Total Hip Replacement

When you and your orthopedic surgeon decide that total hip replacement is right for you, here is an idea of what you mayexpect during the days and weeks leading up to surgery, as well as the day of surgery.

Pre-operative procedure

You and your orthopedic surgeon may participate in an initial surgical consultation. This appointment may include preoperative X-rays, a complete medical and surgical history, physical examination, and comprehensive list of medications and allergies. During this visit, your orthopedic surgeon will likely review the procedure and answer any questions you may have.

Your orthopedic surgeon may require that you have a complete physical examination by your internist or family physician as you will need to be cleared medically by your physician before undergoing this extensive procedure. And you may be instructed by your internist on whether you need to donate blood prior to surgery in the event that you will need a blood transfusion post-operatively.

Also, your orthopedic surgeon may ask you to consult a physical therapist to discuss the recovery period, rehabilitation program, and important precautions, as well as instruct you in exercises that you can begin prior to surgery that will make the recovery much easier.

Your physician and hospital may also require that you visit the admissions department prior to surgery to pre-certify the procedure with your insurance company.

Finally, maintaining good physical health prior to surgery will also improve the recovery period and overall post-operative outcome.

Preparation for the Hospital

You may want to bring the following items to the hospital for your hip replacement surgery: Clothing: underwear, socks, t-shirts, exercise shorts for rehabilitation Footwear: walking or tennis shoes for rehab; slippers for hospital room Walking aids: walker, cane, wheelchair, or crutches if used prior to surgery Insurance information.

You should follow your regular diet on the day before your surgery. DO NOT EAT OR DRINK AFTER MIDNIGHT. Follow your doctor's instructions regarding use of medication in the days leading to surgery. Finally, try to get a long, restful night's sleep.

Day of Surgery

On the morning of the surgery, you will be admitted to the hospital and taken to the appropriate pre-surgical area. The nurse will spend a few minutes preparing you for surgery by taking your vital signs, starting IV fluids, and administering medications as needed. You will be asked to empty your bladder just prior to surgery, and to remove all jewelry, contacts, dentures, etc. You will change into a hospital gown, be placed on a stretcher, and transported to the operating room. The anesthesiologist will meet you and review the medications and procedures used during the surgical case.

Surgery and Recovery

After the surgical case is completed, you will be taken to the recovery room for a period of close observation. Your blood pressure, heart rate, respiration, and body temperature will be closely monitored by the recovery room staff. Special attention will be given to your circulation and sensation in the feet and legs. When you awaken and your condition is stabilized, you will be transferred to your room.

Although the protocols may vary from hospital to hospital, you may awaken to some or all of the following:

• A large dressing applied to the surgical area
• A hemovac suction container with tubes leading directly into the surgical area. This device allows the nurses to measure and record the amount of drainage being lost from the wound following surgery
• An IV will continue post-operatively in order to provide adequate fluids. The IV may also be used for administration of antibiotics or other medications
• A catheter may have been inserted into your bladder as the side effects of medication often make it difficult to urinate
• An elastic hose may be applied to decrease the risk of deep vein thrombosis (DVT). Furthermore, a compression device may be applied to your feet to further prevent a DVT
• A patient-controlled analgesia or PCA device may be connected to your IV. This device allows you to control the relative amount and frequency of the pain medication. The unit is set to deliver a predefined amount of pain medication anytime you press the button of the machine. The machine is programmed so that you cannot overdose on the pain medication

You will typically be placed on a floor of the hospital with other patients who have had surgical procedures. As a result, the nursing staff is well-trained to manage the post-operative program following total hip replacement.