Hip Replacement Surgery

Total Hip Replacement Surgery – Double Hip Replacement Surgery

The objective of total hip replacement surgery or double hip replacement surgery is to remove the upper end of the thighbone (femur) and replace it with a metal ball. At the same time, the hip socket in the pelvic bone is resurfaced with a metal shell and plastic liner.

Total hip replacement surgery also replaces damaged cartilage with new joint material through a meticulous step-by-step process carried out by Doctor Oscar Oeding and his orthopedic surgery team.

Total Hip Replacement Surgery and Double Joint Replacement Surgery are available through Medical Tours Costa Rica:

How are the joints attached during this type of procedure?

Depending on the doctor, cement may or may not be used during orthopedic surgery to attach replacement hip joints. Cement, which acts as a fixative, could be used to attach artificial replacement joints to existing bones. Otherwise, a porous coating could be used, and this coating is designed so that the bone attaches to the artificial joint and new bone grows over time and fills the openings in the coating without the need for cement.

What about anesthesia?

General anesthesia is used during this type of procedure, and this means you will be unconscious during surgery. This also means that you must make the surgeon aware if you have ever had an adverse reaction to general anesthesia or if you have had allergic reactions to general anesthesia.

On the other hand, a local or regional anesthetic is sometimes used during the procedure, and this means you will not feel the area that is being surgically repaired. You will be awake during the procedure, but you might feel sleepy.

The choice of anesthesia during hip replacement surgery will be determined by the doctor, your medical history, your health, and whether you have a personal preference, to some degree. The final decision will be made by the surgeon and the anesthesiologist, taking into account your personal preference, but also taking into account what is best in your particular case.

Will I need antibiotics before and after the operation?

The surgeon will likely recommend for you to take antibiotics before and after the procedure as a precaution in order to reduce infection risk. If you are planning to have major dental work done, then it is highly recommended for you to have dental work before it’s time for the operation. Once the dental procedure has healed, you can proceed with the orthopedic surgery.

Infections can and do spread from other parts of the body to the site that was operated, so infections in the mouth can spread to the area that was surgically repaired. Therefore, if you have joint replacement surgery, and then you have dental work, an infection in your mouth can place the surgical procedure at risk of very serious problems. You need to really plan ahead if you are going to have other medical, dental, or cosmetic procedure done after you have undergone the surgical procedure because of the real chance of infection setting in, not because of the artificial joint, but because the infection found its way into your body through other avenues.

What about the minimally invasive process?

There are surgeons now performing this type of operation through tiny incisions that allow for shorter healing times. These smaller incisions are often referred to as minimally invasive orthopedic surgery.

The advantage of a minimally invasive joint replacement operation is that there is less blood loss and less scar tissue development. This lends itself to quicker healing and recovery time because there is less trauma involved.

However, if you have this type of operation, it also mean you will be under the knife for a longer period of time. The smaller the incisions, the less room the surgeon has to maneuver and perform the surgery.

Additionally, the hip joint replacement has to be fitted snugly and properly through these smaller incisions. If the surgeon cannot fit the hip replacement properly, a larger incision may be required anyway.

Talk to Doctor Oeding and ask whether this of joint replacement procedure is right for you. It is up to the doctor’s education, training, and experience to determine whether the minimally invasive surgical process is right for you.

What can I expect after surgery?

More than likely, you will be on IV (intravenous) antibiotics for one day, on average, when you are recovering from the operation. Medication to control pain will also be administered, and anticoagulants to prevent blood clots could also be prescribed. Please be sure to tell the nurses, your physician, or surgeon if you feel ill after you have had the surgical procedure so that you can be closely monitored.

Once you awaken from total hip replacement surgery, you may have a catheter, which is a small tube connected to your bladder, so you don’t have to get out of bed to urinate. You may also have a compression pump or compression stocking on your leg, which squeezes your leg to keep the blood circulating and to help prevent blood clots. And you may have a cushion between your legs to keep your new hip in the correct position.

It will be up to your surgeon and physical therapist to determine your regimen for a satisfactory recovery from the process, and they will prescribe simple breathing exercises to help prevent congestion in your lungs and DVT (deep venous thrombosis) while you are in bed and your activity level is low.

