Total Hip Replacement FAQs

 

 What is a total hip replacement?

Total hip replacement, or total hip arthroplasty, is a surgical procedure in which damaged bone and cartilage from your thigh bone(femur) and pelvis are replaced with an artificial joint made of metal alloys and high-grade plastics and polymers. 

 

How do I know if I need a hip replacement?

The recommendation to proceed with surgery is based on a variety of factors including surgeon recommendation, overall health, failure of conservative treatment, as well as future expectations and aspirations.  We believe all of your questions and concerns should be addressed before surgery so that you are comfortable with your decision.

 

What are the risks of hip replacement?

Risks of total hip replacement include blood clots (DVT/pulmonary embolism), bleeding, infection which can require reoperation, fracture, damage to nerves or blood vessels.  Other risks include chronic hip pain and stiffness as well as potential anesthesia complications such as heart, lung, kidney, and liver damage.   

 

How is my surgery scheduled?

If Dr. Wilson has recommended surgery and you have consented to proceed, you will be contacted by one of our surgery schedulers, and a date for your surgery will be set.  The time of day your surgery occurs is based on many factors and if you have a specific need or request please let them know.  Our surgery scheduler will coordinate insurance authorizations, specialist referrals, post-operative physical therapy appointments, as well as follow-up office visits.  Our surgery scheduler will contact you several days before surgery to inform you what time to arrive for your procedure. You will be provided instructions on bathing/cleansing measures to perform before your surgery.  DO NOT shave your leg for one week prior to surgery.  If you develop any wounds/sores/cuts/scratches/bites around your surgical site please contact our office 48-72 hours prior to surgery to arrange for evaluation.  Failure to do so could result in your surgery being cancelled. 

 

What will I do on the day of surgery?

You may use the free valet parking if desired and signage is marked throughout hospital grounds.  You will present to the outpatient surgery desk on the second floor of the hospital where you will check in.  The receptionist will verify your identification and update any insurance/billing information if necessary.  Following check-in, you will be taken back to a private room where nursing staff will prepare you for surgery.  Your designated family member may be allowed to accompany you once deemed ready by the nursing staff.  An anesthesiologist will examine you and discuss your medical history.  They will also discuss with you options including general or spinal anesthesia, as well as nerve block procedures.  Dr. Wilson and/or his Physician Assistant Adam will see you before surgery and answer any final questions you may have.  Your family/friends will wait in the outpatient surgery lobby while you are in surgery.  Dr. Wilson will call your designated contact upon completion of the surgery to inform them your procedure is complete.  

 

How long will my surgery take and how long will I be in the hospital?

Your procedure will take approximately 1 hour.  Upon leaving the operating suite you will be taken to the PACU(Post Anesthesia Care Unit) for 1-2 hours before being transported up to your room.  The amount of time you spend in the hospital is based upon many factors.  Uncomplicated total hip arthroplasty is now an outpatient procedure with potential discharge home on the day of surgery.  Overnight stay is common, and you will not be discharged until medically stable and have passed physical therapy goals.  You will be given a blood thinner after surgery.  Please take this medication as prescribed to reduce the risk of blood clots.  You will take this medication for 4 weeks after surgery.  It is normal for you to have a mildly elevated temperature after surgery.  This can sometimes continue for 4-5 days.  However, if a fever persists above 101.0 degrees, or is accompanied by chills, sweats, increased pain, or drainage from the incision, please call the office at 270-417-740 or send a message through MyChart.  

 

How much pain will I have?

Pain is a subjective measure of discomfort that each individual experiences differently.  Pain control requires a multimodal approach including preoperative nerve blocks, intraoperative local anesthesia, and postoperative oral and/or intravenous medications.  If you have an allergy or intolerance to specific medications this should be mentioned before your surgery.  You will be prescribed narcotic pain medication as outlined in full detail in our office policy on prescribing narcotics.  You will be expected to decrease your narcotic use quickly in the postoperative period.  Dr. Wilson will not prescribe any narcotics beyond 8 weeks post-op and if pain control is still an issue a referral to a pain management specialist may be required.  

