When the hip joint has worn down to the point when it no longer does its job, an artificial hip (called a prosthesis) made of metal, plastic and ceramic can take its place. The surgery to implant the prosthesis is termed a total hip replacement. While the idea of getting an artificial hip joint may be frightening to some, it is one of the safest and most effective surgical procedures. Patients rank total hip replacements as one of the most satisfying surgeries in the human body.
Appointment Checklist
What To Bring
- X-rays, see explanation below
- Completed Patient Information
- Signed Insurance Authorization (white enclosure)
- Your insurance cards
- Referral from your Primary Care Physician, if applicable
- A list of any medications you are taking
X-rays, Bone Scans, CAT Scans, MRI’s of the Hip or Knee
If you are scheduled for an x-ray at Rothman Orthopaedic Institute, please arrive at least 15 minutes before your scheduled appointment.
If you are bringing x-ray films to your appointment, they must be current to be of value for your appointment with the doctor (no older than three to four months). If you have older films, please bring them in for comparison.
If you are bringing Bone Scans, CAT scans, or MRI films of the hip or knee please bring a copy of the written report as well.
If You Are Coming For An Evaluation Of A Painful Hip Or Knee Replacement Please Bring The Following Additional Items
Labs
Please bring any recent (no older than three to four months) laboratory blood work related to your joint replacement such as an Erythrocyte Sedimentation Rate (ESR) and C-Reactive Protein (CRP).
If you have had your total hip or knee aspirated (“tapped”) please bring the laboratory results from this procedure.
Operative Records
- The “operative report” from your last surgery on your hip or knee. This is a report dictated by the surgeon which tells what was done during the operation and importantly what implants or “parts” were put in or taken out during the surgery.
- The “part stickers” from the implants or hardware that were put in during your last surgery. These are labels from the box of the implant that are placed in the patient’s chart or operative record during the operation. These are necessary if the operative report does not specify the type of implants used.
For revision surgery, your doctor needs this information to order replacement parts which will match up with the implant that you currently have in place.For conversion surgery (converting previous surgery, such as fixation of a hip fracture, to a total joint replacement), this information allows us to have the necessary tools available to remove the hardware in place.
Due to health care privacy laws, your written permission is necessary in order for you to obtain this information for us. The best places to obtain this information are either from:
- The hospital (Medical Records Department) where the surgery was performed (they should have both the operative report and the part stickers)
OR
- The office of the surgeon who performed the surgery (they will usually just have the operative report).
Recovery
Where can I find additional information on the Internet on Total Hip Replacements?
The American Academy of Orthopaedic Surgeons (AAOS) is an organization dedicated to caring for orthopaedic patients. This is a link to their website that provides additional information about Hip Replacements:
http:/What does my hospital stay look like?
You will arrive in the morning of your surgery and get prepared for surgery. You will be taken down to the preoperative holding area where your surgeon or member of the team will mark the correct operative location. You will meet the anesthesia team at that time and be taken back to surgery.
After surgery, you will recover in the post-anesthesia care unit (PACU) as your anesthesia wears off. You will then be transferred to your room. Once your spinal anesthesia wears off and you can move your legs again, physical therapy will work with you on walking. Once you can walk, eat normal food and have your pain controlled, you can leave the hospital.
How long will I be in the hospital?
Most patients go home within 1 day after total hip replacement surgery. Your discharge may be as early as the day of surgery, or may rarely be prolonged for other reasons.
How painful is hip replacement surgery?
No surgery is painless, and hip replacement surgery is no exception. However, postoperative pain from hip replacement surgery is very manageable. Despite their surgical pain, it is not unusual for patients to state that they feel immediate relief after surgery from the deep preoperative arthritic pain. While the experience of pain is unique to each individual, most patients manage the immediate postoperative pain from hip replacement without difficulty.
How will my pain be managed?
Most patients getting hip replacement surgery undergo spinal anesthesia with sedation, so they are not awake during the surgery. This type of anesthesia has many benefits, not the least of which is the continuation of pain relief for several hours after surgery. Additionally, spinal anesthesia has been demonstrated in studies to have other benefits, such as decreased surgical blood loss and a decreased risk of developing lower extremity blood clots when compared with general anesthesia. The muscle relaxation provided by spinal anesthesia also makes performing the surgery easier and therefore may be less traumatic for the patient.
