Preparing for Total Hip Replacement
Five Important Tips

Posted on April 29, 2006

By Sigrid Macdonald

Undergoing total hip replacement can be painful and distressing, but accurate information can alleviate the worry that comes with such a serious procedure. Although it is a major, invasive operation, total hip replacement surgery is a breakthrough in modern medicine, one physicians have dubbed one of the most important medical developments in the 20th century.

Every year, almost 400,000 North Americans undergo joint replacement. Arthritic hips, knees, shoulders, and occasionally, ankles are replaced with metal and plastic implants. Total hip replacements (THRs) constitute approximately half of these surgeries, allowing people who would otherwise be completely disabled by pain to resume full and active lives.

Most hip replacements are performed because joints wear out due to osteoarthritis or rheumatoid arthritis or bones become weak and crack due to osteoporosis. The cartilage between the joint spaces becomes very thin so that the protective cushion that we need when we walk is no longer there. The end result is pain; when that pain becomes intolerable, many people choose to have their hips replaced.

How can you prepare for hip replacement?

Although total hip replacement is a common procedure, it is major surgery, and it will take some time to convalesce. Each person's recovery is different; however, there are a number of things that you can do before hip surgery to make the entire process go more smoothly.

Pain Management

Obviously, if you have decided to have your hip replaced, you're having difficulty controlling the pain.

Several things can be done to minimize your discomfort during the difficult waiting period before surgery. Physiotherapy, hot packs, cold packs, ultrasound and over-the-counter painkillers such as aspirin and Advil may help somewhat. Some people also find relief with acupuncture and accupressure.

It's always wise to continue with your exercise program if possible because muscles atrophy quickly. It will help you immensely following surgery if you've been able to maintain strong quadricep muscles. BUT don't overdo it! Consider exercising in the swimming pool or on a stationary bicycle—both activities tend to provoke less pain because they're not weight bearing.

1. Plan on Being Out Of Commission

   Think about all of the things that you do every day that you might need help with after the surgery. You won't be able to drive for approximately 5 to 8 weeks. How will you get around? What will you do about meal planning, homemaking, and various chores and errands? Many people sleep on the second floor of their house, and some are unable to navigate the stairs after surgery; they might need to rent a hospital bed temporarily.

   If you're married, have an extended family, belong to a church, or have a large number of friends, you probably have ample social support. However, if you're widowed, divorced, and new to town or have a spouse who is ill and cannot take care of you, you may require more assistance. In order to obtain adequate help, call your local seniors organization or the Arthritis Society to discuss Meals on Wheels or home care. Choose a retirement home or convalescent center in case you don't feel strong enough to return home alone. This may not be necessary, and a hospital social worker will help you with discharge planning, if you require further care upon discharge, but it's always nice to choose your own place if you have the ability to do so before hand.

2. Learn the Hip Precautions!

   This one is really important. After hip surgery, there are three things that doctors worry about: infection, blood clot, and dislocation. Every step is taken to make sure that the first two conditions don't happen. Large doses of intravenous antibiotics are used, and coumadin is given orally along with shots of heparin to thin the blood.

   In order to reduce the risk of the new hip's dislocating from the socket, patients are taught three basic precautions: (1) Do not cross your legs. (2) Do not twist or jar your hip. (3) Make sure that your hip does not exceed a 90° angle. Your physiotherapist and occupational therapist will go through all of these with you before your THR. We are all at 90° when we're sitting upright in a chair. After the surgery, you will not be able to bend forward in your chair or to put on your socks or your shoes. You will use a reacher, an assistive device that you hold in your hand; this device will pick up items on the floor as well as enable you to put on your pants and socks. You may also require a long-handled shoe horn. These can easily be purchased at a medical supply store or through the Red Cross before your surgery.

3. Emotional Preparation

   Having hip surgery is not much fun, especially if you're in a lot of pain while you're waiting. You may feel angry or depressed. Talking to other people is helpful. It's easy to become isolated when your mobility is decreased. Pick up the phone. Add some basic enjoyment to your day, even if it's only having coffee with a friend or renting a special DVD. Laughter is the best medicine. Watch comedy shows and read inspirational books. And remember—all things do pass!

4. Act As Your Own Advocate

   Be proactive. Ask questions of your doctor and make sure that you get as much information as possible about the surgery. Talk to other people who've had the surgery, and read as much as you can on the Internet and in the library. There are excellent books out there by doctors, journalists, and other people who have had hip replacements.

Having a total hip replacement is a big undertaking, but most people are highly satisfied with their new hips several months after surgery. You can expect some degree of discomfort, but that will vary from person to person. If you've prepared adequately, chances are that you will greatly reduce your suffering and ensure a smoother recovery process.

Throughout the recovery process, don't compare yourself to anyone else. Just because your neighbor had a difficult time, it doesn't mean that you'll have the same experience. You will recover in your own time and before you know it, you will be TOTALLY HIP just like me!

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