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Frequently Asked Questions about
Total Hip Replacement
We are glad you have chosen the Joint
Surgery Center 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 Joint
Care Coordinator. You can contact the Joint Care Coordinator at
928
214-2812 or by e-mail at
FMCJointSurgeryCenter@nahealth.com. 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?
Results will vary depending on the
quality of the surrounding tissue, the severity of the arthritis at the
time of surgery, the patient’s activity level and the patient’s
adherence to the doctor’s orders.
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. 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 primary care provider or
specialist 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 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 the hip after surgery is a risk. Your surgeon
will explain the possible complications associated with total hip
replacement.
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, you should consult your
surgeon and physical therapist about the exercises appropriate for you.
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 want to use your own.
How do I donate my own blood?
Call your surgeon’s office, which
will work out the details of your blood donation.
How long am I incapacitated?
You will probably stay in bed the
day of your surgery. However, the next morning most patients will get
up, sit in a chair or recliner and should be walking with a walker or
crutches later that day.
How long will I be in the
hospital?
Most hip patients will be
hospitalized for three days after their surgery. There are several goals
that you must achieve before you can be discharged.
What if I live alone?
Two options are usually available
to you. You may return home and receive help from a relative or friend.
You can have a home health nurse and physical therapist assist you at
home for two or three weeks. You may also stay at a sub-acute facility
following your hospital stay depending on your insurance.
Will I need a second opinion prior
to the surgery?
The surgeon’s 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 and pre-admission appointment, the
Joint Care
Coordinator
will contact you. The Joint Care Coordinator will guide you through the
program and make arrangements for both pre-op and post-op care.
How long does the surgery take?
We reserve approximately 2–2˝
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 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 try to keep you as comfortable as possible with
the 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. 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 private nurse?
No, you do not need a private
nurse, but if you want one, we can assist in making these arrangements
for you.
Will I need a walker, crutches or
cane?
Yes, for about six weeks we do
recommend that you use a walker, a cane or crutches. The
Joint Care
Coordinator can arrange for them if necessary. The Joint Care
Coordinator will be working with a case manager to facilitate your
post-op care and equipment needs.
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, or you may rent or borrow one. 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. Other
equipment needs (with instructions for use) will be arranged by the
Joint Care
Coordinator.
Where will I go after discharge
from the hospital?
Most patients are able to go home
directly after discharge. Some patients may transfer to a sub-acute
facility and stay there for 3–7 days. The
Joint Care
Coordinator 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.
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. If you go directly home from the hospital,
the
Joint Care
Coordinator will arrange for a home health care nurse to
come to your house as needed. Family members or friends need to be
available to help if possible.
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 at
home?
You may need this service. If so,
we will arrange for a physical therapist to provide therapy at your
home. Following this, you may go to an outpatient facility two to 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.
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 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 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.
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.
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 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.
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FREQUENTLY
ASKED QUESTIONS
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TOTAL HIP
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TOTAL
KNEE
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PATIENT
ANESTHESIA FAQs
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CONTACT
INFORMATION
You can contact the
Joint Care Coordinator
at 928 214-2812
or by
e-mail.
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