Total Hip Replacement
Total hip replacement is a common operation I do for arthritis of the hip. The success rate is about 95% with today’s technology, so you won’t have much to worry about. Here are answers to some of the most commonly asked questions.
Why do I need x-rays?
X-rays provide us with a road map of your hip. They tell us how severe the arthritis is and give us an idea of the proper size of the hip replacement which will be necessary, and tell us if we need to take into consideration the overall alignment of your leg, if any special techniques will be required to repair the problem (such as bone grafting, or a special type of hip prosthesis). X-rays also give us an idea of the proper size of the hip replacement, which will be necessary and will tell us if we need to take into consideration lengthening a leg to restore its proper length.
When will I be admitted to the hospital?
We are all concerned with the rising cost of health care. We are lucky to be living in the United States where we can have access to the best health care system in the world. We have to protect that privilege. For that reason, we will not admit you into the hospital until just before your total hip replacement. In some cases, that will be the morning of the operation (this is due to Medicare regulations). You can expect that your preoperative blood tests, electrocardiogram, chest x-ray, and other studies will be completed approximately one week before your surgery as an outpatient.
What happens before surgery?
Before your admission to the hospital, you will be seen in our office for preoperative planning of your surgery. An autologous blood donation schedule will be determined for you. With autologous blood donation, you will donate two or three units of your own blood at the hospital blood bank. This is done within the month preceding your surgery. Your own donated blood will be then given back to you during or after your surgery. Autologous blood donation admonishes the risks of blood transfusions, particularly exposure to the HIV virus (AIDS virus), and the hepatitis virus. Supplemental iron therapy will also be prescribed at the onset of your autologous blood donation program. Approximately one to two weeks before your surgery, you will be seen in our office for a preoperative examination during which your health history will be reviewed and a physical examination will be performed.
After admission, what can I expect?
After your admission to the hospital, you will meet the nurses who will be taking care of you. They will show you around the orthopedic floor, and will answer questions about how to get any assistance you need, Before surgery, the nurse will assist you in cleansing your operative hip area to prevent infection. You may have an intravenous line inserted. You will not get an enema!
What are my post-op pain management options?
Post-op pain management is determined individually for each patient. The options include IM injections, Patient Controlled Analgesia (PCA), or Epidural. PCA dispenses medication at the push of a button into an I.V. line. The epidural is similar to a spinal. The post-op pain system is determined by each patient’s need and hospital protocol.
How long does the surgery take?
As the wise old orthopedic surgeon once said, “The time it takes to do the operation is the time it takes to do it right!” Usually about an hour and a half gives us the time to position you for the surgery, wash your hip and prepare the skin for surgery, do the operation, wake you up, and move you to the recovery room. You can anticipate being in the recovery room for an hour before going back to your room. Ask your family to wait in the surgical waiting room, and I will be looking forward to telling them about your total hip replacement.
How long will I be in the hospital?
This depends on how quickly you heal and how quickly you regain your strength. usually three to five days. You will be seen by a physical therapist the first day following your surgery to begin flexibility exercises. You will be a little sore, but it will get easier each time. Besides, you will have plenty of help. Along with the physical therapist, there will be specially trained orthopedic nurses to assist in your care. You will learn how to get in and out of bed the proper way and how to get to the bathroom and care for yourself. Don’t be concerned, our staff has lots of patience and plenty of experience. When you can do these activities by yourself, you will be ready to go home. If you need additional assistance at home in the way of home health care and physical therapy, we will help you arrange that too.
“How about that therapy, Doc?”
I always tell my patients that there are two parts to the operation. The first is the part that I do, and that usually finishes when they leave the hospital. The second is the part that they do, and that begins the moment they wake up.
When will you see me again?
Our Home Health Care Nurses will take our your staples (we don’t use stitches on the skin anymore!) about ten days after your surgery. You will work on exercises to gain strength and flexibility in your hip at home. About a month after your surgery, we will see you in the office, sooner if there are problems.
How long will I use the walker?
You will use the walker for three to four weeks and a cane until you are able to walk without limping. This may take a month or two. When you can get in and out of the car by yourself safely, you can drive. You can gradually resume usual activities as you become stronger. We will give you specific guidelines.
What activities can I participate in after my surgery?
Pretty much whatever you like. Walking, dancing, bowling, doubles tennis, swimming, bicycling, boating, fishing you name it and we will tell you! We do not recommend contact sports like football, or jarring sports like running.