After surgery, patients are treated with other pain medicine, mostly taken by mouth. While it may seem surprising, often the postoperative pain from hip replacement can be managed simply with oral pain medicine. This spares patients from the side effects of stronger intravenous medicines. If it is felt that intravenous medicine is needed, patients are usually provided with occasional injections depending on the level of pain. These types of pain control are generally provided until the day after surgery. After this, most pain medicine is provided in pill form as needed. Patients are often discharged with a prescription of the pills that worked for them during their hospital stay.
Patients can also help relieve their pain with means other than pain medicine. For example, applying ice and elevation to the hip area after therapy can go a long way toward controlling the swelling that often causes discomfort after such activity. On the other hand, when patients have discomfort from stiffness, usually doing some exercises will help relieve this pain more than any medicine will.
How long will I have pain after surgery?
It is difficult to give a specific answer for this, but most patients notice good pain relief within the first 1-2 weeks after surgery, followed by continued recession of pain over the first 1-3 months. Surgical pain is usually at its worst for the first 24 to 48 hours after surgery. After this, patients are usually more comfortable. They may experience some increased pain when doing exercises or therapy, but this can be easily managed by taking pain medicine before therapy.
Is it OK to take pain medicine?
Many patients express concerns about taking pain medicine after surgery, particularly with respect to narcotic addiction. While it is possible to become addicted to narcotic pain medication, this is rare when the medicine is taken appropriately after surgery. Postoperatively, patients have a good reason to have pain and it is okay to take pain medicine at this time. It often takes less narcotic to control a person’s pain when the medicine is taken appropriately – that is, when the patient begins to experience real discomfort. In the early postoperative period, patients should not try to “hold off” on taking pain medicine because they think the pain will calm down in time. These patients who “hold off” until their pain becomes too severe often need more narcotic to control their pain than they otherwise would have needed if they had taken their pain medicine earlier.
What are the side effects of pain medicine?
Side effects of pain medicine and anesthesia include nausea, constipation, mood changes and sometimes a tired feeling. Having these side effects does not mean that a patient is allergic to the medication. If a patient has a problem with these side effects, often the medication can be adjusted or a different medication tried in order to minimize these effects.
When is my first post-operative office visit?
The 1st office visit after surgery is between 2 and 6 weeks from the date of surgery. If you have staples, the 1st office visit after surgery is often 2 weeks from date of surgery.
When will my staples or sutures be removed?
Approximately 2 weeks after your surgical date, the staples or sutures will be removed. Some patients will have no visible staples or sutures and therefore will not need to have anything removed.
When will my dressing be removed?
If you have a specialized dressing that looks like a large band-aid, you may shower with the dressing in place . The dressing should be removed 5-7 days from the day of surgery. If you have a gauze dressing and tape on your hip, it will most likely be removed before you are discharged from the hospital. If not, it can be removed 2 days after surgery and the area should be kept clean and dry.
How long will I remain on anticoagulation (blood thinners that help avoid blood clots)?
Typically 2 to 6 weeks after surgery. For most patients, aspirin is prescribed. For other patients, especially those who are unable to take aspirin, low-molecular weight heparin (Lovenox) or warfarin (Coumadin) are used. If you are on warfarin, you will need bloodwork drawn 1 to 2 times per week and your medical consultant will adjust your medication dosage. If you are placed on aspirin or low-molecular weight heparin injections, you will not require blood testing.
Is swelling of my hip, knee, leg, ankle, and foot normal?
Yes, for three to six months. To decrease swelling, elevate your leg and apply ice for 20 minutes at a time (3-4 times a day).
Is it normal to feel numbness around the hip?
Yes, it is normal to feel numbness around the incision.
Why is my leg bruised?
It is common to have bruising on the skin. It is from the normal accumulation of blood after your surgery. You can see bruising all the way down to your foot due to gravity.
What exercise should I perform at home?
Please do exercises as instructed by your surgeon. Remember, you are using your hip every time you stand up and walk around – this is actually doing physical therapy for your hip. Focus on walking as much as you can. This is often all that is necessary to appropriately heal from hip replacement. Additionally, you may have been given a link for FORCE Therapeutics that will help guide you on which exercises are safe after your total hip replacement.
How long will I need to use a walker, cane, or crutches?
This varies with each patient. Patients often use a walker at first, followed by a cane for typically 2-6 weeks. Some patients are discharged from the hospital with a cane/crutches and do not need to use a walker.
Do I have to observe hip precautions?