 

How long is my recovery?

Each person recovers from hip replacement differently.  It can take up to three months for you to return to most activities, with most patients requiring 6-12 months to obtain maximal strength and endurance.  Your recovery is affected by many factors including dedication with physical therapy, condition before surgery, additional medical problems, and potential postoperative complications.   Return to activities such as driving will depend on which hip is replaced, what type of vehicle you drive, and one’s comfort level and confidence.  In general, driving is acceptable when you can ambulate safely with a cane, enter/exit a vehicle safely, and are no longer taking narcotic pain medication.  You can anticipate using an ambulatory assistive device such as a walker or cane 4-6 weeks post-op.  The use of assistive devices can help improve gait and balance  while regaining your strength, and decrease the risk of falls. Return to work is based upon your profession and workplace demands.  Someone with a sedentary or office job can often return after 4-6 weeks.  If your job requires frequent walking, standing, lifting, squatting, and/or stairs, 4-6 months recovery may be necessary before you can safely resume working. If your employer offers light duty accommodations we can communicate and coordinate with them to accelerate your return.  Traveling is not recommended for at least 2 weeks after surgery, unless it is an emergency.  If traveling is necessary due to an emergency, take frequent breaks and get up to walk around.  Many people experience symptoms of depression and/or anxiety after undergoing a major operation such as total hip replacement.  Even those without a history of mental disorders are susceptible to these feelings.  If you have a history of depression/anxiety and worsening of symptoms after surgery please reach out to your primary care provider or mental health specialist to discuss treatment/management.

 

What else can I do to prepare for surgery?

We ask that you enroll in MyChart prior to surgery in order to provide a more efficient and effective means of communicating with our office.  Our staff will be happy to help you enroll.  You may be required to obtain medical clearance for surgery based upon your past medical history.  This may entail encounters with your primary care provider or other specialists (allergist, cardiologist, pulmonologist, endocrinologist, etc.) to ensure you are optimized for surgery.  Several tests such as blood and urine samples, x rays, CT scan, MRI, and EKG may be necessary.  Your mobility will be decreased after surgery and preparing your home in advance is helpful to reduce risks of fall or injury.  You will need assistance with daily activities including bathing, cooking, shopping, and laundry.  Removing obstacles such as rugs, cords, chairs, and additional clutter is beneficial.  You will need an assistive device such as a walker or cane and should clear walking paths throughout your home. Purchasing toiletry, food, and wound care items in advance will reduce your or your need for travel outside the home.  Please make arrangements for someone to care for your pets if possible.  In addition, animals pose a potential contamination threat to healing surgical wounds.  Making lifestyle changes prior to your surgery can lessen the chance for complications and improve outcomes.  If you smoke, cut down or quit altogether. Smoking affects blood circulation, delays healing, and slows recovery.  If you drink alcohol, do not consume alcohol for at least 48 hours prior to your surgery.  Major dental procedures and other elective surgical procedures should be postponed for 4-6 weeks post-op or until discussed with Dr. Wilson or Adam.  

 

 

How long will my hip replacement last?

Retrospective data demonstrates that more than 90% of total hip replacements are still functioning well at 15 years.  Maintaining a healthy weight and active lifestyle is essential to the longevity of your hip replacement.  Dr. Wilson uses implants which have a proven track record and successful history.  If you have a history of metal allergies you should let our office know before surgery.  Referral to an allergist may be necessary if you have a history of metal or antibiotic allergies.  The sensitivity of metal detectors varies and it is possible that your prosthesis will cause an alarm to go off.  We no longer provide any “cards” or specific documentation stating you have a joint replacement. 

 

Where can I find additional reliable information about my surgery?

The American Academy of Orthopedic Surgeons has a very informative and easy to navigate webpage including videos about your procedure.  You may visit www.orthoinfo.org