Answers to Frequently Asked Questions About Hip Surgery
We are pleased you have chosen our Center for your hip replacement surgery. Patients have asked many questions about total hip replacements. Below is a list of the most frequently asked questions and their answers. If you have other questions, please contact our orthopaedic coordinator at 928 639-6505. We want you to be completely informed about this procedure.
What is arthritis and why does my hip hurt?
In the hip joint there is a layer of smooth cartilage on the ball of the upper end of the thighbone (femur) and another layer within your hip socket. This cartilage serves as a cushion, and allows for smooth motion of the hip. Arthritis is a wearing away of this cartilage. Eventually it wears down to bone. Rubbing of bone against bone causes discomfort, swelling and stiffness.
What is a total hip replacement?
A total hip replacement is an operation that removes the arthritic ball of the upper thighbone and damaged cartilage from the hip socket. The ball is replaced with a metal ball that is fixed solidly inside the femur. The socket is replaced with a plastic liner that is usually fixed inside a metal shell. This creates a smoothly functioning joint that does not hurt.
What are the results of total hip replacement?
Ninety-95 percent of patients achieve good to excellent results with relief of discomfort and significantly increased activity and mobility.
When should I have this type of surgery?
Your orthopaedic surgeon will decide if you are a candidate for the surgery. This will be based on your history, exam and X-rays. Your orthopaedic surgeon will ask you to decide if your discomfort, stiffness and disability justify undergoing surgery, and the final decision will be yours.
Am I too old for this surgery?
Age is not an issue if you are in reasonable health and have the desire to continue living a productive, active life. You may be asked to see your primary care provider for his/her opinion about your general health and readiness for surgery.
How long will my new hip last and can a second replacement be done?
All implants have a limited life expectancy depending on an individual’s age, weight, activity level and medical condition(s). A total joint implant’s longevity will vary in every patient. It is important to remember that an implant is a medical device subject to wear that may lead to mechanical failure. While it is important to follow all of your surgeon’s recommendations after surgery, there is no guarantee that your particular implant will last for any specific length of time.
Why would I need a second replacement?
The most common reason is loosening of the artificial ball where it is secured in the femur, or loosening of the socket. Wearing of the plastic spacer may also result in the need for revision. Your surgeon will explain the possible complications associated with total hip replacement.
What happens if I get a scratch, cut, or bite on the leg on which I am having surgery?
Call the physician right away; he may want to see it or prescribe an ointment to use on it. If an infection starts, it will delay your surgery at least one week.
What are the major risks?
Most surgeries go well, without any complications. Infection and blood clots are two serious complications that concern us the most. To avoid these complications, we use antibiotics and blood thinners. We also take special precautions in the operating room to reduce the risk of infections. The changes of this happening are one percent or less. Dislocation of the hip after surgery also is a risk. Your orthopaedic surgeon will discuss ways to reduce that risk.
Should I exercise before the surgery?
Yes. Please consult an outpatient physical therapist or follow the exercises listed in your preoperative packet.
Will I need blood?
You may need blood after the surgery. You may donate your own blood if you are able, use the community blood supply or have your relatives donate for you. Bank blood is considered safe, but we understand if you prefer to use your own.
How do I donate my own blood?
Your surgeon’s office will arrange to have you donate your own blood.
How long am I incapacitated?
On the day of your surgery, you will sit on the side of the bed. The next morning, you will get up a walk within your room. Within one-two days you will be walking more than 100 feet.
How long will I be in the hospital?
Most hip patients are hospitalized for three days after their surgery. There are several goals you must achieve before you can be discharged.
What if I live alone?
You may return home and receive help from a relative or friend, or have a home health nurse and physical therapist assist you at home for two or three weeks. You also may stay at a subacute facility following your hospital stay depending on your insurance.
How long does the surgery take?
We reserve approximately 2–2½ hours for surgery. Some of this time is taken by the operating room staff to prepare for the surgery.
Do I need to be put to sleep for this surgery?
You may have a general anesthetic, which most people call “being put to sleep.” Some patients prefer to have a spinal or epidural anesthetic, which numbs only your legs and does not require you to be asleep. The choice is between you, your surgeon and the anesthesiologist.
Will the surgery be painful?
You will have discomfort following the surgery, but we will keep you comfortable with appropriate medication. Generally, most patients are able to stop very strong medication within one day. Most patients control their own medicine with a special pump that delivers the drug directly into their IV.