You might also have to learn to move your feet up and down, flex your muscles and keep your blood circulating. You will also need to learn to keep your hip (hips) in the correct position when you get in and out of bed, and when you move in your bed.

Total Hip Replacement Surgery – The first few days:

In all likelihood, you will still be taking some pain medication the first few days after surgery, but you will take less and less pain medicine as the days go by. You will also have to continue taking anticoagulants the first few weeks after you are done with the surgeon, as a precaution.

You might also be kept on antibiotics to prevent infection, and you need to be sure that you follow the instructions you are given so that you don’t build resistance to antibiotics in case you need them in the future.

Rehabilitation after the Operation:

Rehab (rehabilitation) when you have had artificial hip joint replacement surgery varies depending on whether the surgeon used cement to attach hip replacement surfaces. This will also be a determining factor with regards to how much weight you will be able to place on your leg.

The physical therapist is well-experienced in providing physical therapy after total hip replacement surgery, and he/she will know the limitations you are under. You will be given full instructions about what you need to do after hip replacement surgery and how, and your therapist will assist you with any exercises you need to perform.

Actually, if the surgeon used cement, or if you had a hybrid hip replacement procedure (cemented and uncemented pieces), you should be able to place weigh on your new hip right away even though you will have to use a cane, crutches, or a walker. On the other hand, if you have an uncemented hip, you will usually have to wait at least 6 weeks before attempting to bear weight on the hip.

How much help am I going to need after in undergo the procedure? 

It is expected for you to need help getting in and out of bed the day following the procedure, and the nursing staff and physical therapist will be there to assist you and show you everything you need to do and how to do it. You will have to learn to get around on crutches, a cane, or a walker during the next few days after surgery.

As was noted above, your physical therapist will assist you and teach you how to get in and out of bed, move around in bed, walk, and even how to dress as your hip strengthens and heals. You will have to learn to keep your new joint from dislocating once you have had the operation, and you need to take certain precautions including:

• No movement combinations with your replacement hip. This means you cannot sit and cross your legs crossed since you have to bend your hip and bring it across your body in that position.
• No bending more than 90 degrees when you sit, depending on doctor’s instructions. If this is the case, you cannot sit on low chairs, beds, stools, toilets, etc., which will bring your knees higher than your hips. It will be especially important to get a riser for your toilet seat if you are given instructions not to bend more than 90 degrees.
• As a precaution, you must not raise your knees higher than your hip.
• You must not lean forward if you are sitting down, as you sit down, or as you stand up.
• While standing, you must not bend over more than 90 degrees, which means no bending to pick things up or even to tie your shoes until your surgeon gives you a clean bill of health.
• You may get instructions from your surgeon for your legs not to cross the center of your body toward your other leg.
• You must be especially careful when you get in or out of bed or a car because your leg cannot cross that imaginary line going down the middle of your body.
• You must pay special attention when you are riding in a car so that your knees are positioned lower than your hips.
• You must also be careful not to rotate your legs too far in or too far out, so you will probably be told to keep your toes pointing slightly out or slightly forward.

How soon after undergoing the operation can I travel home?

You will go to the recovery retreat a few days after total hip replacement surgery, but you should plan to remain in the country for at least another ten days. You must allow time for pain reduction, healing, some rehabilitation, and follow up visits to the surgeon to make sure your hip is healing properly.

Something to think about following total hip replacement surgery is whether you have someone at home who can assist you. If not, then you need to think about scheduling more time at the recovery retreat in Costa Rica or going to a specialized rehab center when you get home so you can have more therapy and treatment.

What about continuing the recovery process once I am home?

Once you are home, make sure you keep monitoring the total hip replacement surgery site, as well as your overall health. You must be on the lookout for drainage, oozing, redness, or a bad smell from the surgery site, and contact your physician immediately upon noticing any of these symptoms.

You should also keep track of your body temperature and take it at least twice a day until the wound site is completely healed and it is not longer tender to the touch. If you notice a temperature higher than 100.5 degrees Fahrenheit (38.1 degrees Celsius), you have to make sure that you get in touch with your physician right away.

You know your body better than anyone else, and you will feel it progressing (slowly at first). If you notice anything out of the norm for you, then you should contact your physician because it could be a sign that there is something wrong.

What other precautions should I take once I have undergone the surgical procedure?

