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The surgery of the century
The surgery of the century
Total Hip Replacement (THR), or total hip arthroplasty, is a procedure where the damaged bone and cartilage of the hip joint are removed and replaced with prosthetic components made of metal, ceramic, or plastic.
Why is it needed?
The primary reason is severe pain and functional impairment caused by conditions like osteoarthritis, rheumatoid arthritis, or osteonecrosis. It is recommended when non-surgical treatments (medication, physical therapy) are no longer effective.
When is the right time?
Surgery is considered when hip pain severely limits daily activities (walking, sitting, sleeping) and overall quality of life. The decision is made through consultation, balancing the patient's current symptoms, diagnostic imaging, and health status.
Expected Outcome?
The goal is to achieve significant reduction or elimination of chronic hip pain, leading to improved mobility, strength, and range of motion. For most patients, this results in a substantial return to daily activities and better quality of life.
Rehabilitation
A crucial phase involving physical therapy that begins almost immediately after surgery. The focus is on early movement, strengthening the muscles around the hip, and learning to walk with assistance. Full recovery and realization of surgical benefits can take several months.
Patient Preparation (Before Surgery)
Patient Preparation (Before Surgery)
Thorough preparation is essential for optimizing your outcome and ensuring a smooth recovery.
Medical Optimization
Pre-Surgical Clearance: You will undergo a comprehensive physical examination, blood tests, and potentially an ECG to ensure you are medically fit for surgery and anesthesia.
Medication Review: All current medications, including supplements and over-the-counter drugs, must be reviewed with your surgeon. Specific blood thinners or anti-inflammatory drugs may need to be temporarily stopped.
Dental Health: Any necessary dental work should be completed before surgery to minimize the risk of infection spreading to the new joint.
Home and Lifestyle Adjustments
Home Safety: Modify your home environment to reduce fall risks. This may include securing loose rugs, installing grab bars in the bathroom, and arranging a comfortable recovery area on one floor.
Physical Conditioning: Your surgeon may recommend "pre-hab"—specific exercises to strengthen your upper body and core. Being physically fitter before the operation aids faster rehabilitation afterward.
Support System: Arrange for a caregiver, friend, or family member to assist you with daily tasks for the first few weeks following your discharge.
Logistics
Hospital Bag: Pack essential items, including loose-fitting clothes, non-slip shoes, and necessary documentation.
Fasting: You will be required to fast (no food or drink) for a specified period, typically after midnight the night before the procedure. Specific instructions will be provided by the surgical team.
Immediate Post-Operative Care
Immediate Post-Operative Care
The first 24-48 hours after your procedure are focused on pain management, monitoring, and initiating early movement.
In the Recovery Room
Monitoring: You will be closely monitored for vital signs (heart rate, blood pressure, respiration) as the anesthesia wears off.
Pain Management: Pain control is paramount. This often involves nerve blocks administered during surgery and a combination of oral or intravenous medications tailored to keep you comfortable.
The First Day
Early Mobilization: Under the guidance of a physical therapist, you will typically be encouraged to sit up or stand at the bedside and potentially take a few steps using a walker or crutches. Early movement is critical for recovery and reducing the risk of complications.
Preventing Clots: Compression stockings, inflatable sleeves on your legs, and blood thinners are used to prevent blood clots (Deep Vein Thrombosis, DVT).
Fluid Management: You may have intravenous fluids initially, and nurses will monitor your incision for swelling or drainage.
Hospital Stay
Physical Therapy: Daily physical therapy sessions will focus on safe transfers (getting in and out of bed/chair) and strengthening exercises while adhering to your surgeon's specific hip precautions.
Discharge Planning: The care team will assess your progress. Discharge occurs when your pain is managed with oral medication, you can safely walk short distances, and you are able to perform basic activities of daily living. This typically takes 1 to 3 days.
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