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Hip Replacement FAQs

How long will the hip replacement last?

There is no easy answer to this question. Most studies to date show excellent implant survival rates at long-term follow up (10-15 years). However, the longevity of the hip replacement can be influenced by factors other than implant material, design, and surgical technique. For example, the younger the age of a patient at the time of hip replacement, the higher the risk of needing to revise the implants. This is because the risk of failure increases by 0.5 – 1% for every year of life. Other factors such as infection, bone fracture, and dislocations may also necessitate revising the implants.

What surgical approach will I have?

Dr. Halawi is trained in the posterolateral (Southern), direct lateral (Hardinge), anterolateral (Watson-Jones), and direct anterior (Smith-Peterson) approaches to the hip. Each approach has its pros and cons and no one approach is superior to the other. The choice of surgical approach is made based on the indication for surgery, case complexity, and patient’s anatomy, age, and preferences.

What kind of anesthesia will I have?

For primary total hip replacement, Dr. Halawi’s preferred anesthetic technique is spinal anesthesia with light sedation. Compared to traditional general anesthesia, the advantages of spinal anesthesia include lower blood loss, less pain, less systemic effects, and less complications. However, not all patients are candidates for spinal anesthesia and the choice of anesthesia will be determined by your anesthesiologist.

Will I have a computer- or robotic-assisted surgery?

Both computer- and robotic-assisted surgery are emerging technologies that aim to improve surgical accuracy, but their clinical advantages over conventional instrumentation remain to be demonstrated. Most hip replacements can be performed reliably without the need for computer- or robotic-assistance.

How big will my scar be?

On average, the surgical incision is 3 – 6 inches long depending on the patient’s size and case complexity.

How is recovery process?

Dr. Halawi utilizes minimally invasive surgery and rapid recovery pathways. In the absence of intraoperative complications, patients will ambulate as soon as they recover from anesthesia and are expected to walk at least 100 feet the day of surgery. You will have a therapist teach you how to get in and out of bed or chair, navigate stairs, use the walker, and manage your activities of daily living. The therapist will also teach you certain hip precautions related to your specific surgical approach.

For hip replacement, the best (and sometimes the only necessary) rehabilitation activity is walking. You will likely experience a limp and perceived leg length discrepancy, but this will go away as you practice walking and as your hip muscles become stronger.

The skin incision usually heals in 2 – 3 weeks. Most patients are walking without assistive devices by 6 weeks. Complete recovery (bone and muscle healing) may take up to a year, but most patients experience significant improvement and return to baseline activities or work by 6 – 12 weeks.

How long will I stay in the hospital?

Depending on the time of the day when the surgery is finished and meeting discharge criteria, patients leave to home either the same day of surgery or the following day. In certain circumstances (e.g., a patient with poor health and lack of family support), discharge to a rehabilitation or skilled nursing facility may be necessary and this may require longer hospitalization depending on your insurance carrier. Most patients recover better at the comfort of their homes.

Will I be in pain?

Pain is expected after surgery but will normally improve. Every person reacts to pain differently. In general, the higher the pain level and disability one has before surgery, the higher the chance of experiencing more pain after surgery. Patients on chronic prescription opioids before surgery are especially likely to experience higher pain levels after surgery. If you are on prescription opioids, you will be advised to reduce the medication(s) amount or wean off completely before surgery. This has not only been shown to improve pain control after surgery, but there also is emerging evidence that it reduces the risk of postoperative complications. Dr. Halawi uses multimodal pain relief pathways (before, during, and after surgery) that has been shown to significantly improve pain control and minimize the need for opioid medications. This also permits faster discharge and increased ability to work through the recovery process.

When can I walk?

In the absence of intraoperative complications, patients will ambulate with the help of a walker as soon as they recover from anesthesia. Patients are expected to walk at least 100 feet the day of surgery and daily to tolerance thereafter. Walking is the best activity for your recovery. 

When can I drive?

You can drive when you have good control of your right leg, you are able to get in and out of the car on your own, and are not taking any opioid medications. This can range from 2 – 6 weeks.

When can I return to work?

The decision to return to work primarily rests with you depending on your recovery and the demands of your job. Depending on your occupation, this can range from 2 weeks – 3 months. Most patients return to light duty first and then advance as tolerated. It is important that you plan accordingly to avoid any issues with your employer.

Will I have any restrictions after surgery?

Your prosthetic hip will never be like the native, self-remodeling, and shock-absorbing hip that you were born with. After surgery, you will be encouraged to gradually resume the activities you enjoy as you progress with recovery. However, you are cautioned to avoid high-impact activities such as jumping and long-distance running as it is not clear how these activities may impact your hip replacement in the long-term. Return to sports is not recommended until after 3 months from surgery.

What are the potential complications of hip replacement?

Although infrequent, there are several potential complications associated with hip replacement. These include:

  • Dislocation (most common cause of failure).
  • Implant wear and/or loosening (second most common cause of failure).
  • Infection (third most common cause of failure).
  • Leg length discrepancy.
  • Fractures around the prosthesis.
  • Wound healing issues.
  • Nerve and/or blood vessel injury.
  • Blood clots (in legs and/or lungs).
  • Extra bone formation.
  • Tendon impingement.

Will my hip replacement set off metal detectors?

Yes. If you are at an airport, simply notify the TSA agent of your hip replacement prior to screening. You will still have to be screened like everyone else and may need to show the agent your surgical scar.

How long will I continue to see my surgeon after surgery?

Routine follow-up is 2 weeks, 6 weeks, 1 year, and then every other year.

Do I need antibiotics when I see my dentist?

The use of antibiotics before dental work is a topic of debate due to inconclusive evidence regarding the efficacy of this practice. In general, patients undergoing dental procedures other than simple cleanings, those with immunocompromised health, poor diabetes control, and/or history of prior joint infection are advised to take a single dose of an oral antibiotic one hour prior to the planned dental procedure. Notify your dentist prior to your dental appointment so an antibiotic can be prescribed in a timely manner.

 

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