Click on the following questions to reveal answers to these frequently asked questions.
Hip surgery is complex, and requires judgment and experience. Although team members will assist, and resident physician or students may observe, rest assured that I will perform the entire operation.
We use the new Missouri Orthopaedic Institute in Columbia, a state-of-the-art, technologically advanced specialty orthopaedic hospital in the University of Missouri system. Such centers are specifically equipped for joint replacement surgery and national data show a lower risk of complications, such as infections, and better outcomes from hip and knee replacement surgery.
We routinely use a spinal anesthetic with sedation. This type of anesthesia is safer than general anesthesia for hip replacement surgery. In addition, we use a combination of injections and pain relief modalities. If you have any preference for a certain kind of anesthetic, please let us know. Modern anesthetic drugs ensure that you will probably remember very little, if anything, about the surgery.
Do not eat or drink anything, including gum and candy. Unless advised differently, take your blood pressure and heart medications with a sip of water. Avoid make-up, nail polish on fingers or toes, perfume, or cologne. Remove all jewelry in anticipation of surgery.
You will have to remove your contact lenses prior to going into the operating room. Bring glasses, if you have them, or bring solution and a holder for your contacts.
Your family will be in a waiting room while you are in surgery. They will be informed by telephone when surgery is over and you are in the recovery room. You will remain in the recovery room for approximately 1Ω to 2 hours before going to your room. Your family can see you once you have arrived in your room.
There is very little pain early on, since modern pain medications and anesthetic techniques are very effective. Recovery from surgery is far more comfortable today than it was just a few years ago.
The hip joint itself and the tissues around it are injected with local pain-killing drugs.
If you were taking narcotic drugs before surgery, pain control is more difficult since the body gets desensitized to the pain-killers. In such cases, we typically use a higher dose of pain-killers, and sometimes use a combination of drugs.
Pain medicines can be given by mouth, intravenously, or by intramuscular injection. If you hurt, please let someone know; we want to minimize discomfort and customize the treatment for you.
By the time you leave the hospital, your pain will be properly controlled by an oral pain medication. Depending on the patient, such medications may be taken for several weeks.
You will be monitored in the recovery room for about an hour, and most patients are reasonably alert by this time.
You will notice a bulky dressing and an ice pack on your hip. The ice pack helps to control pain and swelling. You may also have a drain in the incision that looks like a plastic tube; this is removed within 24 to 48 hours. Expect a catheter in your bladder to keep urine drained; this is usually removed within 24 hours.
After an hour or so the nursing staff will take you to a private room. If your family plans to stay in the hospital room with you, please talk to your nurse so that arrangements can be made.
The nursing staff will coach you to take frequent deep breaths after surgery. You will have a breathing device to help with this. This is a plastic breathing exercise machine designed to prevent pneumonia and keep the lungs healthy.
You will have an overhead lift on your bed to assist you in moving independently. This allows you to use your arms to move your body. Feel free to position your body in any way you want after hip surgery. For the first night, we prefer the leg slightly bent, on a pillow, since this reduces bleeding in the hip. The head of the bed can be in any position that you like.
You will have elastic stockings on and some sort of pump device squeezing your feet or legs to reduce the chance of a blood clot. You should exercise your calf and ankles regularly after surgery while you are awake. This will cut down the risk of a blood clot.
Mechanical foot pumps are used to squeeze the feet and ankles intermittently after surgery in order to decrease the risk of blood clots. These are useful while you will be in bed and resting; you will not need them at home.
Right after surgery, avoid eating solid foods. It is better to start with liquids and make sure that you can handle these before you progress to a full diet. Nausea is a very common side effect of modern pain medications. So, go slowly right after surgery to make sure you can keep liquids down, without nausea, before you progress your diet.