Your surgeon and physical therapist will give you an exercise regimen you must adhere to once you are home from the surgical procedure even if you are going to go to physical therapy when you are home. You will need to take short walks a few times a day, and you will probably feel soreness and stiffness.

However, you must not stop your activity completely if you notice soreness or stiffness. Try applying cold packs and to the hips and decrease your physical activity a bit rather than stopping physical activity altogether. If you adhere to your exercise regimen and continue walking, you will actually speed up the recovery process.

Staying with your walking and exercise program will help speed your recovery after your surgical procedure, so make sure you follow your regimen!

Daily living after the surgical procedure:

It should be safe for you to resume sexual activity about 4 to 6 weeks after having undergone this type of surgical procedure. However, you need to talk to your surgeon and physical therapist about when it is safe, and especially how it is safe to resume sexual activity. It is especially important for you to discuss what positions will not put your new hip at risk of dislocation or damage.

The hip is structured to bear weight in a specific manner, and each pound of body weight you add after hip replacement surgery actually means three pounds of stress on your new hip. If you want your new hip to last a long time and not cause you any undue problems, you must control your weight.

It is important for you to stay active once you have had the surgical procedure in order to help give your new hip flexibility, endurance, and strength. Some of the most important activities you can take part in are swimming, waking, golf (No spiked shoes! And do get around in the golf cart!), dancing, and cycling on flat surfaces or on a stationary bike.

When is an artificial joint replacement not recommended?

It is not recommended for you to have artificial hip replacement surgery if you:

• Do not have good general health since you might not handle anesthetic and surgery very well.
• Are at high risk of infection or if you have an unresolved infection.
• Have significant thinning of the bones (osteoporosis).
• Are currently involved and will remain involved in physically demanding sports and/or heavy manual labor.
• Are obese or severely overweight since replacement hip joints are more likely to fail in people who are obese or very overweight.
• Please not that Doctor Oeding evaluates each person individually to make a determination whether he or she is a good candidate for hip replacement surgery.

How Well Does this type of Surgical Procedure Actually Work:

Patients who have undergone artificial joint replacement or double hip replacement surgery report that they have much less pain. The also report that they have been able to resume daily activities, and they have been able to take up activities that had given up before the operation. The reason people give up many activities is due to the pain that was being experience or because of the loss in motion and flexibility.

The fact is that you can expect to be able to carry out your daily activities almost like you did before you damaged your hip to the point where it began to affect your lifestyle and quality of life.  Your hip joint will move better, so you will be able to get in and out of a car, climb stairs, walk without getting tired, walk with less of a limp and even without a significant limp, and take care of your feet.

On the other hand, you may have to give up running, tennis, basketball, and other sports or activities that force you to put a lot of stress on your new hip joint.

Will I need another artificial joint at some point?

Once you have had hip replacement surgery, you can expect your new hip joint to last 10 to 20 years, and oftentimes even longer without loosening. This would depend on other factors such as:

• Lifestyle and just how much stress you put on your new hip joint.
• Your weight since being obese or overweight places undue stress on the new joint.
• Whether your new hip joint and the surrounding bones and muscles mend and bond.
• Your age.
• Strength of your bones and supporting muscles.

The fact is that the younger you are when you have total hip replacement surgery, the more stress you put on your new hip joint, the greater the likelihood that you will need a second operation sometime down the line. Hip replacement components wear down and come loose over time, and they will need to be replaced.

If you take care of your new hip, if you avoid sports and work that stress the joint, if you are not obese or significantly overweight, your new joint should last a long time. If you have a replacement operation when you are 60 or older, you can actually expect your new joint to last for the remainder of your life. Additionally, researchers and doctors are continuing to find new ways to lengthen the life span of artificial hip joints.

There are long term studies being conducted, and the hip joint you will be receiving may have been developed from research during the last 20 years or so. If you have the procedure sometime in the near future, you can expect your new hip to last much longer than it would have lasted if had had the surgery 10 years ago!

What about the risks of having artificial joint replacement surgery?

There are generally two types of risks involved with total hip replacement surgery. 1) The actual risk during hip replacement surgery and during the recovery period and 2) long term risks which may become apparent months or even years after hip replacement surgery. However, many of the complications involved in total hip replacement surgery are dependent upon other health problems or risks you may already have.

