Understanding Hip Replacement Surgery

Understanding Your Hip Replacement Surgery

To understand a total hip replacement you should first understand a little about the structure of the hip joint. The hip joint is a ball and socket with the ball component attached to the top of the femur (the long bone of the thigh). The socket is part of the pelvis. The ball rotates in the socket to permit you to move your leg backward, forward, sideways and in a twisting motion.

On the right is a picture of a healthy hip. The cartilage covers the ends of the thighbone and pelvis. This allows the ball to glide easily in any direction inside the socket. In a hip requiring hip replacement Surgery, the worn cartilage no longer serves as a cushion. As the damaged bones rub together, they become rough, with a surface like sandpaper. This rubbing results in pain with almost any movement and steadily decreasing mobility. In a total hip replacement the ball replaces the head of the thighbone. The stem component of the ball, which is made of a metal alloy, is inserted into the marrow of the thighbone. A cup made out of a durable plastic material replaces the worn socket in the hip. The prosthesis is held in place by either new bone growing into it or by bone cement.

Before your Hip Replacement Surgery

One you have contact us to let us know that you wish to proceed, we set a target date for your treatment once you confirm your travel arrangements, we then dispatch a confirmation letter explaining your full itinerary, together with a "you and your hip surgery" booklet, and a patient pre-surgery questionnaire.

• If you think you may have a moth infection or bad tooth, visit your dentist beforehand.
  
  
• Arrange for someone to help you around the house for a week or two after coming home from the hospital.
  
  
• Set up a "recovery station" at home. Place the TV remote control, radio, telephone, medicine, tissues, reading book, waste basket, and pitcher and glass next to the spot where you will spend the most time while you recover.
  
  
• Place items you use every day at arm level to avoid reaching up or bending down.
  
  
• Stock up on kitchen supplies and prepare food in advance, such as frozen casseroles or soups that can be reheated and served easily.
  
  
• Completed and return the patient pre-surgery questionnaire.
  
  
• Bring with you slippers, trainers or walking shoes, loose comfortable clothing, dressing gown or bath robe, personal toiletries, eye glasses, dentures, reading materials or anything to help you relax such as a personal walkman and music.
  
  
• We provide crutches.
  
  
• Bring phone numbers of people you may want to call.
  
  
• Bring a small amount of money for telephone calls and items such as a magazine.
  
  
• Passport.
  
  
• Form E111 (obtainable from your local post office).
  
  
• Bring any medication and a list of any medicines that you have been taking.
  
  
• Bring along any medical reports, MRI's or x-rays that may be in you possession. It is not necessary to have a medical referral and if you are unable to get hold of your medical records we can manage without them.
  
  
• 5 days before travelling, some vitamin & iron tablets may be taken to boost your immune system, and an antiseptic cleansing shower gel such as "Hubiscrub" may be used to reduce any germs that may be present on your skin. These are obtainable from your local chemist.

Is there much Pain?

Normally following your surgery you will experience little or no pain. If following the surgery you are experiencing pain, inform the nurse.

The nurse will notify the anaesthetist who will then make an assessment and provide you with pain medication.

What is involved in the Surgery?

The day before Surgery

You will undergo a number of tests and x-rays, you will receive a clinical examination and have a consultation with the consultant orthopaedic surgeon.

The Night Prior to Surgery

You will be asked not to eat or drink anything after midnight.

The Day of your Surgery

You will meet a registered theatre nurse who will care for you until you are moved to the operating theatre.

The anaesthesiologist will review your history and type of anaesthesia used.
An IV will be started and sedative medication will be administered, Epidural anaesthesia may be started at this time.

The Hip Replacement Operation

Your surgery generally takes 1½ to 2½ hours, don't be surprised if the time for your surgery passes by. The theatre schedule is flexible to allow for some procedures to overrun.

After Your Surgery

After surgery is completed you will be moved to the recovery area in intensive care for a short time, if you have any medical history of heart problems you may well be held in intensive care for a few days. This is just a precautionary measure. Whilst you are in intensive care especially trained nurses will closely monitor you.

You will then be transferred to your room where your family will be allowed to be with you.

You will have received extensive physiotherapy during your stay in the hospital, therefore you will be in good shape for your return home.

Continue to take any prescribed medication and follow the doctor's instructions regarding the medication.

Follow the physio therapist exercises and instructions for your hip.

Wear an apron for carrying things around the house. This leaves hands and arms free for balance or to use crutches.

Use a long-handled "reacher" to turn on lights or grab things that are beyond arm's length.

Preventing Blood Clots (thrombosis)

The day before Surgery

After surgery, clots may form in the veins of the leg as a result of immobility. This could lead to a post-operative complication known as a Deep-Vein Thrombosis. For this reason you will receive a form of low weight heparin to ensure that thrombosis doesn't occur.

You may receive some of these drugs to take home with you.

Recovering from Surgery

You will have:

• A dressing over the hip and mid thigh area
  
  
• A foam wedge pillow between your legs. This is to help keep your new hip in place during early healing
  
  
• You may have a drain from the surgical site. This drainage tube collects any bloody fluid that has accumulated under the skin and muscle. This tube is usually removed the day after surgery
  
  
• A bar (trapeze) will be hanging over the bed. Use it to help lift your body when you change positions
  
  
• An IV (intravenous infusion)
  
  
• Vital signs taken which consist of blood pressure, pulse, respiratory rate and temperature
  
  
• A Foley catheter (urine bag) to monitor the amount and colour of your urine. This is usually removed 1 or 2 days after surgery you can normally drink fluids and eat it will normally take 4 to 6 weeks to become fully mobile following your Hip
  
  
• Replacement Surgery. Please remember that each person is different so times will vary, if you are older or in poor physical condition, or not very mobile it may take longer to recover from your surgery. In these circumstances we recommend that you avail yourself of the extra weeks stay and physiotherapy.

Please note that after Hip Replacement Surgery you are not permitted to drive for 2 months.

Rehabilitation and Physiotherapy following Surgery

The day before Surgery

Your participation in physical therapy is essential to your success. The more committed and enthusiastic you are, the quicker your improvement and recovery will be.

A physiotherapist will visit you on the day after surgery and will start to instruct you on the exercise program. You will receive physiotherapy each day following the surgery.

These sessions are normally one on one with a physiotherapist.

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