4 things to consider before having a hip replacement
Hip replacement surgery can be a life-changing option for patients suffering with the pain and disability associated with end-stage osteoarthritis. By the year 2030, over 500,000 hip replacements are expected to be performed annually. Many patients experience anxiety about the idea of having a hip replacement. Fortunately, the rates of complications are very low and the rates of successful outcomes are very high.
To make the most of total hip replacement, patients should thinks about these four things before the operation ever occurs.
- Choose the right surgeon. It is important that you choose a surgeon you trust, and who has regular experience in hip replacement surgery. It has been shown that surgeons who frequently perform hip replacements have better outcome scores, lower complication rates and more consistent results than surgeons who perform fewer hip replacements. Furthermore, some surgeons have additional training specific to hip replacements through a fellowship. When looking for a surgeon, patients should do research and talk to people they trust, such as their primary care physician..
- Do not get hung up on surgical approach and implant choice. There are multiple approaches to perform a total hip replacement – posterior, direct anterior, anterolateral and direct lateral – and they are chosen based on particular conditions of the patient or the experience and specialty of the physician. Each offer theoretical advantages; however, there is a lack of data that conclusively supports one approach over the rest. In the hands of an experienced surgeon, any of the surgical approach options can yield an excellent outcome. Likewise, there are many different implant options available in hip replacements and there is not one single implant choice that has proven itself superior to the rest.
- Prepare yourself for surgery. Every patient has risk factors that can affect the outcome of surgery. Most importantly, patients should get in the best medical and physical shape possible in preparation for surgery. If you are a smoker, try to quit. If you are a diabetic, get your glucose under control. If you are overweight, try to lose the excess weight. In addition, some surgeons recommend “pre-hab” or physical therapy before hip replacements in order to strengthen the muscles and increase flexibility in preparation for postoperative rehabilitation.
- Commit to rehabilitation. Hip replacement surgery is not a destination, but rather one step forward in a long journey. Although the surgeon performs the operation, the aftermath requires hard work from the patient including several weeks of physical therapy. Some patients will spend a short stint in a rehab facility and some patients will go right home after surgery. Patients commonly deal with pain and general fatigue during the early stages of physical therapy, but in spite of this, a physical and mental commitment on the patient’s part is essential in maximizing results after a hip replacement surgery.
If you follow these suggestions, you will be well on your way to a successful hip replacement surgery that will likely improve your activity level and overall quality of life.
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About the Author
Dr. Jeffrey Goldstein is an orthopaedic surgeon on staff at Advocate Lutheran General Hospital in Park Ridge, Ill. He specializes in adult hip and knee reconstruction. He is one of the few surgeons in the area fellowship trained in both anterior and posterior approach total hip replacement. In addition to primary joint replacement, he focuses on complex revision surgery, addressing complications such as instability, implant loosening, metallosis, periprosthetic infection, periprosthetic fractures, and extensor mechanism disruptions.
All excellent points. Before my hip replacement, I did “pre-hab” by exercising in a warm-water pool three mornngs each week for a few months.. That pool was available at our local university. About a dozen of us were in the pool for different reasons, all encouraging each other. We usually finished with a spirited version of water volleyball which was fun. My surgeon was delighted with my conditioning, and my recovery was quick.
Every word of this article rings true; especially pre-hab. I have studied and performed Middle Eastern dance for some years so I had reasonable hip strength before my THR. But many weeks before surgery with Dr Wayne Goldstein, I worked A LOT on the elliptical at the gym because I knew the glute muscles would thank me later. As a result, rehab came and went without a problem; even the day after surgery I was able to do the rehab stairs at the hospital. In June. exactly 1 year after surgery, I was performing on stage again. I still however never miss a day on the elliptical, cross trainer and treadmill
My grandma is needing a hip replacement. I want to help her have a good experience. I will look into getting her to Physical Therapy as to help her prepare for surgery and also help her commit to rehabilitation so she recovers faster. Thanks for the tips!
My brother has been looking for an orthopedic surgeon, and he asked me to look up good advice for him. You wrote that a great place to get a referral is from your primary care physician. Since my brother has been seeing that doctor for years, he trusts him and is comfortable asking him for referrals. Thanks for the great tip, I’ll be sure to relay it to my brother.