|
 |
|
Some of the most frequently asked questions for Total Hip Replacement are listed below. Select any question and click on it for an answer.
WHAT IS INCLUDED IN THE PRE-ADMISSION VISIT? At your pre-admission visit you will be registered for surgery. This will include lab tests such as blood work, and your doctor may order an EKG or a chest x-ray. Plan to spend approximately 1 ½ to 2 hours in the pre-admission testing area. The pre-admission nurse will review your medical history, current medications and inform you of any pre-surgery instructions from your doctor. The instructions to be followed will be specific to your needs. At this time, the nurse will also obtain your surgical permit. If you have an existing medical condition, you may need to consult your medical doctor for clearance that you are medically fit for surgery. Anesthesia will review all of the information compiled by the pre-admission nurse and discuss your options for anesthesia and pain control. The anesthesiologist will work with your doctor to ensure your comfort after surgery. If at any time you experience more pain than you expect, please tell the nurses and your doctor. Also, you will meet with an orthopaedic nurse. He/she will inform you as to what to expect during the hospital stay, review medications, discuss the surgery, and show pictures of equipment and rooms that will be utilized during your hospital stay. The nurse will also provide you with written information reviewing the surgery, and you will have the opportunity to ask any questions that you may have about post-operative concerns. To the pre-admission visit, we strongly recommend
you bring someone—family or friend—who will be assisting you after surgery. HOW LONG WILL I BE IN SURGERY? Total joint replacement surgery typically lasts
1-2 hours. If your case may require longer, your doctor will have discussed this
with you. If for some reason your surgery takes longer than anticipated, the
operating room staff will be in contact with your family. HOW LONG WILL I BE IN THE RECOVERY ROOM? Recovery time in the Post Anesthesia Care Unit (PACU)
is typically 1- 1½ hours. If the PACU nurses feel you need further monitoring,
they will keep you. The nurses will be in contact with your family to let them
know of your progress. Most patients do not require blood
transfusions. Your doctor will have discussed or will discuss this with you. I AM CONCERNED ABOUT INFECTION AFTER SURGERY. DO I RECEIVE ANTIBIOTICS? You will receive a dose of antibiotics prior to
the surgery and after surgery—usually 3 or 4 doses are given in total. WILL I BE ON MEDICATION OR RECEIVE TREATMENT FOR PREVENTION OF BLOOD CLOTS? All of the surgeons incorporate preventative
measures to decrease the likelihood of developing a clot. This does not mean
that you cannot develop a clot. Your doctor may order a tablet, a small
injection, or devices such as stockings or wraps for your feet. A combination
of these methods may also be used. Early ambulation is also important to
decrease the likelihood of a blood clot, as well as performing the ankle
exercises. WILL THE IMPLANTS BE CEMENTED? This is a decision made by your doctor. There
are various reasons to cement or not cement. Your doctor will discuss this
with you. WHAT WILL I HAVE FOR PAIN MANAGEMENT? You, your doctor and the anesthesiologist will
make this decision. There are several factors to be considered, and these will
be discussed in your pre-admission visit. Controlling your pain is often a
combination of pills to address “breakthrough pain” along with the use of PCA
for the first day or two. PCA is a device that provides pain relief via your
IV line when you, the patient, activate it. The nursing staff will work to
ensure a very good level of comfort, and together we will achieve control of
the pain. Your pain is controlled as evidenced by the ability to rest and
participate in activities. Staff will asses your level of pain control at
regular intervals, so be sure to report any “new” or unrelieved pain. The goal
is to solely utilize oral medications for pain control before you are
discharged. WILL I HAVE SOME TYPE OF DRAIN? Usually, there are 2 types. One is a drainage
system only that is removed after 24 to 36 hours. Another drain, which is
called auto transfusion, collects the blood drainage for a specific time
frame, and then the blood is delivered back to you. The type of drain used
depends on the preference of your doctor and the amount of drainage expected. That is a decision made by your doctor. Usually you will stand within 24 hours of the surgery. Physical therapy involves safely getting in and out of bed, learning how to safely move your hip joint, learning how to safely walk with the appropriate assistive device, and learning a variety of exercises to rebuild your muscle strength and endurance. Follow the directions of the nursing staff or therapy staff when getting in or out of bed. It is also encouraged that you intermittently
