In an Indian study, a total of 3,604 Total Hip Replacement procedures were recorded. These included 2162 (60%) male patients and 1442 (40%) female patients. The average age was recorded to be 52 years (range 17 to 85 years) and average BMI (Body Mass Index) was 25.8 (range: 17.3 to 38.5). The main reason for a total hip replacement was found to be avascular necrosis in 49% of the cases.
I understand that you have already decided on the surgery. You also need to know about the magnitude of the problem attached to hip replacement; it is still relaxing to know that you decided to go for the right path. Anyhow, today we will discuss more major things you should do or know before the surgery initiates.
- Decide for the hospital
- Well-known hospitals may not always be the right choice
- Getting a second opinion is always informative
- The experience of the hospital and surgeon in terms of a number of successful surgeries always counts.
- Always check hospital figures for:
i. Surgical infection details
ii. Patient Readmission details
iii. Deaths during Surgery
- Learn more about the procedure
- Time taken for the procedure
- The surgical steps
- Options of the prosthesis to choose from
- Material of prosthesis
- Stability versus mobility, etc.
- Learn about the risk and complications of the surgery
- Wound infection presented as warm, red or tender incision
- Heart attack or stroke
- Irregular heartbeat
- Blood clot or deep vein thrombosis
- Blood loss
- Breathing difficulty
- Lung or kidney failure
- Chest pain
- Clouding of memory. Do you specifically have any high-risk susceptibility?
- Get medical consent from your general physician in terms of medical stability and vital statistics well within optimized parameters, for example, blood sugar, blood pressure, etc.
- Plan an exact map of surgery – This step can be opinionated with the help of your surgeon who will take you step by step of that day.
- Choose a place for physical therapy rehabilitation program – You should decide this before surgery that if you want to stay close to the hospital to attend OPD rehabilitation sessions for the next one and half months. You can also get discharged and call a therapist home for rehabilitation.
- Stay aware of contraindications and instructions from your surgeon – You will have to stop blood-thinning medications, NSAIDs, supplements, etc. No alcohol, no tobacco.
- Prehabilitation too is essential – You also have to start strengthening your large hip muscles like hip flexors, extensions, and back muscles so that strength regain after surgery becomes easy. Practice upper body strength too for accommodating crutches and walkers.
- Take OK from your dentist too. A tooth infection if existent may interfere with surgical incision healing and even lead to infection. It’s important to get your dental issues fixed well in advance for safe surgery.
- Apply leaves from the workplace for a month. If you stay alone, arrange for a relative or hire help for the first few days. You will also need help with driving from the hospital and then for follow up visits. Pre-arrange for a cab. If your relative is not good to cook, arrange for a cook or tiffin too.
- Toilet at your home should be western or you can arrange for a raised toilet seat or a chair. A shower chair is also essential.
- Arrange house safe for post-surgical rehabilitation. Remove throw rugs, loose carpets. Mounting handrails in bathrooms and staircases is important. Put everything you might need in an arms reach. Wear slip-on rather than shoes.
- Arrange for a walking aid after discussing it with your surgeon. You might need a walker for the first month followed by a stick or a tripod.
- Keep all valuables at home on the day of surgery.
- You may be given an antibacterial soap to take shower from, 1-2 days before surgery. Use as instructed.
- Keep fasting for 6 hours before surgery and keep your calm. If you are posing restless meditate or pray.
It may not be a minor procedure, but it is an extremely common procedure and with the amount of research you have put into finding the right doctor and hospital, you will be back on your feet in no time. Let’s do this…
Dr. Rajesh Verma, Director & Senior Consultant – Orthopaedics, Spine Surgery, Narayana Superspeciality Hospital, Gurugram