We are glad you have chosen the center for Joint replacement to care for your hip patients have asked many questions about total hip replacement. Below is a list of the most frequently asked questions along with their answers if there are any other questions that you need answered, please ask your surgeon or the Total Joint care coordinator 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 (femur) as well as 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 or metal 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 to ninety-five 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 orthopedic surgeon will decide if you are a candidate for the surgery. This will be based on your history, exam and X-rays. Your orthopedic s surgeon will ask you to decide if your discomfort, stiffness and disability justify undergoing surgery. There is usually no harm in waiting if conservative, non-operative methods are controlling your discomfort
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 personal physician 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? 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 might I require a revision? Just as your original joint wears out, a joint replacement will wear over time as well. The most common reason for revision is loosening of the artificial surface from the bone. Wearing of the plastic spacer may also result in the need for a new spacer dislocation of
What are the major risks? Most surgeries go well, without any complications infection and blood clots are two serious complications. 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. Your orthopedist will discuss ways to reduce that risk.
Should I exercise before the surgery? Yes, consult your surgeon and physical therapist about the exercises appropriate for you.
Will I need blood? You may need blood after the surgery. Bank blood is considered safe, but we understand if you want to use your own. For more information read “Blood Transfusions and You – Know Your options” in The guidebook appendix.
How do I donate my own blood? Most patients will not need to donate blood if however, your physician requests you donate your own blood, the surgeon office will help you arrange this.
How long am I incapacitated? You will probably stay in bed the day of your surgery However, the next morning you will get up, sit in a chair or recliner and will be walking with a walker.
How long will I be in the hospital? Most hip patients will be hospitalized for two nights after their surgery. There are several goals that you must achieve before you can be discharged.
Where will I go after discharge from the hospital? Most patients are able to go home directly after discharge. Some may transfer to a sub acute facility and stay there for 3–5 days. The care coordinator and discharge planner will help you with this decision and make the necessary arrangements. You should check with your insurance company to see if you have sub-acute benefits.
What If I live alone? Three options are usually available to you. You may return home and receive help from a relative or friend and go to outpatient physical therapy or have a home health nurse and physical therapist assist you at home for approximately one hour 3 times a week. The nurse and therapist will provide assistance for 2-3 weeks. You may also stay at a sub acute. Facility following your hospital stay depending on your insurance please refer to page x-x for further information on discharge planning
Will I need a second opinion prior to the surgery? The office secretary will contact your insurance company to pre-authorize your surgery if a second opinion is required, you will be notified.
How do I make arrangements for surgery? After your surgeon has scheduled your surgery, the Total Joint coordinator will contact you about four weeks before surgery. She/He will guide you through the program and make arrangements for both pre-op and post-op care The coordinator's role is described in this guidebook and her office number is 443-481-1698.
How long does the surgery take? We reserve approximately 2–2 1/2 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 your legs only and does not require you to be asleep. The choice is between you, your surgeon and the anesthesiologist. For more information read “anesthesia and You” in your guide book appendix.
Will the surgery be painful? You will have discomfort following the surgery, but we will try to 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 orthopedic surgeon will do the surgery an assistant often helps during the surgery and you will be billed separately by that assistant.
How long, And where, will my scar be? The scar will be approximately six inches long it will be along the side of your hip.
Will I need a walker, crutches or cane? Yes, for two weeks you will use a walker or crutches. You will then progress to a cane for up to four weeks. You should not switch to a cane until you have practiced with your physical therapist Switching to the cane too early can result in a limp because your operated leg is not strong enough to support you.
Will I need any other equipment? After hip replacement surgery, you will need a high toilet seat for about three months. We can arrange to have one delivered to you at the hospital, or you can borrow one from friend or family. You will also be taught to use assistive devices to help you with lower body dressing and bathing. You may also benefit from a bath seat or grab bars in the bathroom, which can be discussed with your occupational therapist.
Will I need help at home? Yes, the first several days or weeks, depending on your progress, you will need someone to assist you with meal preparation, etc Family members or friends need to be available to help. Preparing ahead of time, before your surgery, can minimize the amount of help required. Having the laundry done, house cleaned, yard work completed, clean linens put on the bed and single portion frozen meals will reduce the need for extra help .
Will I need physical therapy when I go home? Yes, you will have either outpatient or in-home physical therapy patients are encouraged to utilize outpatient physical therapy if you need home physical therapy, we will arrange for a physical therapist to provide therapy at your home 3 times a week. Following this, you may go to an outpatient facility three times a week to assist in your rehabilitation. The length of time required for this type of therapy varies with each patient.
How long until I can drive and get back to normal? The ability to drive depends on whether surgery was on your right hip or your 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 getting “back to normal” will depend somewhat on your progress consult with your surgeon or therapist for their advice on your activity. You must be off all narcotic pain medication before driving.
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 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 orthopedic surgeon. The center for Joint replacement has a guide on sexual intercourse and will give you a copy
How often will I need to be seen by my doctor following the surgery? You will be seen for your first postoperative office visit 2–3 weeks after discharge. The frequency of follow-up visits will depend on your progress many patients are seen at six weeks, twelve weeks and then yearly.
Do you recommend any restrictions following this surgery? Yes, high-impact activities, such as running, singles tennis and basketball are not recommended injury-prone sports, such as downhill skiing, are also restricted. Hip patients will be restricted from crossing their legs, twisting operated leg, bending 90 degrees at hip or twisting side-to-side (see page x-x) Your therapist will help you understand these restrictions in the hospital
What physical/recreational activities may I participate in after my surgery? You are encouraged to participate in low-impact activities such as walking, and swimming once wound is completely healed if you experience pain, stop and consult your physician before continuing
Will I notice anything different about my hip? In many cases, patients with hip replacements think that the new joint feels completely natural. However, we always recommend avoiding extreme positions 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 You may also have some numbness around the incision, which is normal, and may last for a year or more