How should I prepare myself for surgery?
1) Fitness
Recovering from an operation is tiring. Try and get as fit as you can. Patients who are fitter before surgery tend to have an easier recovery. Try and increase the amount of exercise that you do. Most patients will benefit from seeing a physio before surgery to get some specific exercises and even to try out crutches.
2) Weight
Generally, the lighter you are, the easier it is to move around on crutches. It can be difficult to exercise before surgery, as the hip is too painful to walk long distances / exercise. If you are obese, with a BMI of over 35, this will increase the risks of surgery. If you fall into this category you can discuss these risks with your surgeon.
3) Supplements
Taking Vitamin D supplements (around 1000 units per day) has been shown to reduce complications around hip surgery. Iron supplements can be useful to build up reserves in elderly patients. Please avoid Arnica, as this can make internal bleeding much worse.
4) Around the home
If you live alone, many patients stock up their freezer with food before they come into hospital. You will be able to walk up and down stairs after you have been discharged from hospital. Crutches and raised toilet seats will be provided by the hospital. You will not need to get specially adapted beds and chairs into the home for your hip replacement.
5) Will I need to go for rehab?
Most mobile people do not need to go for specialist rehab after a hip replacement. However, if you are worried and feel that you may need some help to look after yourself after surgery, a rehab unit can be very useful. The two units that I recommend around Sussex are
What can I expect in Hospital?
The surgery is usually performed using a spinal anaesthetic and sedation. For more information on spinal anaesthetics, please see Patient.info. You can be asleep or awake.
The surgery usually takes around an hour to an hour and a quarter. After the surgery, you will wake up in the recovery room, where you will be looked after by specialist nurses. Usually, after about half an hour, you will be returned to the ward.
The spinal anaesthetic makes your legs numb. This starts to wear off from about 2 hours after it was inserted, but can take 4 or more hours to fully wear off. Ward nurses will check how your legs are recovering. A physiotherapist will help you walk the day of surgery once your legs have recovered.
You will be discharged home when you are safe, mobile and the pain is under control. Most people are usually able to climb stairs and look after themselves within a day of surgery. (Usually Day 1 or 2 post operatively)
Will I be in pain?
You will have just had an operation, and there will be some operative pain. Pain affects everyone differently.
A spinal anaesthetic can help reduce pain for 12 hours. During the operation, the surgeon will inject some local anaesthetic around the new hip and the wound. This will also give pain relief for up to 8 hours. It is very important to start taking pain killing medicine (analgesia) before the local anaesthetic wears off. There will be some pain, but this should be manageable. Without enough analgesia, y0u won't be able to do the physiotherapy. Although it sounds strange, moving your new hip and walking will actually reduce your pain. Movement also reduces other risks too, such as getting a blood clot, developing chest problems, or even a pressure sore.
Most patients need strong painkillers for a week to ten days, but it is not uncommon for patients to need them for longer.