Pre-op and Surgery Day
Once you and your orthopedic surgeon decide that hip surgery is right for you, the days and weeks leading up to surgery, as well as the day of surgery, require preparation. Here is what you may expect.
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 surgeon will likely review the procedure and answer any questions.
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. Your surgeon may suggest that you consider donating your own blood to save in case you need it during surgery or in the event of a post-operative blood transfusion.
Also, your surgeon may ask you to consult a physical therapist to discuss the recovery period, hip 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 hip surgery will also improve the recovery period and overall post-operative outcome.
Preparing for Home before the Surgery
Since you will be spending a lot of time at home following surgery and your movements and activities will be restricted, it is important that you arrange your furniture and household items ahead of time to maximize your comfort and convenience during rehabilitation. Some things you may wish to do before surgery:
- Add extra cushions to couches and chairs for comfort and to ensure that you will be sitting high enough to accommodate your new hip during your rehabilitation period. Since you should avoid bending your hip past 90 degrees, it is important that you not sit in a way that will bend your waist lower than your knees.
- Cover or remove all chairs without arms. During rehabilitation, you should only sit in armchairs, as you will need the arms to help you sit down and get up.
- Arrange to have an elevated toilet seat and/or support bars fitted in your bathroom when it is time to leave the hospital.
- Make sure that any items you may need to reach have been moved to shelves or tables above waist level. You should not be bending past 90 degrees in rehabilitation.
- Remove all throw rugs and anything else on the floor that it might cause you to slip or trip.
Help at Home
The nurse assisting you and your family in planning for your care at home can offer home healthcare sources and information. 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, and exercise shorts for rehabilitation
- Footwear: Walking or tennis shoes for rehab and slippers for hospital room
- Walking aids: Walker, cane, wheelchair, or crutches if used prior to surgery
- Insurance information
The days before surgery, you should do the following:
- Follow your regular diet the day before the surgery.
- DO NOT EAT OR DRINK AFTER MIDNIGHT. On the morning of surgery, you may brush your teeth and rinse your mouth, but do not swallow any water.
- Follow your doctor's instructions regarding use of medication in the days leading to surgery. In some cases, a blood thinner may be ordered a few days before surgery. Generally, aspirin and non-steroidal anti-inflammatory medications should not be taken seven days prior to surgery.
- Try to get long, restful nights of sleep.
Day of Surgery
On the morning of the surgery, once you are admitted to the hospital, you will be taken to the appropriate pre-surgical area where the nursing staff will take your vital signs, start intravenous (IV) fluids, and administer medications as needed.
You will be asked to empty your bladder just prior to surgery, and to remove all jewelry, contacts, dentures, etc. If you choose not to remove a ring, it will be taped. 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 to be used during surgery.
Surgery and Recovery
When surgery 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.
Protocols vary from hospital to hospital, and you may awaken to some or all of the following:
- A large dressing applied to the surgical area
- A drain tube 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.
- Support stockings may be applied to decrease the risk of deep vein thrombosis (DVT). A compression device may be applied to your feet to further prevent DVT.
- A patient-controlled analgesia (PCA) device may be connected to your IV, allowing you to control the relative amount and frequency of the pain medication. To prevent overdose, the unit is programmed to deliver a pre-defined amount of pain medication anytime you press the button of the machine.
You will typically be placed on a floor of the hospital with other patients who have had surgical procedures and a nursing staff that is well-trained to manage the post-operative program following hip replacement.
Progress varies from patient to patient, so discharge instructions may vary. You will receive specific instructions and precautions from your surgeon, nurse, and physical therapist. These instructions should be continued until you return for your follow-up examination.