If you have seen an orthopedic surgeon and have scheduled replacement of your hip or knee, it is important to make sure certain things are evaluated prior to surgery. Most surgeons will ask you to see your primary care provider to ensure that any ongoing health conditions are appropriately addressed prior to surgery and to evaluate the status of your overall health. Preoperative labs will need to be drawn usually within three weeks prior to surgery. If you are a certain age, an EKG and chest x-ray may be required. If you have any ongoing dental problems such as infections, gum disease or a need for root canal, these should be addressed prior to surgery as they can increase the risk of infection after joint replacement. If you have a history of any urinary tract issues, these should be appropriately dealt with prior to surgery to minimize the risk of infection. If possible, pre-op physical therapy is useful to try and improve your overall health status and fitness prior to surgery and to make rehabilitation easier, then this may include some preoperative therapy or conditioning. Many hospitals will have a preoperative seminar, run by the therapists or nurses, to help educate respective patients about the recovery from joint replacement surgery. If you are having a primary (first time) joint replacement, more often then not preoperative blood donation is not required and the need for transfusion is very low. Any skin conditions such as psoriasis or other conditions that can adversely affect the skin should be dealt with prior to surgery. Arranging for help after surgery such as rides to and from the doctors office and or therapy is important prior to entering the hospital and having somebody stay with you for the first few days/week when you return home from the hospital is very useful. Making sure these items are done prior to surgery will facilitate and maximize your recovery.
William P. Barrett, M.D.
WPB/ceb
Hi Dr. Barrett: I am scheduled for a total hip replacement on 12/10/07. My goal for recovery is to get back on my horse. What kind of therapy will I need to accomplish this? Will my new hip joint allow me the range of motion to get in the saddle easily? What is a realistic time frame for starting to ride? I know I will have to start easy but I would like to be trail riding by next summer. I am looking forward to finally stopping the pain. Walking, sitting, standing is bad enough but trying to ride the last few months has been agony. Not being able to ride makes both me and my horse very unhappy campers. Stay healthy and I will see you next month.
thanks for all you do. God bless.
Francine Jacobsen
Dear Francine,
Thank you for taking the time to read my blog and showing interest in my blog. Therapy will be anywhere from 6-8 weeks. You will be trail riding by summer 2008. I will see you on your surgery date of 12/10/07. At that time I will be happy to answer any questions or concerns regarding your surgery and time frame for starting to ride your horse.
Regards,
William Barrett
Hi Dr. Barrett,
I have a friend who had a debridement of her hip a couple of months ago and she has been miserable ever since; walking on crutches and in a great deal of pain. I have encouraged her to come and see you for a second opinion. She wants to have the surgeon who did the first surgery to do her Total Hip(he encouraged her to have a total, but she was afraid).
My first question is; have you ever done a debridement instead of a Total Hip for a patient? I do not recall seeing many hip debridements at VMC when I was there in the OR, but maybe I wasn’t paying attention.
Before she had the debridement, I strongly encouraged her to come to you, but she declined and had it done at a small hospital in Chehalis which is near her family support system. I fear her next outcome with not be very good either.
Second question; Is there anything I might suggest to her that would be helpful? She is 55 yr old, probably about 40 lbs overweight and is a colleague of mine. Her work involves being at computer all day and she has had to stand up at her desk currently due to her pain. She is in extreme pain now.
Third Quesiton; How long does it normally take to get in to see you for an appt?
Thank you in advance for your response and
Happy Thanksgiving to you and your family.
Barb Harter
Hi Barb,
Thank you for the question. I have not done hip debridements as the indications are fairly narrow. If this has failed and xrays reveal significant arthritis then a total hip will be necessary. She can try some NSAIDS and modify her activity to hold off from surgery. Patients can usually get an appointment in 3-4 weeks. Take care and Happy Holidays,
Dr.William Barrett
Dr. Barrett,
Thank you for creating such an informative website about joint replacement surgery. It is rare to receive information via the internet without some heady advertising getting in the way. I have started a new blog (http://phdroadshow.blogspot.com/) and have written a few posts about hip replacements. I would certainly welcome your comments and thoughts, considering your extensive experience.
Thank you and take good care!
Dear Anna,
Thank you for enjoying my blog, but regarding informative info found on the internet…be careful not to get your info from doc ads. You can get good information from the American Academy of Orthopedic Surgeons website.
http://www.aaos.com
Regards,
Willliam Barrett
Dr. Barrett,
Your blog is very informative. I am just beginning to weigh my discomfort and decide if I should have my hip replaced now or suffer with it a while longer. You were recommended by a friend, but first I will discuss my situation with my primary doctor. I have two questions related to preparing for hip replacement.
1. I take a beta blocker. Will this be a problem? I could switch to a diaretic if that would be advantageous for surgery.
2. I have osteoporosis. Will that be a problem with hip replacement?
Thanks in advance.
Sharon
Sharon,
In answer to question #2…”not usually” is there a problem having osteoporosis and having a hip replacement.
William Barrett