It's important to be prepared and to understand everything that will happen before and during the procedure. Once total hip replacement is completed, a recovery period should be anticipated.
Before Total Hip Replacement
- Your doctor will explain the procedure to you and offer you the opportunity to ask any questions that you might have about the procedure.
- You may be asked to sign a consent form that gives your permission to do the procedure. Read the form carefully and ask questions if something is not clear.
- In addition to a complete medical history, your doctor may perform a complete physical examination to ensure you are in good health before undergoing the procedure. You may undergo blood tests or other diagnostic tests.
- Notify your doctor if you are sensitive to or are allergic to any medications, latex, tape, and anesthetic agents (local and general).
- Notify your doctor of all medications (prescribed and over-the-counter) and herbal supplements that you are taking.
- Notify your doctor if you have a history of bleeding disorders or if you are taking any anticoagulant (blood-thinning) medications, aspirin, or other medications that affect blood clotting. It may be necessary for you to stop these medications prior to the procedure.
- If you are pregnant or suspect that you are pregnant, you should notify your health care provider.
- You will be asked to fast for eight hours before the procedure, generally after midnight.
- You may receive a sedative prior to the procedure to help you relax.
- You may meet with a physical therapist prior to your surgery to discuss rehabilitation.
- Stop smoking, as smoking can delay wound healing and slow down the recovery period.
- Lose weight if needed.
- Perform conditioning exercises as prescribed to strengthen muscles.
- Arrange for someone to help around the house for a week or two after you are discharged from the hospital.
- Based on your medical condition, your doctor may request other specific tests or examinations.
During the Procedure
Hip replacement requires a stay in a hospital. Procedures may vary depending on your condition and your doctor's practices.
Hip replacement surgery is performed while you are asleep under general anesthesia or sedated under spinal anesthesia. Your anesthesiologist will discuss this with you in advance.
Generally, hip replacement surgery follows this process:
- You will be asked to remove clothing and will be given a gown to wear.
- An intravenous (IV) line may be started in your arm or hand.
- You will be positioned on the operating table.
- A urinary catheter may be inserted (after you are asleep).
- The anesthesiologist will continuously monitor your heart rate, blood pressure, breathing, and blood oxygen level during the surgery.
- The skin over the surgical site will be cleansed with an antiseptic solution.
- The doctor will make an incision in the hip area.
- The doctor will remove the damaged parts of the hip joint and replace them with the prosthesis. The hip prosthesis is made up of a stem that goes into the femur (thighbone), the ball (head joint) that fits into the stem, and a cup that is inserted into the socket of the hip joint. These components are made of various materials, including metal, ceramic and plastic. It is up to you and your surgeon to decide what the best prosthesis is for you based on your age, activity level and functional demands. The two most common types of artificial hip prostheses used are cemented prostheses and uncemented prostheses. A cemented prosthesis attaches to the bone with surgical cement. An uncemented prosthesis attaches to the bone with a porous surface onto which the bone grows to attach to the prosthesis. Sometimes, a combination of the two types is used to replace a hip.
- The incision will be closed with stitches or surgical staples.
- A sterile bandage or dressing will be applied.
After Total Hip Replacement
In the hospital
After the surgery you will be taken to the recovery room for observation. Once your blood pressure, pulse, and breathing are stable and you are alert, you will be taken to your hospital room. Hip replacement surgery usually requires an in-hospital stay of a few days. The length of that stay is dependent upon the magnitude or complexity of your surgery, your post-operative recovery and your discharge plan. It is important to begin moving the new joint after surgery. A physical therapist will meet with you soon after your surgery and plan an exercise program for you. Your pain will be controlled with medication so that you can participate in the exercise. You will be given an exercise plan to follow both in the hospital and after discharge.
You will be discharged home or to a rehabilitation center. In either case, your doctor will arrange for continuation of physical therapy until you regain muscle strength and good range of motion.
Once you are home, it is important to keep the surgical area clean and dry. Your doctor will give you specific bathing instructions. The stitches or surgical staples will be removed at home or at your rehabilitation facility by a nurse.
Take a pain reliever for soreness as recommended by your doctor. Aspirin or certain other pain medications may increase the chance of bleeding. Be sure to take only recommended medications.
Notify your doctor to report any of the following:
- redness, swelling, bleeding, or other drainage from the incision site
- increased pain around the incision site
- numbness and/or tingling in the affected leg
You may resume your normal diet unless your health care provider advises you differently.
You should not drive until your doctor tells you to. Other activity restrictions may apply. Full recovery from the surgery may take several months.
It is important that you avoid falls after your hip replacement surgery because a fall can result in damage to the new joint. Your therapist may recommend an assistive device (cane or walker) to help you walk until your strength and balance improve.
Making certain modifications to your home may help you during your recovery. These modifications include, but are not limited to, the following:
- proper handrails along all stairs
- safety handrails in the shower or bath
- shower bench or chair
- raised toilet seat
- stable chair with firm seat cushion and firm back with two arms, which will allow your knees to be positioned lower than your hips
- long-handled sponge and shower hose
- dressing stick
- sock aid
- long-handled shoe horn
- reaching stick to grab objects
- firm pillows to raise the hips above the knees when sitting
- removing loose carpets and electrical cords that may cause you to trip
Your doctor may give you additional or alternate instructions after the procedure, depending on your particular situation.