What outcome(s) can I expect from the surgery?
The primary purpose of the procedure is relief of pain. Enhanced walking
ability is a secondary consideration and finally, restoration of the anatomy as
close to normal as possible.
What level of activity will the procedure restore?
The prosthesis is designed for walking (even brisk walking) but not designed for
running etc.
What risks are associated with the procedure?
There are a number of risks that are generally applicable to many surgical
procedures. Among those that apply to a total hip replacement procedure
are, in no particular order:
Should I use a general or local anaesthetic?
A general anaesthetic means you will be unconscious during the surgery and
should have no recollection aside from going to sleep and waking up. A
local anaesthetic allow you to remain conscious without feeling pain. One
commonly used "local" anaesthetic is a spinal anaesthetic which blocks all pain
in the area while leaving the patient conscious. This is a personal choice and
can be discussed with the anaesthesiologist.
What can I do to minimize the risks of a blood clot?
To minimize the risks you will be asked to start walking as soon as possible
after the surgery and you will receive a blood thinner, low molecular weight
heparin, for approximately a week. It is my preference to prescribe
another five weeks of aspirin use, 325mg per day. As well, if tolerated,
the compression stockings provided to you at the hospital should be worn for a
total of six weeks. Under these circumstances the risk of death from
pulmonary embolism appears to be well below one in on thousand.
Do I need to donate blood prior to surgery?
Rarely complications during surgery can lead to rapid blood loss and require a
blood transfusion. If this concerns you then you should discuss this
possibility with your doctor.
How long before I can walk again?
Mobilization after surgery is important to prevent complications and to resume
independent self-care as soon as possible. That said, the degree of
weight bearing that is allowed immediately after surgery is decided upon by the
surgeon during the surgery, depending on the achieved firmness of the
fixation. With a non-cemented prostheseis, protected weight bearing may
be necessary for approximately six weeks. Again, the risks associated with
stability and leg-length discrepancy may influence how the postoperative
course for mobilization proceeds.
How long is the hospital stay?
How soon you leave the hospital depends on when the pain can be brought under
control using medication by mouth and upon how soon you achieve safe,
independent mobilization. Depending on circumstances this is usually
anywhere between 2-7 days of hospital stay.
Will I need physiotherapy? How soon?
Physiotherapy starts immediately after the operation while still in hospital
and is continued in the outpatient department after discharge.
How long before my knee feels "normal"?
Initially, residual discomfort is common. "Normal" is of course different for everyone but these initial
issues usually settle in approximately six months, occasionally a year. Through use of less invasive surgery, I attempt to minimize residual pain from disruption of soft tissues.
Do I need to come and see you again after surgery?
Standard follow-ups are done at 8 weeks, 6 months and 1 year. After
this, yearly follow-up with X-rays is recommended, to allow early detection of
possible problems with the prosthesis.