Important Questions About Anterior Hip Replacement

When is it time to have a hip replacement?

The decision to have a hip replacement is not to be taken lightly. When I am having a discussion with the patient in regards to total hip arthroplasty (hip replacement) the following factors are very important.

  • Does the patient have severe arthritis of the hip?
  • How long has it been going on for?
  • Have all conservative measures been tried and exhausted?
  • Are the x-rays consistent with the patient’s history and symptoms?
  • Is the patient starting to consider or asking for additional pain medication, narcotics, for the pain that they are experiencing from their hip?
  • Is the patient healthy enough to consider a hip replacement?
  • Is the hip pain beginning to impact their life-style?
    • Beginning to lose sleep
    • Having difficulty walking or getting around
    • Having pain in the hip, even at rest.

Where do you perform the hip replacement surgery?

Anterior hip replacement surgery is performed at Dixie Regional Medical Center in St. George. A special clean air operating suite is devoted to joint replacement surgery. In addition Dixie Regional Medical Center has two specialized operating room tables specifically designed for anterior hip replacement.

Do you use a direct anterior hip approach?

Yes, I recommend the anterior hip approach for the vast majority of primary hip replacements. I feel that it is less invasive, less painful and with less blood loss allowing a quicker recovery and shorter hospital stay. Not everyone is suitable for the anterior hip replacement and I recommend a careful in depth discussion of the approach prior to surgery.

How long do I stay in the hospital?

The majority of my patients in the last year have gone home in less than 24 hours.The length of stay for my patients, in the last year has decreased from 3 to 4 days to just about one day. The typical patient enters the hospital on Monday morning, has surgery, and is discharged the next morning. Extensive preoperative education has made the early discharge both safe and recommended.

Where do I go when I leave the hospital?

Most, if not all patients would prefer to recover in the familiar surroundings of their own home. My experience has been that patients recover quicker and with fewer complications if they can be at home. There is a lot to be said for “home cooking”.

What is physical therapy like after a hip replacement?

I do very little in the way of physical therapy in the first six weeks for my total hip patients. Patients seem to recover faster without Physical Therapy. The best form of therapy, in my opinion, is whatever reduces pain. Aside from walking with either crutches or a walker I don’t recommend physical therapy typically.

Will my legs be the same length after surgery?

The question of leg length equality often comes up prior to surgery as it should. With the anterior approach leg length is usually approximated very close. The use of x-ray during surgery as well as anatomic landmarks help minimize the risk of a limb length inequality. On occasion, however, for reasons of stability or other anatomic factors one lower extremity may end up slightly longer or shorter than the other.

How do you prevent blood clots after surgery?

A number of methods are used to prevent deep vein thrombosis (DVT). Depending upon the specific clinical situation certain medications are prescribed, usually for just four weeks. Probably more important in prevention of DVT’s is the early ambulation for the patient and return to normal household activities.

Should I donate blood before my hip replacement?

Not that many years ago it was almost routine that patients would receive a transfusion following a hip replacement surgery. In the last year my rate of transfusion for anterior hips fell to lightly below 4% which is well below the national average of 16%. You have a very low risk of needing a blood transfusion following your Anterior Total Hip replacement.

How long does a hip replacement last?

Because the implant is made of non-biologic materials it does not have the capacity to heal itself and will eventually wear out. The materials that are used to have the capacity, with normal use, to last 20+ years. For young person this is an important consideration as the hip may require a revision at some point in their lifetime.

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