How do I prepare for surgery?
In order to prepare for surgery, patients are requested to schedule a series of appointments prior to the surgery date to receive testing and clearance for surgery. You will receive a routing schedule in the mail one to three weeks before you are to have surgery to tell you what appointments you have and their locations. During these appointments, studies including lab testing, urine analysis, EKG, and X-rays are conducted. Based on the results of these tests and the patient’s health history, clearance is initiated for the surgery. Depending on the patient’s condition, additional testing may be required prior to surgery.Patients can also take steps at home to help ensure an easier recovery after surgery. Make a few simple changes around the house, and arrange for someone to help you during the few weeks following surgery. Discuss with your surgeon about whether you should donate your own blood for surgery, and schedule appointments to see your primary care doctor and your dentist. If you smoke, try to stop or cut down to improve your surgery risk and recovery rate.Do not eat or drink anything after midnight the night before surgery.You can try these tips at home prior to surgery:
- Remove any loose rugs, as they can be hazardous when you are walking in the house. Make sure you tape down all electrical cords.
- Store additional canned and frozen foods, and make sure all supplies are between waist and shoulder level.
- You will need to keep both legs elevated for the first 4 to 6 weeks following surgery. This is best accomplished in a recliner chair, or a chair with armrests and an ottoman for appropriate leg support.
- Prepare a sleeping room on the main floor, or ensure that you only have to climb the stairs once a day.
- Make sure you have a cordless phone for greater efficiency in answering any phone calls.
Special equipment will help to ensure an easier recovery following surgery. Your physical and occupational therapists will recommend equipment for you and will help you and your family in obtaining this equipment following surgery. Some of this equipment may include:
- Elevated toilet seats
- Shower seats
- Handrails and grab bars, especially when getting in and out of the bathtub
- Grasping device for putting on socks and shoes
Inform your surgeon about all of your medications, both over-the-counter and prescription. Some medications do not react well with anesthesia, and others such as aspirin, ibuprofen and blood thinners, increase bleeding. For these reasons, you may need to stop taking certain medications before hip replacement. If you are taking aspirin or aspirin-based medication for arthritis, you must discontinue these 2 weeks before your surgery. If you are taking medications for other medical problems, do not discontinue taking these without checking with your primary care physician. Make sure to bring a list of all medications, the dosages, and how often you take them. This includes all herbal supplements and vitamins. This is important information that will be documented in your hospital records.
Have your teeth cleaned and make sure you do not have any cavities that might need to be taken care of during the first few months following surgery. Since the blood supply to the hip is increased during healing time, it is better to have any routine dental work done either before surgery or 3 months after. In addition, any emergencies must be taken care of immediately. You will continue to use antibiotics prior to any dental work for the rest of your life once you have a total joint replacement.
Someone from The Cleveland Clinic Anesthesia Department will meet with you before your surgery. They will explain the various types of anesthesia available to you and the risks and benefits of the surgery. The spinal, or regional anesthetic block, is the most common and safe method used for orthopaedic procedures. You will also be asked to complete a health questionnaire from the Anesthesia Department for surgery clearance to ensure your safety.
An evaluation by the Cleveland Clinic Physical Therapy Department is conducted on all patients prior to surgery. After surgery, you will have daily physical therapy.
It is possible for you to donate your own blood for surgery. You should notify your doctor or physician’s assistant if this is of interest to you.
Are there exercises that I can start now prior to surgery?
It is important to do strengthening exercises and conditioning prior to surgery to help ensure a better outcome and recovery. Being stronger prior to surgery is a big benefit and helps in your rehabilitation program progress.The following exercises are recommended prior to surgery:
- Tighten muscles in the thigh then straighten your knee flat. Hold for a count of 5 then relax. Do 10 times, twice a day.
- Tighten buttocks, pushing heels down into the bed. Hold for a count of 5 then relax. Do 10 times, twice a day.
If you have any questions about these exercises, please contact your Cleveland Clinic physician assistant or nurse.
What happens during surgery?
The surgery technique involves removing the diseased portion of the hipbone and replacing it with an artificial hip joint (called a prosthesis).
What happens after surgery?
After surgery, medicines or physical therapy may be prescribed by your surgeon to prevent blood clots. To decrease your chances of having a Deep Vein Thrombosis (DVT) after surgery, you may be given medication, wear special stockings and do ankle pumps two to three days following surgery. You also may be given patient-controlled analgesia (PCA) which allows you to control your own pain medication through an IV and lasts for 1 or 2 days after surgery. You may have an appointment after surgery depending on the wound closure method preferred by your surgeon to have the sutures removed. You should call your surgeon before this appointment if you experience any of the following symptoms:
- Increased redness
- Pain or swelling
- Drainage at the incision
- Bumps or pimples
- Any other changes you question