Who will be performing the surgery?
Your orthopaedic surgeon will perform the surgery with the assistance of a dedicated surgical team.
How long, and where, will my scar be?
The scar will be approximately six inches long or less, and will be along the side of your hip.
Will I need a private nurse?
You do not need a private nurse.
Will I need a walker, crutches or cane?
We recommend you use a walker, cane or crutches for approximately four weeks. A case manager can arrange for them if necessary. The orthopaedic coordinator will be working with a case manager to facilitate your postop care and equipment needs.
Will I need any other equipment?
After hip replacement surgery, there is specific equipment recommended to help you in following your hip precautions and facilitating your independence. These may include: a raised toilet seat or commode chair, a reacher, long-handled shoe horn and sponge, dressing stick, sock aide, and shower seat or tub transfer bench. The type of shower seat you choose to purchase or borrow should be discussed with your occupational therapist. You will be taught to use assistive devices to help you with lower body dressing and bathing.
Will I need physical therapy at home?
Physical therapy is a vital part of your recovery. The most advanced and cost-effective way of rehabilitating your hip is with outpatient physical therapy. It will help to assess your transportation options before surgery. Therapy lasts approximately four weeks.
How long until I can drive?
The ability to drive depends on whether surgery was on your right or left hip and the type of car you have. If the surgery was on your left hip and you have an automatic transmission, you could be driving at two weeks. If the surgery was on your right hip, your driving could be restricted as long as six weeks.
How long until I can get back to normal?
Getting “back to normal” will depend on your progress. Consult with your surgeon or therapist for their advice on your activity.
When will I be able to get back to work?
We recommend that most people take at least one month off from work, unless their jobs are quite sedentary and they can return to work with crutches or a walker. An occupational therapist can make recommendations for joint protection and energy conservation on the job.
When can I have sexual intercourse?
The time to resume sexual intercourse should be discussed with your surgeon.
How often will I need to be seen by my doctor following the surgery?
You will be seen for your first postoperative office visit two-three weeks after discharge. The frequency of follow-up visits will depend on your progress. Many patients are seen at six weeks, 12 weeks and then yearly.
What physical/recreational activities may I participate in after my surgery?
You are encouraged to participate in low-impact activities such as walking, dancing, golf, hiking, swimming, bowling and gardening.
Do you recommend any restrictions following this surgery?
High-impact activities, such as running, singles tennis and basketball, are not recommended. Injury-prone sports such as downhill skiing also are restricted. Your physical therapy team will teach you your movement precautions when you are in the hospital.
Will I notice anything different about my hip?
In many cases, patients with hip replacements think the new joint feels completely natural. However, we always recommend avoiding extreme position or high-impact physical activity. The leg with the new hip may be longer than it was before, either because of previous shortening due to the hip disease or because of a need to lengthen the hip to avoid dislocation. Most patients get used to this feeling in time or can use a small lift in the other shoe. Some patients have aching in the thigh on weight bearing for a few months after surgery.
When can I go up and down stairs?
It is important that the Nursing staff and physical therapist be aware of any stairs you will need to climb to get into your house. This way the physical therapist can instruct you on proper technique prior to discharge from the hospital.
How long should I continue taking my medication after I go home?
Blood thinning medication (Coumadin) should be taken until your surgeon has instructed you to stop. All pain medications may be taken as directed for pain. If you have any questions, consult your doctor.
How long will my hip continue to hurt and swell?
Swelling usually increases during the first few days at home from the hospital. This is improved by spending one hour in the morning and one hour in the evening with the feet elevated each day. (Remember to follow your hip precautions when elevating your legs.) Swelling generally is worse in the evenings and is increased by exercise.
The pain after joint replacement usually decreases rapidly during the first month. Sometimes there is a dull ache after long walks, which can occur for up to 18 months. “Start-up” pain (pain with the first few steps after standing up) may present for a while. This improves without treatment and does not mean the implants are loosening or failing.
How much exercise should I do, and how can I tell if I have done too much?
Mild to moderate exercise is beneficial. Twenty minutes, four times daily should be devoted to performing your exercises. Increased swelling and pain, not alleviated by elevating your feet, are good indicators you may have done too much.
How long do I need to follow my hip precautions?
Taking care of your new hop is a lifetime process. Your surgeon will determine the length of time you need to follow the three precautions that prevent dislocation.
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