IS
AN OPERATION INDICATED?
Surgery is indicated only when the quality of life is significantly
reduced and function is extremely limited. The decision to operate
is a joint one between the patient and the surgeon after all the benefits
and the risks have been discussed and fully understood by the patient.
Meanwhile, conservative treatment is indicated: movement of the joint
without undue loading such as achieved during swimming and exercises
done lying or sitting are encouraged. The use of a walking stick is
very useful. Non steroid anti-inflammatory medication is helpful with
a careful watch for any gastrointestinal complications.
Before your orthopedic surgeon recommends hip replacement surgery,
your hip problem will be carefully diagnosed and evaluated. Your medical
history will be taken to evaluate prior injuries, diseases, allergies
and the medications you are taking, as well as the details of your
current medical state and your current specific hip problem.
A physical examination will be done to determine the range of motion
in the affected joint and your general state of health. An electrocardiogram
and chest X-ray must be done.
X-rays of your hips, spine, and knees provide your doctor with valuable
information about the source of your pain and the architecture and
disease process in your hip joint and will help with the selection
and fitting of the appropriate implant. Joint aspiration (withdrawing
a small amount of fluid from the joint) may be done to determine if
infection is present. Blood tests will be performed to check for signs
of other disorders. Occasionally a bone scan or a CT scan are needed.
After all this information is evaluated, the final decision is made
whether to operate or not.
THE
RISKS
As with all major surgical procedures, there can be risks and complications
with a total hip replacement. Infection, pneumonia, dislocation of
the joint, the formation of blood clots in the leg or pelvic veins,
clot embolism to the lungs, are some of the possible, although unlikely,
complications that may occur. Preventative treatment is given to minimize
the occurrence of these complications. Also to avoid these complications
follow your surgeon’s advice carefully.
You will be required to sign a statement of “informed consent” in
which you declare that you understand the risks that these have been
fully explained to you, and that you wish to have the operation.
REPLACING YOUR DISEASED HIP
If you and your doctor agree that hip replacement is the best solution
to your problem, admission to the hospital and surgery will be scheduled.
Before Surgery
If you take Aspirin, then you must stop 1 week prior to surgery.
Your doctor may schedule your admission to the hospital the night
before surgery, or the same day of the procedure. Regardless of
your admission time, it is extremely important that you do not eat
or drink anything after midnight the day before surgery. Prior to
surgery, an IV (intravenous) line will be started to allow for the
injection of fluids, medications, and the transfusion of blood should
this be required. You will probably be given an injection of medication
to help you relax before surgery and you will receive prophylactic
antibiotics to prevent infections.
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