By Dr. Michael Ayers

michael_ayersIf you have made the decision to undergo a total hip replacement, it is completely understandable to feel apprehensive about the procedure.  At South Shore Orthopedics, we want our patients to feel confident heading into total hip replacement surgery and during their recovery. For this reason, our surgeons use a web based application called Healthloop which provides you with to do lists and other information to help you prepare. Our patients also attend a Joint Replacement Class prior to surgery which also helps to answer many questions that they may have.

Below is a sample of what you can expect as you prepare for total hip replacement:

Step 1: Ensure Your Health. It is common for your surgeon to request a complete physical examination by your primary care doctor prior to the total hip replacement. The purpose of this visit is to ensure that you are healthy enough for surgery and well equipped to handle the recovery.

In addition to your physical with your primary care doctor, we will schedule a preoperative evaluation appointment for you with one of our PA’s. This will take place prior to your procedure. Much like your annual physical exam, this visit gives us a chance to review your complete medical history so that we can make the necessary preparations. Labs and tests may also be ordered as part of the exam. Your surgeon may request tests such as blood and urine samples, chest x-rays, and an electrocardiogram, known as an EKG. If these tests are ordered, rest assured they serve a purpose in planning for your hip replacement. This is an important event, so please make sure to put it on your calendar.

 If you have a history of recent or frequent urinary infections, your surgeon may recommend an evaluation by an urologist prior to your hip replacement. Furthermore, if an older male patient has been diagnosed with prostate disease, treatment prior to hip replacement surgery is optimal.

Be sure to schedule an appointment with any doctor(s) treating you for heart conditions (heart attack, stents, valve surgery, pacemaker, heart failure, chest pain), lung problems, or other medical conditions such as diabetes, respiratory conditions or rheumatoid arthritis to make sure you are medically cleared for surgery. If you are older than 65, medical clearance is often necessary.

The last step in ensuring your health is evaluating your skin. Prior to surgery, it is important that your skin is clear of any infections or irritations. If you notice an area of concern, such as rashes, scratches, bruises, pimples, or scabs around the area where your procedure will be performed, contact your surgeon for examination. If any of the conditions above are present on the day of surgery, it could cause the procedure to be postponed.

Step 2: Prepare Your Body. Before your total hip replacement, speak with your surgeon about any medications you may be taking. Depending upon the medication, your surgeon may advise you to stop a prescription prior to surgery. For more information and guidelines about medications that may interfere with your procedure or recovery, including pain medications and medications that can interfere with blood clotting, please refer to Healthloop. If you take daily medications, you will need to contact your prescribing doctor(s) to make a plan about adjusting, stopping and/or restarting these medications before and after your procedure.

It is important that you are upfront with your surgeon about your alcohol and pain medication usage. Both of these items could interfere with your surgery and recovery. Additionally, if you smoke, it is important to disclose this information to your surgeon.  Smoking affects your body’s healing ability and smoking cessation is advised prior to joint replacement surgery.

For patients that may be overweight, it is recommended to focus on weight loss prior to surgery. Added weight may place unnecessary stress on the new hip, as well as increase risks that are associated with total hip replacement surgery. Nutritional and surgical options exist regarding weight loss. Feel free to contact your primary care doctor for more information.

Daily exercise is one of the most important things that you can do to ensure a strong recovery. Even 10 minutes per day can make a huge difference. Your Preparation Guide which is available on Healthloop includes a section on “Getting Into Shape” before the procedure, and your “Recovery Guide” includes a section with home exercises that should be practiced after the procedure.

If you are anticipating any dental work, such as a root canal or tooth extraction, it is wise to complete this work prior to surgery. It is possible for bacteria to enter the bloodstream during dental procedures, causing an infection. In order to avoid infections post surgery, we ask that you avoid any major dental procedures and routine cleaning for 4 or more months after your hip replacement. You may want to contact your dentist now so that you have enough time to schedule and complete any pending dental work prior to your procedure.

Step 3: Plan for Your Recovery. After your total hip replacement, we will have you up and walking with crutches or a walker prior to discharge. However, we encourage you to identify a care plan partner to support you and keep you motivated. It can be a spouse, significant other, family member, or friend, as long as the person is available to spend time with you before, during and after your surgery. Following surgery, you need time to rest and recover so having help with cooking, chores, bathing, and errands is a must. If you are unable to secure a caregiver, resources may be available to provide temporary help in the home, or a recovery facility may be an option. As you prepare for your procedure, we recommend bringing your care plan partner with you to your preoperative appointment and the Total Joint Replacement Class.

To make your recovery easier, there are several modifications that can be made to your home before your total hip replacement, such as installing safety bars or handrails in your bathroom. We also recommend a raised toilet seat, a chair for bathing, a reacher that will allow you to secure items without bending, and firm pillows for sitting. To decrease the chance of slipping or tripping, please remove throw rugs and any other items that might block your way or cause you to trip while moving through your home. We offer a complete set of our recommendations for your safety on Healthloop.

For 6 weeks following your surgery, it is crucial to ensure proper healing. Please follow all safety recommendations provided by your surgeon. We may recommend use of a walker, cane, or crutches during this time. Try not to overdo it and remember to go slow and be extra careful and vigilant.

Contact South Shore Orthopedics Today

Once these steps have been completed, you are ready to undergo your total hip replacement surgery. If you have any questions about preparing for a hip replacement, we invite you contact our office. At South Shore Orthopedics, we are dedicated to providing our total hip replacement patients the best experience around from pre-op, to surgery, to post-op. We look forward to treating you.