Precautions and Surgical Process
Total Hip Precautions
If you are overweight or obese, your orthopedic surgeon may recommend losing some weight prior to surgery to minimize the stress on your new hip, and possibly decrease the risks associated with surgery. If any infections are present, surgery will be postponed until they resolve. In addition, because infections can enter the bloodstream during dental procedures such as tooth extractions and periodontal work, these should be scheduled several weeks prior to hip surgery. Further, routine dental cleaning should be postponed until a few weeks after surgery.
Due to the risk of blood clots, patients undergoing hip replacement surgery are often started on anticoagulants such as warfarin, heparin, low molecular heparin, or aspirin the night before surgery. This dose is adjusted after surgery depending on the patient’s hematologic values. Upon discharge, patients who are at a high risk for deep vein thrombosis (DVT) will remain on anticoagulation therapy for 4 to 6 weeks. Special precautions must be followed when you are on anticoagulants due to the increased risk of bleeding.
The Total Hip Replacement Surgery Process
The damaged bone and cartilage is removed and replaced with prosthetic components, following these general steps:
- The damaged femoral head is removed and replaced with a metal stem that is placed into the hollow center of the femur. The femoral stem may be either cemented or “press fit” into the bone.
- A metal or ceramic ball is placed on the upper part of the stem, which replaces the damaged femoral head.
- The damaged cartilage surface of the socket (acetabulum) is removed and replaced with a metal socket. Screws or cement are sometimes used to hold the socket in place.
- A plastic, ceramic, or metal spacer is inserted between the new ball and the socket to allow for a smooth gliding surface.