admission into the hospital or operation room, the patient is evaluated by the
anesthesia team. The most regular type of anesthesia is general anesthesia (which puts the patient
to sleep) or spinal, epidural, or regional nerve block anesthesia (makes the body stay awake but
the body feels numb from the waist down). The anesthesia team, with your input, will determine
which type of anesthesia will be best for you.
In the present artificial hip joints, several distinct kinds of models and equipment are
used. These comprise of both the base component of a ball and of a plastic, ceramic or metal
component, which may have an external metal shell. The ball component is made from a highly
polished metal or ceramic material. The prothesis parts can be inserted into the bone so that the
bone can be placed on the parts or cemented. A range of variables like the size and strength of
the bone determine the choice to insert the parts or cement. It can also combine a cemented stem
with a non-cemented socket.

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Post-Operative Requirements
After the hip replacement procedure, the patient may wake up due to the decrease of the
anesthesia dose. In order to keep the legs spread, a triangle-shaped pillow will be kept in between
the patient’s legs. The pillow is kept under the legs to steady the hips. The doctor may prefer to
keep the pillow under the legs of the patient while sleeping or resting after the surgical procedure
that is hip arthroplasty is finished. Just after few days of surgery, the patient will start to recover
the senses in their legs (Florschutz et al., 2015). The doctor will provide a pre-emptively
treatment to reduce the pain through different pain-relief techniques and will also reduce the side
effects. This approach is called multimodal analgesia (Su & Su, 2014).
Patients who had hip arthroplasty have to take care of their surgical site or the incision. If
possible, the patient or the nurse should help the patient in keeping the incision clean and
covered with a clean gauze dressing. After five days of the post-surgery, the patient will be able
to take a shower(Pauser et al., 2016). The patient should lightly wash their incision with the help
of antibacterial soap and water. After the post-surgery, there can be signs and symptoms of
infection like redness, swelling, warmth, drainage, increase in pain, or a fever over 101 degrees.
It is normal to have such symptoms which can be treated with the help of proper medicines;
however, if it increases, then it is necessary to take the suggestion of a doctor (Pauser et al.,
2016). Also, after the post-operation of hip replacement, there are chances of deep venous
thrombosis. In order to reduce the danger of blood clots, patients are given heparin injection
(Lovenox), a blood thinner, just after the operation and also includes aspirin therapy. After the
patient is discharged, the patient is provided with medicines like 325 mg of enteric-coated aspirin
which are needed to be consumed twice per day for six weeks. The patient should remain active
as much as possible to reduce the chances of blood clot formation.

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Patients who had cemented implants (bipolar or total hips) were given weights as soon as
the patient was able to stand appropriately after the post-surgical procedures and were also
suggested for hip and knee exercises. Patients who underwent hybrid hip replacements were
suggested to move around carrying a certain amount of weight for around three weeks, and later
their weights were increased for over the next three weeks. Patients who did not receive
cemented implants (bipolar or total hips) were initially suggested to move without any weight for
three weeks, then later they were asked to carry a certain amount of weight for around nine
weeks and then finally suggested to carry full weight without any assistance. Active hip
abduction exercises were started after six weeks. However, precisely how the post-surgery hip
can carry much amount of weight depended on a specific number of factors like the kind of
operation and prostheses used, the status of the patient’s original bone and how the prostheses
were hooked on the natural bone.
Many of the patients who have undergone hip replacement are discharged within three to five
days. Usually, a patient’s discharge is approved by a surgeon after the assessment of the pain. If
the outcome of the pain results in under control, then the patient is allowed to leave the hospital.
Though they are recommended individual suggestions -
 Such as they should move around for small distances normally around 150 to 300 feet
with the help of specific devices such as a walker or crutches or somebody’s assistance.
 The patient should have their meals by sitting in a proper posture.
 Implement simple exercises
 The patient should follow the patient’s suggestions to help themselves and also to avoid
dislocation of the new hip.

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Conclusion
In the old age, there are usually femoral neck injuries or injuries in the femur's neck. It is a key
wellness problem and has a significant effect on the cost of health insurance. Before any hip-
replacement surgery takes place for the improvement of the fractured neck of femur, the doctor
or the nurse will discuss about a recovery and rehabilitation plan which will aim.

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REFERENCES
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