Hip Replacement Surgery

Hip replacement surgery, also called arthroplasty, removes a diseased hip joint and replaces it with an artificial joint, called a prosthesis. These implants are made to resist corrosion, degradation and wear. Hip replacement is typically used for people with severe joint damage from arthritis or an injury. Followed by rehabilitation, hip replacement can relieve pain, restore range of motion and mobility and in many cases lead to an overall increase in the quality of life. 

Some of the conditions that might result in hip replacement are:

  • Osteoarthritis
  • Rheumatoid arthritis
  • Trauma or accident
  • Bone tumor
  • Avascular necrosis (also called osteonecrosis)

Related

 
Preparing for your hip replacement surgery
Because your joint replacement is usually a scheduled surgery rather than an emergency, you’ll have time to prepare for the surgery and recovery period.  Riverside offers classes and services to help you get ready so you’ll have a worry-free surgery and rehabilitation. This section highlights our services and offers some tips to make your recovery a more positive experience.
 
Riverside joint replacement classes
Hip replacement is major surgery. Our Joint Replacement Class fully prepares you for the surgery and afterwards. To help alleviate surgery jitters, our staff walks you through what you can expect from surgery and rehabilitation. We’ll show you exercises that will strengthen your muscles, which will speed your recovery. You’ll learn what equipment you’ll need post-surgery and how to get your house set up for your recovery period. We’ll also cover the rehabilitation programs at the Riverside Rehab Centers as well as what you should expect in terms of pain management, time on crutches or a walker, length of physical therapy, type of home assistance required, and time until you can resume full activities.
 
Riverside home health care visit
Because the recovery period you spend in your home is so essential to your healing, Riverside offers a unique, free service. A home health care nurse will come to your house, at no charge to you, and review with you and your family how to make it comfortable and rehab-friendly. You won’t be a victim of “if only I had thought of that” while you heal. For instance, our expert may point out something as simple as rugs that need to be moved to prevent tripping or slipping.  Or, you may be advised on what type of bed or other medical equipment to acquire for the recovery period. To schedule your free home visit, call (757) 594-5600.
 
Riverside tips
We have a few tips on things you will want to take care of before your surgery to reduce worries and to make life more convenient while you are healing.   
 
Make sure your medical insurance coverage in order
Insurance coverage is one area you don’t want to worry about. Well before the surgery, contact your insurer to make sure you understand the following:
  • Need for a second opinion on your hip replacement surgery.
  • Hospital and health care providers’ status as “in-network” or “preferred”.
  • Deductibles for hospital services.
  • Limits on length of stay.
  • Coverage for hospital rehabilitation services.
  • After-care services for your hip replacement surgery, such as physical or occupational therapy. (Ask whether the therapists must be from an approved list and how many visits or sessions are covered.)
  • Equipment such as wheelchairs, walkers, and crutches, and whether they must be obtained from approved vendors.
  • Home health care coverage, what type, and for how long.
 
Get your home ready for recovery
After your surgery, your mobility and flexibility will be severely limited while you are recovering. Planning ahead can save aggravation and keep you safe.
  • Rearrange furniture to create wide walkways to accommodate a walker or crutches.
  • Remove rugs that may cause trips or slips.
  • Go through the house and place frequently used items within arm’s reach.
  • Make sure you have a sturdy chair with arms in the room where you will spend most of your time. Place a table, wastebasket, phone and TV remote control nearby.
  • A lightweight bag, like a cloth grocery bag, that you can put over your shoulder is convenient for carrying the phone or a book with you while you are on crutches or using the walker. Some people use a carpenter’s belt.
  • Set up a bedroom downstairs. You don’t want to attempt the stairs during this period.
  • Buy or prepare and freeze meals in advance.
  • Take care of important paperwork and get caught up on bills.
  • Buy a long-handled grabbing device. You won’t be able to reach down or over to pick up things.
  • Consider buying an elevated toilet seat and a shower bench.
  • Consider installing handrails and grab bars in the bathroom and shower.
  • Ask neighbors, friends and family for help in advance.
Contact your Orthopaedic Surgeon’s office to sign up for the free visit from the home health care nurse.
 
Medical preparations
  • Donate your blood
    Because you may require a blood transfusion during or after your surgery, you may be asked to donate your own blood.
  • Pre-operative testing
    You’ll need to go for Preoperative Assessment testing before your operation or on the day of your surgery. Call Riverside scheduling at (757) 989-8830.
  • Exercising
    You’re getting a new hip, so it may sound counterintuitive to exercise and strengthen the one you’ve got now. It’s essential that the muscles surrounding your new hip are strong enough to support you as you move, walk and to get in and out of bed after surgery. You’ll also need strong arms to help you sit down and pull yourself up. Riverside physical therapists will recommend specific exercises.
  • Nutrition
    Your body needs to be in the best condition possible before the stresses of surgery.  This means you should try to lose weight if you are overweight. You should eat a healthy, well balanced diet and increase your intake of calcium, iron and vitamin C. Calcium is important for building and maintaining bone strength. Iron builds red blood cells, which help healing. Vitamin C improves the absorption of iron into the body.
    • The Recommended Daily Allowance (RDA) of calcium is 1000 to 1200 milligrams a day.
    • The RDA for iron is 8-18 milligrams a day.
    • The RDA for vitamin C is 75-90 milligrams a day.
 
