Main Line Orthopaedics
TOTAL HIP REPLACEMENT
Total hip replacement is a common surgical procedure to relieve the pain associated with hip arthritis. It is a major surgical procedure that requires general or spinal anesthesia and an overnight stay of 1 to 2 days with a possible short stay at a rehabilitation center if there is not an adequate support structure at home. Your surgery may be performed at the hospital or our new MUVE non-hospital joint replacement center depending on your individual situation.
The success rate is extremely high. It is one of the most successful surgery performed in relieving arthritic pain. Over 450,000 placements are performed each year in the United States.
The most significant benefit of total hip replacement is pain relief. This relief of pain is often times rapid and dramatic. Range of motion is generally improved.
The average recovery is approximately 60 to 70% at six weeks and 85 to 90% at 12 weeks. Following recovery most patients are able to return to a normal lifestyle including walking, hiking, biking, golf, tennis and even skiing.
What does total hip replacement involve?
Arthritis is when the cartilage cushion on the ends of the bones has worn out and there is no longer any smooth space between the bone ends. This results in rough surfaces scraping and rubbing against each other causing pain. Total hip surgery relieves the pain by resurfacing the ends of the bones with smooth surfaces. In addition removing the rough surfaces results in better range of motion.
The surgery is done through an incision on the outside of your hip near the area of the seam on your pants. The length of the incision varies with the size of the hip but is generally 5 to 6 inches in length. During the surgery the worn ends of the bones are removed and replaced with the two parts of the hip prosthesis. The hip socket (acetabulum) is replaced with a metal shell with an insert of specialized smooth plastic. This piece of plastic functions as your new cartilage. The ball (femoral head) is replaced with a smooth ball which is attached to a specialized metal stem that goes inside the top of the upper thigh bone (femur). All of these parts come in various sizes so that they can be customized to fit each patient's needs. When put together, these new services provide smooth pain-free motion
Before surgery, preoperative evaluation is necessary. The extent of the testing depends on each patient's age, gender and medical condition. All patients need at least a history and a physical examination by a medical doctor, usually your primary care physician.
An EKG and bloodwork are also necessary and sometimes evaluations by medical specialists, such as a cardiologist may be needed.
Our surgical scheduler will determine the specific tests and evaluation of that you need.
You will arrive the morning of surgery. There is no need to come in before that as all of your pre-admission testing will have been completed prior to that time. Remember not to eat or drink anything that morning. You should not have anything by mouth from the midnight before your surgery until the time of your surgery, and that includes chewing gum, cough drops, etc. You may brush her teeth, and take your morning medicines as instructed by anesthesia with a very small sip of water.
Dr. Vernace will see you in the pre-operative area before your surgery to review your chart and to mark your hip with his initials in order to identify the proper side for surgery.
From the time you leave the preoperative area to go into the operating room to the time that you are in the recovery room will be approximately 90 minutes. The surgery itself takes approximately one hour.
At the completion of your surgery Dr. Vernace will contact your family to let them know that all is well and that you are on your way to the post-anesthesia care unit (PACU). Following your stay in the PACU, you will be taken to your room to start your rehabilitation.
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Potential Complications
As with any major surgery, hip replacement surgery carries certain risks and potential complications. The most significant of these are infection, blood clot, anesthesia risks and the possibility that the hip implant may not last forever. You will be given antibiotics in the pre-operative area to help prevent infection. The risk never goes to zero but our infection rate is below the national average and is approximately one half of one percent.
In order to to try to prevent blood clots, you will be placed on 81mg aspirin twice a day for 4 to 6 weeks. If you are at higher risk for blood clots because of your medical history you will be placed on a different blood thinner.
Anesthesia risks are minimal for healthy individuals. You will fill out an anesthesia information questionnaire that will help the anesthesiologist discuss risks directly with you, as well as to discuss your options for the type of anesthesia to be used.The implant used today are very long lasting and we would expect 90 to 95 percent of hip replacements to last 20 years or more.
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Your Postoperative Program and Physical Therapy
You will be up and out of bed very rapidly after your hip replacement surgery.
You will start walking with a walker and progressed to a cane as you tolerate your rehabilitation in the days or weeks following your surgery. You will be provided pain medication during your stay and when you were discharged. Although we understand the need for pain medication we recommend weaning this down as rapidly as possible to avoid any potential complications. For most patients the first or second day after surgery will be your discharge day.
If you have support at home you will be discharged home, in those instances where further inpatient rehabilitation is needed this can be arranged as well.
Once home, your physical therapy program should start almost immediately. You will receive physical therapy tailored to your needs. For some of you this will involve following an online rehabilitation program and for others it will involve in person outpatient physical therapy.
Your first postoperative visit to the office will be approximately two weeks after surgery to have your incision checked and to obtain an x-ray. There will be no need for suture removal since all of the sutures as all sutures are placed under your skin at the time of surgery.
If you have any questions following surgery you may call the office at any time at 610-527-9500.
101 South Bryn Mawr Ave, Suite 200, Bryn Mawr, PA. 19010
Monday - Friday 8:00 a.m. to 4:30 p.m.