Hip Replacement Surgery

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KEY POINTS

• Hip replacement surgery is a procedure done to remove a painful, broken, or arthritic hip joint and replace it with an artificial hip joint.
• Ask your provider how long it will take to recover and how to take care of yourself at home.
• Make sure you know what symptoms or problems you should watch for and what to do if you have them.

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What is hip replacement surgery?

Hip replacement surgery is a procedure done to remove a painful, broken, or arthritic hip joint and replace it with an artificial hip joint.

Your hip is a ball-and-socket joint where the top of your thighbone meets the cup-shaped socket of your hipbone.

When is it used?

Hip joint replacement is done mainly in people age 60 and older. Possible reasons for replacing the hip joint include:

• Severe pain from arthritis in the hip that limits your ability to do the things you want to do
• Hip joint fractures or tumors

Hip replacement should relieve the problems of a painful hip. After surgery you should be able to move your hip more easily and with less pain. It will be easier for you to walk and do other activities. Most people get back to a more normal life.

This surgery may not be recommended if you have certain health problems. Ask your healthcare provider about your choices for treatment and the risks.

How do I prepare for this procedure?

• Talk to your healthcare provider and to other people who have had the surgery. Knowing what to expect can help lessen anxiety about the operation.
• You may meet with a physical therapist before surgery to learn exercises that will help you after surgery. If you can, increase your leg motions and general exercise before surgery. The more fit you are, the easier it will be to recover from the surgery. Getting yourself into an exercise habit helps you continue good exercise habits after surgery.
• Because you may need blood transfusions during the operation or during recovery, you may want to donate some of your own blood before the procedure. Ask your healthcare provider about this.
• Make plans for your care and recovery after you have the procedure. Find someone to give you a ride home after the procedure. Allow for time to rest and try to find other people to help with your day-to-day tasks while you recover.
• Get equipment that will help you while you recover at home, such as an elevated toilet seat, a shower seat, and grab bars or handrails. Remove rugs and anything that might cause a fall.
• Your healthcare provider may prescribe medicine to prevent blood clots from forming during and after the procedure.
• Your healthcare provider will tell you when to stop eating and drinking before the procedure. This helps to keep you from vomiting during the procedure.
• Tell your healthcare provider if you have any food, medicine, or other allergies such as latex.
• Follow your provider's instructions about not smoking before and after the procedure. Smokers may have more breathing problems during the procedure and heal more slowly. It’s best to quit 6 to 8 weeks before surgery.
• You may or may not need to take your regular medicines the day of the procedure. Tell your healthcare provider about all medicines and supplements that you take. Some products may increase your risk of side effects. Ask your healthcare provider if you need to avoid taking any medicine or supplements before the procedure.
• Follow any other instructions your healthcare provider gives you.
• Ask any questions you have before the procedure. You should understand what your healthcare provider is going to do. You have the right to make decisions about your healthcare and to give permission for any tests or procedures.

What happens during the procedure?

You will be given a regional or general anesthetic to keep you from feeling pain. A regional anesthetic numbs the lower part of your body. If you have regional anesthesia, you will also be given medicine to help you relax. The medicine can make you drowsy or you may fall asleep before the procedure. A general anesthetic relaxes your muscles and puts you into a deep sleep.

Your healthcare provider will make a cut along the side of your hip and remove damaged bone. A metal or plastic artificial joint will be attached to the healthy bone. Your provider will then close the cut in the side of your hip with stitches or staples.

You may need a blood transfusion. The hospital will use either blood you have donated or blood from a donor that matches your blood.

What happens after the procedure?

After surgery, your hip will be covered with a padded dressing. Special boots or stockings will be put on your feet or legs to help prevent blood clots. You may also need medicine to help prevent blood clots. A triangular shaped pillow or a splint may be positioned between your legs to keep your legs from crossing or rolling inward. For a few days you may have a catheter, which is a small tube used to drain urine from your bladder. You will be given medicine to help control pain.

You may stay in the hospital for several days, depending on how fast your hip heals. You will usually start physical therapy right away by learning how to move from your bed to a chair. By the second day, you'll start walking using your crutches or a walker. Your therapist will teach you exercises to start strengthening your thigh and hip muscles. If you and your healthcare provider think you might need extra help with recovery, you may first go to a rehabilitation center before returning to your home. Deciding if a rehab center is needed depends on your fitness, your general health, your ability to do the exercises recommended, and whether or not you have help at home.

After you go home from the hospital, a physical therapist may visit you for in-home treatments. Your therapist will suggest safety tips such as using elevated toilet seats and bathtub benches and making sure that couches and chairs are the right height for you. Raised sitting surfaces keep your hip from bending too much when you sit down.

You may get instructions on what to do or not do as your hip heals. Being careful will allow the hip to heal and help prevent the hip joint from dislocating, meaning the ball comes out of the bone socket.

Constipation is common after joint replacement surgery. It is often caused by narcotic pain medicines as well as inactivity. You may be given a stool softener and a laxative after surgery to avoid this. When you are home again, be sure to eat a high-fiber diet and drink plenty of liquids according to your provider’s recommendations.

Ask your healthcare provider:

• How long it will take to recover
• If there are activities you should avoid and when you can return to your normal activities
• How to take care of yourself at home
• What symptoms or problems you should watch for and what to do if you have them

Make sure you know when you should come back for a checkup.

Let all of your healthcare providers, including your dentist, know that you have an artificial joint. If you get an infection, such as a gum, sinus, bladder, or skin infection, the infection should be treated right away. If you have a procedure, like deep cleaning for tooth and gum problems, or sinus surgery for infections, talk to your provider about taking preventive antibiotics to protect your new joint.

What are the risks of this procedure?

Every procedure or treatment has risks. Some possible risks of this procedure include:

• You may have problems with anesthesia.
• You may have infection, bleeding, or blood clots.
• Other parts of your body may be injured during the procedure.

Ask your healthcare provider how these risks apply to you. Be sure to discuss any other questions or concerns that you may have.