Total Hip Replacement FAQ with Dr. Leonard


Dr. Leonard

How should I prepare for my hip replacement?

Low impact cardio exercises are a good way to prepare for hip replacement surgery.  Consider using an exercise bike, doing water aerobics or swimming.  Not only are these exercises helpful in your surgery preparation, it can also improve the symptoms of your arthritis.

Should I add or subtract any foods from my diet?

I really like it when patients have enough calcium in their diet.  I ask patients to take 400 mg of calcium with each meal and 1000 IU of Vitamin D each day.  The extra vitamins will help your body grow into your hip components and make it stronger.

How old are your hip replacement patients?

I have had patients in their 30s, which is rare, 40s which is not quite as rare, 50s, 60s and 70s are the most common ages.  That being said I have had patients in their 80s and even in their 90s.

Why did the 30-year-old need a hip replacement?

They had a condition where the hip bone died and it could not be replaced.

When should I expect to feel relief from my hip pain after my hip replacement?

Total hip replacements are really fun because it is no exaggeration that patients will tell me they feel better the day-after-surgery then they did the day-before-surgery.  Not everyone tells me that, but every year several people will…  It is really cool.

What should I expect to be the hardest part of my recovery following my hip replacement surgery?

The hardest part will probably be gaining physical capabilities you haven’t had in years. Many people are just happy to get their hip replaced and be able to do the things they used to do immediately before the replacement but now can do it without pain.   My goal is for the patient to think back years ago before they had pain and regain that level of fitness.  The reason it is hard is because a lot of people don’t ever think they will get back to that activity level.  It just takes time.  How far were you hiking? Or dancing? Or golfing?  Were you riding your bike further?  Were you doing other things?  You can regain a higher level of fitness you haven’t had in years.

Will I have to stay in the hospital after my hip replacement surgery?

Yes, the surgery is an inpatient procedure; however, most patients leave two days after surgery.

Will I be on bed rest for those two days following my hip replacement surgery?

No, if we do the surgery in the morning you will be out of bed by the end of the day.  If we do the surgery later in the day, you will be out of bed the following morning.

What will I do “out of bed”?

You will be weight bearing as tolerated.  They (the hospital staff) will teach you how to get in and out of bed safely. Before you go home, they will make sure you are able to go up and down stairs.

 Will you prescribe physical therapy?  How long will therapy last?

We always prescribe physical therapy.  It usually starts in your house and progresses to an outpatient facility.  The sooner we can get you to a physical therapy clinic the better because the therapy center has more equipment and is more conducive to recovering from a hip replacement surgery.

Can I replace both of my hips in the same year?

You can easily replace both hips in the same year.  The real go-getters will have their surgeries within six weeks of each other… I get a couple patients every year who do it. More commonly people will have the hip replacement surgeries three months apart.

What brand of replacement to you prefer to use?

Stryker.  We have been using Stryker for more than ten years.

What are possible complications with a total hip replacement?

There are a lot of complications that can occur, but they are all quite rare.

Complications can include:

  • The hip components are pressed into place and if you press too hard they can crack.
  • We can change the length of your leg. We can make your leg too long which can stretch nerves and stretched nerves don’t work very well
  • Hips can dislocate
  • Infection

Those all sound bad and they are, but they are very rare.

When can I return to work after my hip replacement?

Someone with a desk job might return to work in 3-6 weeks. For someone in construction it will be closer to 8-12 weeks.

Will I have any limitations in regard to physical activities after I fully recover from my hip replacement surgery?

There are dislocation precautions that are theoretically in place your whole life. Practically speaking, no one ever feels restricted after their hip replacement.  They don’t feel like they can’t do things.  The hip dislocation precautions are just part of your life.  They are not that restrictive but they are onerous

How many hip replacements do you perform in a year?

About 50:  Approximately one per week.

What approach do you use when performing a total hip replacement?

I use the posterior lateral approach which is the traditional/standard approach.  There was a time that I did the anterior lateral approach.  I learned it because at the time it was popular and being advertised as having a lower dislocation rate.  Lately there has been a lot of press on the anterior approach so I will keep an eye on it, but I’m not convinced that it is the better approach.  We have such great results with the standard posterior approach – my patients are walking within two days and some take very few pain pills – it is hard for me to mess with that.

How large will my scar be following my hip replacement?

My shortest scars are less than four inches and it is unusual that I would go more than six inches.

I’ve heard you send your patients to the dentist before a total hip replacement, is this true?

Yes, I have all my patients see the dentist before I replace their hips to make sure their mouth is healthy.  If you have any source of infection in your mouth it needs to be treated as best as possible so there is no risk of infection from your mouth to your new hip.  After the replacement I want

you to see a dentist 2 times per year.  Good dental hygiene is very important.

Do I need to take an allergy test?

No.  Your allergic response at the skin level is much different then that at the bone level.  I have never had to take out a hip or knee because of allergies.

Will I need a walker?

Is there anything else I should pre-plan for?
Yes, most people want a walker right after surgery; however, most people are done using their walker by the time they get to the ten day post-operative follow-up in my office.

Pre-planning is important. It is helpful to have people at home to help.

Is there anything else that people ask that I have forgotten?

  • It’s much easier to recover from a hip replacement verses a knee replacement.
  • Most people don’t need a blood transfusion.
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