Timeline for Hip Replacement (What to Expect)

Surgery Scheduled with Joshua Hickman, MD

• Review the information about your surgery at joshuahickmanmd.com
• Ensure that you have a preoperative appointment scheduled with Dr. Hickman or the physician assistant 1-3 weeks prior to surgery
• Make a list of all current medications including dosages and times taken and bring this to your preoperative appointment
• Receive primary care physician clearance for surgery if instructed by Dr. Hickman's office

One to Three Weeks Prior to Surgery

• Stop all anti-inflammatory medications (Diclofenac, Naproxen, Ibuprofen, etc.) 1 week before surgery.
• If you are on a blood thinner, contact Dr. Hickman's office or be sure to discuss this at your pre op to determine when it needs to be stopped
• Make sure to attend your preoperative appointment with any questions you may have.
• Notify your physician if you or any family member has a history of previous DVT/blood clot

Day Before Surgery

• The hospital or surgery center will call with instructions and arrival time
• Bring your own loose-fitting clothing for therapy after surgery
• Nothing to eat or drink after midnight
• Bring a list of medications including dosages and instructions to the hospital
• If you use a CPAP machine, bring it with you to the hospital
• Scrub the hip and entire leg with the brush given to you at your preoperative appointment

Day of Surgery

• Upon arrival to the hospital or surgery center, you will have labs drawn and an IV placed
• IV antibiotics will be given 30 minutes prior to surgery to decrease the risk of infection
• You will be given spinal anesthesia (we work to perfect the optimal anesthesia and pain control as well as decrease nausea)
• You will be given minimal sedation to relax and sleep through the surgery but no tube will be placed down your throat, you will breathe on your own during surgery
• Surgery time is approximately 60-90 minutes
• You will be given minimal sedation to relax and sleep through the surgery
• No tube will be placed down your throat. You will breathe on your own during surgery
• We will wear special suits and practice sterile techniques in an effort to prevent infection
• A small incision is made to preserve muscle
• The implant will perfectly match your anatomy and will allow for near normal function and motion
• A bandage and ice will be placed on your hip
• You will be in the recovery room for approximately 45 minutes
• Specialized nurses trained in joint replacement recovery will welcome you to the floor. Our staff takes pride in serving your needs and routinely is ranked at the highest level of quality care
• Your diet will consist of solid foods and you will have several menu choices
• There are typically no restrictions on light to normal activities
• Important Tasks on Day 1:
  • Sit up in bed, eat regular food, and drink
  • Urinate on your own (if not within 4 hours of arrival on the floor, notify the nurse)
  • Deep breathe
  • Stand and get out of bed with staff assistance
  • Walk the halls with assistance
  • IF THESE TASKS ARE ACCOMPLISHED YOU MAY GO HOME THE DAY OF SURGERY, most hip replacement patients go home within 24 hours of surgery

First Day After Surgery

• Your dressing will be changed
• You will have physical therapy in the morning and afternoon
• An occupational therapist will discuss issues such as dressing, driving, getting in and out of vehicles and other helpful home tips
• A discharge planner will meet with you regarding discharge
• You will receive a blood thinner to prevent blood clots and you will need to take as directed
• You will receive pain medication orally in the hospital as well as an IV anti-inflammatory medication
• You will go home with main medication. GET OFF PAIN PILLS as soon as possible. Narcotics will not be refilled after 4-5 weeks postoperatively
• Please notify the staff of any issues with urinating but keep in mind that difficulty with bowel movements is normal (it could be several days before you have a bowel movement)
• You will receive instructions regarding your incision, medications, and bathing before you leave the hospital

1-3 Weeks After Surgery

• You should not have a dressing, you may cover your incision with sterile gauze and light tape if spots or small amounts of drainage occur (this is common)
• You may get your incision wet with soap and water, but don't soak it
• Peel off tape strips and clean incision 2 weeks after surgery
• No hot tubs or under-water baths for 4 weeks
• Most hip replacement patients do not need outpatient physical therapy
• Walk frequently throughout the day followed by ice and elevation
• Most patients will not have restrictions on normal activity, participate in activities as tolerated
• Fever around 100 degrees in the first week is normal
• It is common to have bowel difficulty, however, notify our office if you go several days after leaving the hospital without a bowel movement
• Some bruising, swelling, and redness is normal
• It is common to have some numbness around the incision
• Worrisome findings include: drainage from the wound, redness that increases, shortness of breath or chest pain, fever of 102 or higher, and dramatic new leg swelling- contact Dr. Hickman's office immediately if you have any of these symptoms.
• If you have any concerns call 801-295-7200 ext. 112 or email ma.hickman@mountainortho.com
• If you go to a rehab center, you should not stay longer than 14 days

3-6 Weeks After Surgery

• Many hip replacement patients are walking normal or very well without crutches by 3 weeks
• It is common to be stiff and sore at the end of the day
• It is common to be stiff after sitting
• Most patients may continue taking anti-inflammatories as needed (as long as you are cleared to do so by your primary care physician)
• Most hip replacement patients do not need pain pills at all after 3-4 weeks postoperatively
• You should need less and less pain medication and be completely off by week 4.
• There are no restrictions on activity for most patients, in fact increasing your activities as tolerated is good for your recovery
• Worrisome findings include: drainage from wound, redness that increases, shortness of breath or chest pain, fever of 102 or higher, and dramatic new leg swelling- contact Dr. Hickman's office immediately if you have any of these symptoms

3-4 Months After Surgery

• Most patients are back to full activity with no restrictions or difficulty
• Some patients have stiffness and soreness at the end of the day
• Activity should be near normal and you can increase your activities without any restrictions.

12 Months after Surgery

• Less stiffness, however stiffness can exist
• Sore at the end of the day
• Sleeping should improve
• Swelling should be near normal.