sit in a chair. We do not want you staying in bed all the time. You are
encouraged to reposition every 2-4 hours in bed, alternating between your back
and your non-operative hip. The nursing staff will assist you in this move as
you must maintain your wedge between your knees as ordered. Always wait for
the nursing staff or therapy staff to help you get in or out of bed. HOW LONG DO I HAVE TO USE AN ABDUCTOR PILLOW? You will have some type of abduction device
between your legs while in bed for a few weeks after surgery. This protects
your new joint from dislocation. You may be able to use something as simple as
a regular bed pillow. You must remember your total hip precautions and always
follow the orders of your doctor. WHAT DO I NEED TO BRING WITH ME TO THE HOSPITAL? Bring closed-toe shoes with a non-skid sole and
a robe. Some patients prefer to stay in the hospital gown, some ladies prefer
a long t-shirt or short gown, and some men prefer shorts or pajamas. Keep in
mind that you are here for surgery and to begin the healing process. We want
you to be comfortable. HOW MANY DAYS WILL I BE IN THE HOSPITAL? The normal hospital stay for total joint
replacement is 3 days. This consists of your surgery day and additional 2-3
days. If there is a medical necessity for an additional day, your doctor will
work with your discharge planner and your insurance provider. Your discharge
planner and case manager will work with you, your doctor and your insurance
provider to meet your needs while in the hospital. If you should need
additional medical equipment for your return home, they will help you obtain
the necessary equipment. The discharge planner and case manager will also make
arrangements for continuation of your physical therapy upon discharge. DO I HAVE TO USE A WALKER OR CAN I USE CRUTCHES? Physical therapists as well as the orthopaedic
staff prefer you use a walker. A walker has four legs and is more stable than
crutches. Thus, a higher level of stability will equate to a higher level of
protection to you and your new joint. If you have used crutches in the past
and can use them well, you may be allowed to use them. If so, physical therapy
will determine your stability with the crutches prior to discharge. UPON DISCHARGE, WILL I GO HOME? Each patient is different. There are several
factors to consider when evaluating your ability to return home: age, living
arrangements, and insurance are the three main factors. Some patients go home
with home care services, others go home with therapy scheduled in an
outpatient setting, and some may go to a rehabilitation facility. Your doctor
will help to determine what is best for you. HOW DO I PREPARE FOR MY RETURN HOME? Home preparations need to begin as soon as you schedule the surgery. Family, friends, and significant others who will assist you during this time are encouraged to be involved in making any changes in your home now to create a safer environment for you. Also, you need to arrange for assistance once you return home. Safety concerns, needed equipment, and meal preparation should be addressed before admission for the surgery, and arrange for family or friends to be available on the expected day of discharge. Equipment needs may include a shower bench,
elevated toilet seat or commode, long handled shoe spoon, long handled shower
sponge, long handled reacher, walker, crutches or a cane. You will need a firm
chair with armrests to sit in after surgery, but one that keeps your hips
higher than your knees in order to protect your hip while healing. WHEN DO I SEE THE DOCTOR AFTER DISCHARGE? Normally you will visit with your doctor within 2 weeks after discharge. At that time, the surgical staples are removed, and the doctor will review your need to continue total joint precautions and therapy. The doctor will also address any specific modifications to your normal daily activities including work-related concerns, so bring a list of questions and/or concerns. The manufacturer of your new joint typically
sends you a wallet card to identify the components used in the construction of
the joint and any lifelong considerations such as antibiotics required before
dental or medical procedures. Any doctor who provides care to you needs to be
aware of your joint implant. Also, the implant may activate metal detectors, so
an x-ray replica of the joint will also be made available to you to show as
proof of the implant. |