Pre-admission Testing
Within 1 month of your surgery, you will be asked to undergo several laboratory tests, an electrocardiogram, and chest x-ray. This is called pre-admission testing. This will help us to tell whether there are any conditions which might increase the risk of surgery. A physical examination, performed by your primary care physician and cardiology/pulmonology (if necessary), is also a part of pre-admission testing.
You may also be asked to obtain additional imaging which will often include a quick CT scan. We use the information for this additional imaging to preoperatively plan for your surgery on a computer in increase day-of-surgery success.
Just Before Surgery
You will usually be asked to arrive 1.5-2 hours prior to your scheduled surgery time.
You will not be allowed to drink or eat anything after midnight and on the day of your surgery. In some cases, you may be allowed to take a medication you normally take in the morning with a minimal amount of water. We will often let you ingest clear liquids or a pre-operative specialty drink up to 2 hours prior to your arrival.
Anesthesia
You will be seen by the anesthesiologist on the day of surgery. The anesthesiologist can answer specific questions you might have. Most of our surgeries are performed under spinal anesthesia, though we will also use general anesthesia when a spinal does not seem to be the best option.
You will receive some medications in the holding area prior to your surgery. These may include specific pain medications and antibiotics for your surgery.
The Surgery
As stated before, the surgery involves the removal of all of the damaged bone and cartilage. This is done with saws and drills much like a carpenter uses. The next step is to prepare the bone for the prosthesis. This involves using specialized tools to make precise cuts and to shape the bone so that the prosthesis will fit properly. The artificial joint is then placed into the bone, most often without bone cement. The surgery itself takes between 1.5-2 hours, depending on the complexity of your case.
The surgical approach is a topic of frequent discussion. When bone quality allows, we generally perform anterior hip replacement using muscle-sparing techniques. This allows for a faster early recovery and does not require strict mobility precautions. Alternative approaches, such as direct lateral or posterior, are utilized on a case specific basis.
Recovery Room
When your surgery is completed, you will go to the recovery room where you will be closely monitored until the effects of the anesthesia and intra-operative medicines are decreased and you are relatively awake and comfortable.
Orthopedic Unit
When you have completed your stay in the recovery room, you might be transferred to your hospital room if you are planned to stay overnight. As long as you feel well, you will be out of bed on your day of surgery, hopefully taking your first steps! The therapists will instruct you in learning how to use crutches or a walker and you will be taught some of the precautions that are necessary in the immediate post-operative period. Our therapists are extremely good and will help you navigate these first challenging days.
Discharge
Most patients will be able to go home on the day of surgery. Some may stay overnight depending on their medical needs. In order to leave the hospital, you need to be safe moving out of your bed/chair, have pain controlled by medications you can take at home, and be able to tolerate a diet. We will usually have you walking with a walker and using stairs within a few hours of leaving the operating room.