You just got off the phone with your orthopedic surgeon’s office, and your hip replacement surgery date is set. No matter how long you’ve been suffering with the pain of hip arthritis, it is probably a relief to know that once you’ve recovered from surgery, you’ll be living the active lifestyle that arthritis had taken from you. You are about to take a very positive step toward improving your life—and your health—but, it is very important that you are ready to have a hip replacement, both physically and emotionally. So, have you asked all the right questions of your orthopedic surgeon? Do you know what to anticipate and what you can do yourself to enhance your own recovery? Let’s take a look at some of the questions you should consider, so that you understand what you need to know before your hip replacement surgery.
What should I do before my surgery date?
It is very important to get yourself ready before you have hip replacement surgery. If need be, write down your questions for your orthopedic surgeon so that you have the peace of mind that you’ve asked all that you think you need to know. You should expect that you will have preoperative tests and appointments to be taken care of before your surgery. You’ll see your primary care doctor to receive clearance for surgery, and you may need to see specialists, have blood drawn and have x-rays or EKGs done, depending on your personal medical history.
Good nutrition is extremely important to your recovery from hip replacement surgery. Eating a well-balanced, healthy diet that is low in fat and high in fiber will provide you with the nutrients necessary for adequate healing. If you are overweight, weight loss that you sustain over time will protect your new hip. And if you smoke, you should stop before surgery. Smoking can delay healing and increase your risk of post-operative complications.
You should also prepare your home for your homecoming from the hospital or surgery center. If you have stairs, try to create a living space on the lower level of your home. If this is impossible, create an environment that would require minimal stair climbing. This may include having some type of refrigeration upstairs so that you don’t have to go downstairs to get a drink or something to eat. You should also avoid recliners after surgery so make sure you have a chair with a firm, straight back to sit in. Finally, it is very important to avoid falling for obvious reasons, so make sure you clear your living space of any fall risks such as throw rugs, electrical wires, and toys. You may also need to secure pets temporarily. Adequate lighting is also essential to prevent falls, including night lights in areas you may need to be in during the evening and night hours.
What will happen in the operating room?
The day of surgery you will receive anesthesia to relax you and make you sleep through the surgery so you are unaware and will have no memory of the surgery. Numbing medication from spinal anesthesia will also be given to prevent pain. Once you are under anesthesia, your surgeon will make a skin incision and then expose the hip joint. Because the hip joint consists of the ball at the top of your thigh bone, rotating inside of a socket that is part of your pelvis, both ends of the joint will need to be replaced. Your surgeon will remove the worn out ball portion of the hip and replace it with an artificial replacement ball made of metal or ceramic. Then your surgeon will reshape the damaged inner surface of the hip socket and insert a new socket which has an inner gliding surface for the new joint which is a special polymer. After a surgical closure of your incision, you are now ready to wake up from anesthesia and get on the road to recovery.
What should you expect right after surgery?
After surgery, you will be given medications for pain. You should expect to stay in the hospital overnight, and some very healthy and active patients may have an outpatient procedure where they can return home on the same day as surgery. You will initially have a wedge-shaped pillow in between your legs to stabilize your hip until any sedation from anesthesia has resolved. You should expect to be up and out of bed with physical therapy within a few hours, so that you can quickly begin the work of recovery.
How long will your recovery take?
After you have safe mobility in the hospital or surgery center, you will be able to go home. Your outpatient physical therapist will work closely with your orthopedic surgeon to give you the right exercises at the right time. Most people are able to resume a normal lifestyle with minimal to no pain within a matter of weeks or months, but you may experience improvement for up to a year. During this time, you will be following up regularly with your orthopedic surgeon. The good news is that approximately 90% of hip replacements will last 20 years or more.
What kind of activity should you expect?
On the day of surgery, you should expect to be up walking with a physical therapist with the help of an assistive device such as walker initially to ensure good stability. As you recover, patients typically progress very quickly to a cane and then to no assist devices. Exercises will be prescribed to improve the normal movement and strength of your new hip and will be done multiple times daily. While you should be doing the exercises as your doctor and/or physical therapist has shown you, there are specific activities that you should avoid in the beginning. You should not pivot or twist on the leg of your new hip, nor should you cross it over the midline of your body or twist it inward. You should also avoid bending your hip more than 90 degrees—this includes bending over or squatting. These initial precautions help to protect your new hip during your early recovery while you work to strengthen the muscles and support around the new joint. You will be able to enjoy low impact activities such as walking early on, under the advice of your surgeon, but high impact activities such as running or heavy lifting should be avoided. You should also discuss activities such as yoga or Pilates with your surgeon, because over stretching the hip joint could injure it. Other activities to discuss with your orthopedic surgeon would be driving, sexual activity and gym exercises.
Are there any possible complications?
As with any surgery, there is the possibility of complications, so you should know how to avoid them and how to spot them. People who have hip replacements are at risk of developing blood clots that can get lodged in your leg or your lungs. This is why you will be taking a blood thinner initially after surgery. If you notice swelling of one or both of your lower legs, with or without pain, you should call your surgeon right away. If you develop shortness of breath or chest pain, you should call 911. These complications are rare, but they should be treated immediately.
After any surgery, there is the risk of infection. The best way to prevent infection is by not smoking or being overweight and by following the instructions given to you for care of your incision. Keeping good nutrition is also important for healing. However, if you notice redness, swelling or drainage from your incision, you should call your surgeon.
In a small number of patients with a hip replacement surgery, the joint can become dislocated. This means the ball portion of the top of the thigh can become dislodged from the socket. If this occurred, the joint can typically be moved back into place while you are under sedation. However, the best medicine here is prevention, which is following your post-operative activity instructions carefully until your muscles have a chance to get stronger.
The good news is that hip replacement surgery is one of the most successful orthopedic surgeries available today, and it can greatly improve your quality of life if you suffer from arthritis of the hip. An informed patient is in the best position to have a positive experience with hip replacement, or any type of surgery, so make sure you ask all of your questions and understand all of the answers before the day of your surgery.
If you have any more questions about hip replacement surgery, our friendly team is here to answer them. To seek the expert advice of Dr. Brett Gilbert who will address your unique concerns, contact us today by calling us at (919) 788-8797 or request an appointment online, and work to start living pain-free once again.