Our general policy is that hip precautions are not required. You should avoid things that are uncomfortable, but you are allowed to sit on regular chairs, use regular toilet seats, go in a car, and lay or sleep on your side. You do not ‘need’ to use high chairs, elevated toilet seats or pillows between your legs, but they may be more comfortable for you in the initial period after surgery. Interestingly, you do not have to be concerned about stretching your hip as the hip joint will gradually loosen up on its own over 6 months after surgery. There may be exceptions where certain patients need to avoid bending, crossing legs, or twisting at the waist - this will be explained to you specifically by your surgeon.
May I go outdoors prior to my first postoperative visit?
Yes, we encourage you to do so.
May I drive or ride in a car before my first postoperative visit?
Yes, you may ride in a car; however, you must be off all narcotic pain medications prior to driving. It is a patient's responsibility to determine their own safety. If your right hip is replaced, you will usually need to wait longer before driving, depending on your ability to maneuver your leg to the brake.
May I ride in an airplane before my first postoperative visit?
Yes, you may ride in an airplane. Be sure to get up and move around at frequent intervals to prevent blood clot formation. You may find it more comfortable to sit in an aisle seat.
What is the short-term outlook?
The short-term outlook of total hip replacement is excellent. Most patients can stand the afternoon of surgery and begin exercise that day. With the support of walkers, crutches and canes, patients can walk with confidence, climb stairs and ride in a car by the time they leave the hospital. Some swelling, aching and numbness are normal during this time. Most patients are up and about within six weeks after surgery. It is normal to limp for 2-3 months after surgery.
When can I return to work?
Most patients will return to work within 1-3 months after surgery. This typically depends on the type of work you do and the speed of your recovery. A more sedentary job can be performed even sooner than a month (as soon as a week). A more physically demanding job may require as much as 3 months for you to properly recover before returning.
Can I return to my normal activities after a hip replacement?
Fortunately, hip replacement surgery not only restores our patients' quality of life but, of equal importance, allows them to return to their activities of daily living. Please discuss specific activities with your surgeons, as some activities may need to be limited.
Please note:
All questions will be answered at your follow-up exam. For non-emergency questions, please call the allied health professional for your physician.
For all emergencies or questions after 4:30PM or on weekends, please call 267-339-3500. If you do not speak with someone immediately, then please go to your nearest emergency room.
Message left on voicemails during business hours will be answered. Messages left on voicemails AFTER business hours will NOT be answered until the next business day. Messages left on Force Therapeutics will be answered during the next business day. Clinical questions/comments should NOT be left on Force Therapeutics and should be directly addressed to the allied health professional by a phone call.orthoinfo.aaos.org/topic.cfm?topic=a00377
Patients
Total hip replacement is recommended for patients with arthritis that results in severe pain and limited function. Pain cannot be measured, and the degree of pain sufficient to warrant surgery should be decided by the patient and doctor together. Age (young or old) is rarely an issue anymore. It is important for patients to work with their medical and orthopaedic physicians to be in the healthiest possible condition before undergoing surgery.
For More Information
Where can I find additional information on the Internet on Total Hip Replacements?
The American Academy of Orthopaedic Surgeons (AAOS) is an organization dedicated to caring for orthopaedic patients. This is a link to their website that provides additional information about Hip Replacements:
http://orthoinfo.aaos.org/topic.cfm?topic=a00377
FAQs
What is the average full recovery time for a hip replacement? ›
“On average, hip replacement recovery can take around two to four weeks, but everyone is different,” says Thakkar. It depends on a few factors, including how active you were before your surgery, your age, nutrition, preexisting conditions, and other health and lifestyle factors.
What time of year is best for hip replacement surgery? ›Consider spring and fall. Doctors recommend spring and fall as the ideal times for surgery. Moving around and exercising are essential parts of recovery. The weather around this time is perfect for maximizing visits to a physical therapist.
What is the newest procedure for hip replacement? ›What Is Anterior Hip Replacement Surgery? The anterior approach is a newer minimally invasive technique now being performed by some surgeons. This approach uses a smaller incision near the front of the hip and avoids muscle cutting to access and replace the joint.
What 3 things should be avoided after hip replacement surgery? ›Don't cross your legs at the knees for at least 6 to 8 weeks. Don't bring your knee up higher than your hip. Don't lean forward while sitting or as you sit down. Don't try to pick up something on the floor while you are sitting.
What hurts the most after hip replacement surgery? ›However, even the most successful hip replacement is not immune to postoperative aches and pains, the most common of which being pains in or around the buttocks. The pain does not render you immobile and does indicate an unsuccessful surgery as it is entirely normal following a hip replacement.