Other questions?
Your Riverside surgeon and staff will be happy to explain the hip replacement procedure, the type of device being implanted, and what you should expect in terms of pain management, your rehabilitation center stay or the type of home assistance required.  Don’t hesitate to ask questions. The Riverside Nurse service is also a good resource for information about hip replacement surgery and recovery. They can be reached at (757) 595-6363.
 
The night before your surgery
Do not have anything to eat or drink after midnight before your surgery. (This includes mints, chewing gum, coffee, tea or water.) Since you’ll be using anesthesia, it’s essential that your stomach is empty during surgery.
  • If you smoke, cut down or quit as soon as possible. Smoking changes blood flow patterns, delays healing and slows recovery. Do not smoke after midnight before your surgery or the first 24 hours after. Please be advised that Riverside Regional Medical Center is a non-smoking hospital.
  • If you drink, do not consume any alcohol for at least 48 hours before surgery.
  • If you use any type of controlled substances, tell your doctor. Narcotics and other drugs can have an impact on your surgery.
  • Take a shower or bath the night before your surgery to help reduce the risk of infection.
  • Do not shave the area of your surgery.
  • Do not wear any make-up, lipstick or nail polish.
 
Day of Surgery
 
What to expect
Hip surgery requires a hospital stay. Riverside offers surgery on the same day you are admitted, so instead of spending the night before in the hospital, you can sleep in your own bed. You’ll be given instructions on food, medicine and liquid intake and told the time to come to the hospital.
 
What to Bring
  • Low heeled walking shoes with non-skid soles or tennis shoes. No open heel shoes or clogs.
  • Pajamas and a short bathrobe.
  • Loose fitting, comfortable clothing wear when you get up and move after surgery.
  • Toilet articles and any other needed personal items.
  • Eyeglasses.
  • If you use an inhaler, please bring it.
  • Bring any orders given to you by your doctor and give them to the person who admits you.
  • Insurance card, driver’s license or other government issued-issued ID.
  • A list of your home medication including nonprescription or herbal items along with a list of: Dosage, why you take them and how often.
  • Do not bring your crutches or walker unless asked to.
  • Leave all your valuables at home--money, jewelry and credit cards.
Admission
  • At the hospital, you’ll take care of some hospital admission paperwork. Don’t forget to bring your insurance card and a driver’s license or other government-issued ID.In the pre-surgery unit, a nurse will speak with you and verify your health history and allergies.
  • You’ll put on a gown and lay on a stretcher. From here on out, you’ll be wheeled to the various areas for your hip surgery and recovery.
  • Intravenous fluids will be started to provide you with medication and fluid during surgery and for a day or two after your operation.
  • You may receive medication to help you relax and dry out your mouth.

Total Hip Replacement Procedure
The operation will take two to four hours. You’ll be given general, spinal, or epidural anesthesia. After you are anesthetized, your surgeon will make an 8-12 inch incision along the side of your hip and reveal the hip joint. After removing the ball part of the joint from the top of the thighbone, your surgeon will attach a new synthetic or metal ball joint. Your surgeon will repair the surface of the hipbone and attach a new socket, then reattach the muscles. Your surgeon will choose the materials for your implants, based on your age and level of activity. Typically, the prostheses are implanted without the use of bone cement. The surface of the implants has a special design that allows bone to grow into the prosthesis, providing a secure attachment.  Sometimes, bone cement is used if the quality of the bone is poor. After the prosthesis is in place, an x-ray is taken to verify that it is correctly positioned. The incision is then washed with saline solution as a safeguard against infection. Source: Encyclopedia or Surgery
 
Recovery room
After the operation is over, you’ll be moved to the recovery room where specially trained nurses will continue to monitor your vital signs. Once your condition is stabilized, you’ll be moved to a hospital room where you’ll be given pain medication. Your family will be notified as soon as your operation is over. In your hospital room, nurses will continue to monitor your vital signs and wound dressing.
 
Orthopedic unit stay
  • During your time in the hospital, your orthopaedic surgeon, nurses and physical therapists will monitor your condition and progress closely.
  • It’s important after surgery to cough and breathe deeply to help your lungs remain clear.
  • You’ll also need to change positions with the help of a nurse about every 2-4 hours to help keep your skin and blood flow healthy.
 
Pain relief
Postoperative pain management enables you to do the required physical therapy and to minimize pain and stress. If a general or spinal anesthesia was used, postoperative pain relief may be delivered intravenously. You will be able to control the flow of medication, within preset limits as you feel the need for additional relief. Gradually the pain medication will be reduced and you’ll be given solid food.

Usually, you’ll be discharged once you meet rehabilitative milestones such as getting in and out of bed unassisted and walking a short distance.

 


 

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