I will discuss the pros and cons of surgical vs non-surgical treatment for hip osteoarthritis, and a tailor a treatment plan to your individual needs. Once a mutually agreed decision to have surgery has been made, you will be listed for a total hip replacement. You will be taken through the consent process for surgery and asked to sign a form.
You will receive an appointment to attend the pre-operative assessment clinic. Your relative/carer is also encouraged to attend with you as they will be an important part of your recovery and timely discharge. During this appointment a detailed medical history will be taken. A blood sample will be required, heart tracing will be taken (ECG), swabs will be taken to check for the presence of bacteria (MRSA). We may need to organise other investigations based on your individual needs to ensure you are optimised and safe prior to having your operation.
Before you come into hospital it is important you are as fit as possible for your operation. You can do this with a healthy balanced diet and regular exercise. We appreciate walking may be painful, but a lot of exercises can be done by sitting in a chair or laying down in bed. It is important that your skin is in good condition, as wounds or rashes on the skin increase the chances of you getting an infection. If you have any concerns regarding your skin in the days leading up to your operation, we strongly advise you to let us know.
Day of Hip Replacement Operation
You will be welcomed on to the ward by one of our friendly healthcare professionals. You will meet the nurse or healthcare assistant who will methodically go through your admission paperwork and carry out a few baseline observations.
You will meet the anaesthetist who will discuss the anaesthetic plan with you. We usually tend to do the operation under a spinal/epidural anaesthetic as this usually leads to the quickest post-operative recovery and allows you the opportunity to mobilise early on your new hip. Sometimes a general anaesthetic may be required.
You will meet me, and I will confirm the operation plan with you and will happily answer any questions that you might have. The operation lasts approximately an hour or hour and a half.
After Your Hip Replacement Operation
You will be transferred from the recovery area to the ward. You might experience some pain which will be different to the pain you were experiencing prior to surgery. You will be given pain killers to help manage this. Depending on how long it takes for the anaesthetic to wear off you may be able to walk on your new hip on the day of surgery or the following day.
The length of stay in hospital is usually a couple of nights, but you may be able go home sooner or later depending on your general condition and safety with mobilisation with the physiotherapists. A small proportion of people may be able to go home within 24 hours of their operation once all the safety requirements are fulfilled.
After you go home, simple walking with two sticks/ crutches is one of the best exercises for your new hip. Start with frequent short walks and build up the amount you walk slowly as your stamina improves. There is no set walking regimen, rather walk what distance you feel comfortable doing.
Discard one crutch or stick when you feel confident or competent to do so. Discard the second crutch or stick only when you feel you no longer need it.
Precautions advised for a period of 12 weeks to reduce the risk of dislocation:
1) Do not sit with your legs crossed.
2) Avoid bending your hip beyond 90 degrees.
3) Do not twist the operated leg in or out.
4) When walking upstairs remember to lead with the un-operated leg. When coming downstairs put the operated leg down first.
5) Try sleeping on your back if possible.
6) Do not drive until you cleared to do so. This period is usually 6 weeks from surgery.
7) If you are a passenger in the car, always try and sit in the front seat.
8) Avoid using a bath. You can use a free-standing shower with a waterproof dressing over the hip or once your wound has fully healed.
9) You are advised to use dressing aids to wear undergarments, socks, trousers, and shoes on the operated leg.
You must not drive till you have be given the go ahead by me. This period is usually 6 weeks from surgery. It is your responsibility to inform your insurance company that you have had a total hip replacement.
Depending on your individual needs, you might be provided equipment by the occupational therapist on discharge to maintain your safety and independence once you are home. After the precautionary period of 12 weeks, most leisure activities may be enjoyed and continued with care. Remember to take things gently, not overdo it, and when in doubt seek advice.
Continue with the exercise programme provided by the physiotherapist on discharge form the ward until normal strength and function are regained. During the early days do take care with heavy manual work and lifting heavy weights. Avoid activities causing repetitive impacts to your hip. Do not gain excess weight, or take part in activities that involve running, jumping, pulling or twisting.
If you are planning a holiday after your operation, wait at least 3 months to go on a short haul flight and 6 months for long haul flights and coach holidays. Beware, coach or airline toilet seats may be too low.