Hip Replacement - Preparation

If after undergoing an orthopedic evaluation, you and your surgeon decide that hip replacement surgery is the best possible treatment for you, our team of medical experts will provide you with information on how to prepare for the procedure.

A few weeks before your procedure, you will need to have a complete physical by your primary care physician to rule out any other medical problems that may interfere with your surgery. At this time, your doctor also will take your medical history and order various tests that must be performed before surgery, such as blood tests, urinalysis, chest X-rays and electrocardiograms (EKG or ECG).

Be sure to tell your orthopedic surgeon about all medications that you are taking. They will then advise you on which medications you should continue or stop taking prior to surgery. In addition, if you develop any kind of infection prior to surgery, such as a cold or the flu, notify your surgeon immediately.

You should be in the best possible health before your surgery. If you are overweight, your doctor may suggest that you lose weight. If you smoke, it is highly recommended that you stop prior to your surgery because smoking can change blood flow patterns and delay healing and recovery.

Seven days prior to surgery, you should stop taking all aspirin or other non-steroidal anti-inflammatory drugs, such as NSAIDS like Aleve, Motrin, Ibuprofen, Advil and Naproxen. You may continue taking Cox-II inhibitors such as Vioxx, Celebrex and Bextra. You may take Tylenol for pain and discomfort.

Total hip replacement surgery can result in blood loss that may require a blood transfusion. Therefore, it is suggested that you donate your own blood before surgery. If you are unable to donate blood for yourself, your family or friends may donate for you. They must have the same blood type and meet criteria for donation. Otherwise, banked blood is available. Banked blood, which is from volunteers, is screened for viral diseases and is matched to your blood type.

If you are having surgery due to an infected prosthesis, you are not allowed to donate your own blood for surgery. In these cases, you must have family or friends donate blood or receive blood from a volunteer.

Significant dental conditions and problems should be treated prior to surgery. Although uncommon, an infection can occur as a result of these dental procedures if bacteria enter your bloodstream. If necessary, be sure to schedule an appointment with your dentist before your joint replacement surgery to treat any problems you may have.

When planning your hip replacement surgery, you will discuss the many options available for the design and materials of your artificial implant, or prostheses, with your orthopedic surgeon. An implant is designed to replicate the action of a healthy ball-and-socket hip joint. It consists of three parts: the stem, the ball or head, and the shell and accompanying liner.

Eventually, due to continuous movement and friction between the different parts of your implant, certain surfaces may wear out and need replacement. The vast majority of total hip replacements are performed using a metal ball and a plastic socket made of an ultra-high weight polyethylene material. However, in certain circumstances depending on your age, bone quality and activity level, your surgeon may recommend an alternative bearing surface. These bearing surfaces, in some cases, could provide increased resistance to wear of your total hip replacement. UCSF Medical Center is one of several medical centers in the country that are studying the potential benefits of these new implants.

Once your surgery has been scheduled, call your insurance company and inform them of your upcoming procedure. You will need to provide them with the date of your surgery, procedure type and the phone number for our office. You should also discuss what type of post-surgery services, such as rehabilitation hospital care and home physical therapy, as well as equipment, such as a commode and walker, your insurance carrier covers.

It is recommended that you plan for your return home prior to your admission to the hospital so that you are as comfortable as possible. We recommend a family member or friend be with you twenty-four hours a day for the first week. In addition, make sure you have rides planned from the hospital and to all follow-up visits, which will be at three, six and 12 weeks after surgery.

If you have crutches or a walker, bring them to the hospital. If you don't already have walking aids, let us know and we will help you to either rent or purchase these and other recommended devices, such as a raised toilet seat, bedside commode, tub chair and stock aid, at the hospital.

After surgery you will need help caring for yourself at home. Figure out ahead of time who will be able to assist you and talk with them about your concerns. If no one is available to care for you, please let us know and a discharge-planning nurse can help make arrangements for skilled nursing or caregivers to help you at home.

In addition, arranging meals that can be stored and frozen and stocking up on prepared foods will eliminate extra work for your caregiver. It also is highly recommended that you organize your home with safety features to prevent accidents. These include making pathways in crowded areas, eliminating all throw rugs, securing extension cords and telephone cords strung across the floor, securing handrails in your bathtub and stairways, and placing all needed items at a level so that you can easily reach them. You also should be sure that your house is equipped with the following:

Pack a small suitcase for your hospital stay that includes a list of all medications you are taking, personal hygiene items, comfortable and loose clothing, a knee-length robe and slip-on shoes. Please leave all of your valuables, including jewelry, wallet and watches, at home. It is not necessary to bring your actual medications, however do bring a list of your medications and their dosages. The hospital will provide you with your medications. Also, we recommend you to bring a phone card.

Our hospital staff will call to notify you of your surgery and scheduled admission times. You may not eat or drink anything after midnight the night before your surgery. Please take a shower or bath and wash your body thoroughly. Try to rest and go to bed early.