Is it better to have a hip replacement sooner rather than later? ›And many of these things can be reversed. When you restore ambulation, you restore the ability to get out and exercise. So I think patients often today are much better to have an arthritic hip or knee replaced sooner rather than later.
Which hip should be replaced first? ›ANSWER: In a situation like yours, it's typically recommended that the joint causing the most symptoms be replaced first. If symptoms are similar, then it's usually best for the hip replacement to be done first. You'll need to allow about six weeks for recovery and rehabilitation after your hip replacement.
Will I ever be the same after hip replacement? ›Around three months after your hip operation, most things will go back to normal, and the pain goes away for most people. You need to look out for signs of complications and continue being careful with how you move your hip. After 6 to 12 months, the recovery is considered complete.
What is the safest hip replacement? ›Since they were first used in 1970, ceramic-on-ceramic hip implants have been considered by many orthopedic experts the best option for hip prostheses, in terms of quality and durability. Ceramic-on-ceramic hip implants have lower rates of bone deterioration, loosening or dislocation and, ultimately, revision.
What is the most advanced hip replacement surgery? ›The surgical technique for a SUPERPATH® Hip Replacement was developed as an advancement to traditional total hip replacement. The SUPERPATH® technique is a tissue-sparing procedure which aims to get patients back on their feet within days (possibly hours) instead of weeks or months.
Do you have a catheter during hip replacement? ›
Indwelling bladder catheters frequently are placed in patients undergoing total hip arthroplasty with spinal anesthesia, presumably to lower risk for postoperative urinary retention.
What is the most frequent complication after a hip replacement? ›One of the most common serious medical complications related to joint replacement surgery is blood clots. Deep vein thrombosis (DVT) refers to a blood clot in the leg and is called a deep vein thrombosis.
When can I bend to put socks on after hip replacement? ›You should not bend your hip beyond 60 to 90 degrees for the first six to 12 weeks after surgery. Do not cross your legs or ankles, either.
What is the best thing to do after hip surgery? ›Low-impact exercises such as walking, swimming, golfing and bicycling are very beneficial to patients recovering from joint replacement surgery. Avoid activities that involve impact stress on the joint, such as jogging or jumping, and contact sports, such as football.
How long do you need a caregiver after hip surgery? ›Since no two people or recoveries are the same, it's difficult to predict exactly how long you may need assistance—you might be good to go in just a few days or need extra help for several weeks. Most people can expect to need assistance for about a week.
How long are you on bed rest after a hip replacement? ›Expect about one to four days of bed rest immediately after surgery, but physical rehabilitation usually starts the same day as your procedure. The process is slow and steady, barring complications, and each week should bring less pain, better balance and increased mobility.
Can you drive 2 weeks after hip surgery? ›If surgery was performed on your left leg, assuming you don't drive a manual transmission vehicle you can start driving once off narcotic pain medication. If surgery was performed on your right leg, you can typically resume driving between 3-4 weeks after surgery.
What should I wear after hip surgery? ›loose-fitting tops and bottoms (shorts with an elastic waistband, generous sweat pants). You will get dressed each morning in your own clothes. clothing you will wear home, including loose-fitting pants, shirt, underwear and socks. flat shoes or athletic shoes (comfortable, supportive with nonslip soles)
Can you do stairs after hip surgery? ›It's not uncommon for people to use a cane, walker, or other equipment for walking assistance immediately after hip surgery. When climbing or descending stairs, hold onto the railing with one hand and place the crutch or cane on the opposite side of your repaired hip.
How long will I need pain meds after hip replacement? ›» You will likely require some form of pain medication for about 3 months after total hip replacement surgery. At first you will be on a strong oral pain medication (such as a narcotic). After the first month most people are able to wean off from the narcotic.
At what age is hip replacement not recommended? ›
UH orthopedic surgeon Steven Fitzgerald, MD, says there is no upper age limit for knee and hip replacement surgery. A patient's overall health is the main consideration. “The oldest hip I replaced in the last 10 years was in a man who was 100 years old,” Dr. Fitzgerald says.
What happens if you don't replace hip? ›In many cases, hip damage and dysfunction will worsen without treatment. Inactivity can lead to loss of muscle strength and increased stiffness of the hip joint. Without a hip replacement, weak hip muscles and joint stiffness could lead to a noticeable limp.
Does arthritis go away after hip replacement? ›Total hip replacement eliminates osteoarthritis in the hip entirely. It may dramatically improve your quality of life by alleviating pain and restoring stability and range of motion to the hip.