In general, some of the risks of total hip replacement surgery and recovery are:

Blood clotting: Patients undergoing total hip replacement surgery could develop clots in a leg vein. If a clot blocks blood flow back to the heart from the legs, or if the clot goes into the lungs, it can be really dangerous.

It is a known fact that blood clots are common in people as they age, in people who are obese or severely overweight, in people how have previously developed blood clots, and in cancer patients.

Infection: Total hip replacement surgery involves the risk of infection in the in the new joint or the wound. If you are in good physical condition and general health, infections are actually rare.

However, if a person has other health risks or problems including rheumatoid arthritis,diabetes, or chronic liver disease, or if a person is taking corticosteroids, then that person is at higher risk of developing an infection after a double artificial joint replacement procedure.

Infections in the total hip replacement surgery wound will usually get treated with antibiotics. If the Infection is deep in the joint, or very deep in the wound site, then it may require more surgery.

In rare instances, surgeons have had to remove the artificial hip joint after total hip replacement surgery. If a surgeon has to do a second surgery to remove pieces of the new hip joint after infection, the pieces can be replaced, but revision (second surgical procedure) is usually more complicated than the original total hip replacement surgery, and there are other risks involved.

Nerve injury: In very rare instances, there may be nerve damage around the site of the operation. If the orthopedic surgeon is also trying to resolve deformities in the hip joint, it is more common for nerve damage to occur, but it is still a very rare risk.

If you have had hip replacement surgery and you notice tingling, numbness, or difficulty moving a muscle, it may be due to nerve damage. However, these symptoms may be caused by trauma to the nerve rather than permanent damage, and the symptoms will usually get much better as time goes by, and they might go away entirely.

Wound site healing problems: Some people have reported problems with wound healing problems once the artificial joint is in place, and these tend to be more common in people who are on corticosteroids, people who have immune system diseases, especially those who have rheumatoid arthritis, and in people with diabetes.

Bone tissue deposits in the soft tissue surrounding the new hip joint or hetero-topic ossification: Although this condition doesn’t generally affect how the joint works after total hip replacement surgery, it might decrease hip range of motion. You will not usually need treatment for this condition unless your range of motion is severely limited and it is causing you great pain and distress.

Dislocation after total hip replacement surgery: It is actually quite rare to dislocate the artificial joint after the operation, but it can happen and has been known to happen if you do not follow aftercare instructions. If you dislocate your artificial joint after surgery, you surgeon or physician will usually be able to move the hip back into place without the necessity of having you undergo a second procedure.

The surgeon or physician could also require you to wear a brace to avoid further dislocations. In rare instances, in order to put back in place, follow up surgery could be required.

Leg length: After artificial hip joint insertion, one leg might be slightly longer than the other, but the difference is usually minute so that no further treatment is required as long as there is not functional problem or pain. On the other hand, if the difference is noticeable or if there is pain or a functional problem, then a shoe insert could be required for correction.

Long-term risks after artificial hip joints are in place:

Artificial hip joint parts come loose: As time goes by, the most common problem reported by people who have undergone total hip replacement surgery is that the hip joint parts come loose. This may be due to tissue growing in between bone and artificial hip joint components, which then leads to loosening.

If joint parts are loose, they are only visible through X-rays, and no symptoms might be present. However, in some instances, loosening causes severe pain, and a second total hip replacement surgery could be required.

Risk of infection: If you have artificial material placed in your body, and this includes components used during hip replacement surgery, you are at higher risk of infection, especially around the foreign materials.

Antibiotics could be administered before and after this type of operation to minimize the risk of infection. In addition, there are tests that involve the insertion of instruments into the body to see how well your body will tolerate components used during surgery.

How do I start the process of contacting medical facilities and an orthopedic surgeon?

If you want to start the process, if you want more information or a free quote, all you have to do is call 1-866-665-6433, Monday to Friday, from 9 AM to 5 PM US Central Standard Time and speak live to a hip replacement surgery consultant. You can also fill out the contact form, and a hip replacement surgery consultant will get in touch with you, usually within 24 hours and provide the information or quote you requested so you can make an informed decision whether this type of procedure is right for you. You can also ask to speak to orthopedic surgeon who performs the surgery, and your consultant will help set up a conference call.

Red the Wikipedia article with general information on total hip replacement surgery.