What is success rate of hip replacement? ›The success rate of hip replacements 10 years after surgery is 90- 95% and at 20 years 80-85%. Should an implant wear or loosen, revision to a new hip replacement is possible.
How painful is a new hip? ›The pain you may have experienced before the operation should go immediately. You can expect to feel some pain as a result of the operation itself, but this will not last for long. You'll be offered pain relief medicines every few hours.
Can you ever cross your legs again after hip replacement? ›No Leg Crossing
For at least two months after hip replacement surgery, avoid crossing your legs. This is particularly a risk if you bring your knee across your body. Putting a pillow between your legs while sleeping can prevent inadvertent leg crossing during sleep.
Avoid heavy household tasks (such as vacuuming, washing windows, moving furniture) for 3 months or until your surgeon says it's OK.
Which hip prosthesis is best? ›Titanium Implants
Both the ball and the socket of the hip joint are replaced with a titanium implant, and a plastic spacer is placed in between. Titanium metal has a long history of established effectiveness in hip replacement and continues to be preferred by many surgeons.
Who Is NOT a Good Candidate for Hip Replacement? You may not be a good candidate if: You have a chronic disorder, such as Parkinson's disease or a condition that causes severe muscle weakness. You have a severe illness or infection.
Which surgery is better for a hip replacement robotic or regular? ›Studies show robotic-assisted hip replacement surgery is five times more accurate at matching leg length and twice as precise at achieving optimal hip joint angle than conventional hip replacement surgery. Other benefits include: Reduced blood loss. More natural feeling after surgery.
Which is better ceramic or titanium hip replacement? ›
Research shows that ceramic hip replacements may be preferable to metal or plastics, as ceramic is more durable and may last longer. There are some limitations for ceramic materials, including a risk of fracture during implant. Improvements in modern materials have made fractures less of a concern today.
How long does it take a 70 year old to recover from hip surgery? ›Long Recovery Time
In general, the older individuals are and the greater number of conditions they have, the longer it can take to recover. The recovery time for a hip replacement ranges from four weeks to up to six months.
Many people return to normal activities within 10 to 12 weeks after surgery, but full recovery can take six to 12 months. Pain usually goes away during this time, but some people feel some pain beyond the first year. Most hip replacements last 20 years, but a fraction of implants fail sooner.
How long will pain last after total hip replacement? ›Most people, though, experience surgical pain for approximately two to four weeks following hip replacement surgery. Your activity level, medical history, and any pain you're dealing with before surgery have an effect on how long it will take you to make a full recovery.
Is it normal to still limp 12 weeks after hip replacement? ›How long can I expect to be limping for after my operation? There are many reasons for a limp. This is expected for the first few months after your operation. The majority will have settled after 3 months, some may continue to limp up to 12 months after the operation.
Will I need a caregiver after hip surgery? ›Over the days and weeks following your knee or hip replacement surgery, you will need someone to help you out with basic tasks and mobility. Building an after-care plan with your caregiver—whether that's a spouse, family member, friend, or professional caretaker—is one of the most critical details of recovery.
How long will I need a walker after hip surgery? ›In most cases, you will need to use a walker or crutches for two to four weeks after surgery.
Can you climb stairs after hip replacement? ›Climbing stairs may also be difficult during recovery. With anterior hip replacement, patients can bend the hip freely immediately after surgery and use the hip normally without cumbersome restrictions. Under supervision, they go up and down stairs before leaving the hospital.
Why is total hip replacement so painful? ›Loosening of the joint
This happens in up to 5 in 100 hip replacements. It can cause pain and a feeling that the joint is unstable. Joint loosening can be caused by the shaft of the implant becoming loose in the hollow of the thigh bone (femur), or due to thinning of the bone around the implant.
The best hip replacement operation out there, is through the anterior approach. Anterior - meaning from the front of your hip. Most of the country traditionally goes from the posterior approach. The posterior approach works, but post-operative dislocations are higher than the anterior approach.
When can I start using a cane after hip replacement? ›
Instructions after first postop visit (6-8 weeks after surgery): You should now be comfortable in walking with a cane or nothing at all, placing full weight on the operated leg. At this point, if you haven't already done so, you may wean to using 1 crutch or cane in the opposite hand/arm.
How Long Will my leg be stiff after hip replacement? ›When a person has this procedure, their body has undergone significant trauma to replace the damaged joint. While this will reduce pain and discomfort in the long term, it can cause acute pain in the short term. Most people can expect mild to moderate swelling and pain to subside in 3–6 months.