X. Planning for Your Surgery
Medications
If you are taking anti-inflammatory medications such as aspirin, Indocin, Motrin, Feldene, Naprosyn, Voltaren, Mobic, Lodine, etc., it is advised that you discontinue their use one week prior to surgery. Please stop Coumadin 6 days prior to surgery. Rheumatoid medications such as Methatrexate and Embrel should be stopped one month prior to surgery and held one month following surgery. Plavix and Aggrenox should be stopped 14 days prior to surgery.It is also recommended to discontinue all herbal supplements or other over-the-counter remedies two weeks prior to surgery. You may continue to take Celebrex and Tylenol until the day of surgery.
Home Exercises
Obtaining crutches or a walker and practicing walking with these before your surgery is very helpful. It is also recommended that you begin a preoperative program of exercise (only if it is comfortable to do so). Easy isometrics (muscle tensing exercises) will help maintain the strength of your leg muscles in preparation for postoperative walking. The following exercises can be done in bed. Exercise each leg remembering to breathe normally throughout the exercise. Perform 2-3 times per day.
a. Gluteal Setting Exercise: Squeeze your buttocks together tightly, hold for ten counts. Relax. Repeat 10 times.
b. Quadriceps Setting Exercise: Tighten the muscle on the top of your thigh by pushing the back of your knee down on the bed. Hold for 10 counts. Relax. Repeat 10 times.
c. Hamstring Setting Exercises: Keep the knee bent slightly. Push your heel down into the bed and then pull toward buttocks. Hold for 10 counts. Relax. Repeat 10 times.
d. Ankle Circles: With lower leg resting on a towel roll, move the ankle in a circle first in one direction, then in the other. Repeat 10 times.
e. Ankle Pumps: Move the ankle up and down slowly. Repeat 10 times.
You will be using your arms often during the postoperative period while moving in bed and with the walker or crutches. Therefore, strengthening your upper body is also important. Exercises should include:
a. Pull-ups: While sitting in a chair, hold onto a bar that is overhead and raise your buttocks off the chair. Repeat 10 times.
b. Reverse Push-ups: While sitting in a chair, place your arms at your side and hold onto the chair next to your buttocks. By straightening your elbows, lift your buttocks off the chair. Repeat 10 times.
c. You can also do general strengthening exercises with small weights.
Weight Reduction
The stresses across the hip joint are high and can be equal to three times your body weight during normal walking. Therefore, one pound of weight reduction equals three pounds in stress reduction. These reduced stresses can be helpful both before and after your surgery.
Home Preparation
After your surgery you will be using either a walker or crutches. You should try these around the house and make sure important areas (bathroom, kitchen, and bedroom) are easily accessible. You may need to rearrange furniture or temporarily change rooms for your convenience after your surgery. Remove all throw or area rugs that could cause one to slip. Bathroom modifications which may be helpful include a shower chair, gripping bars, flexible shower handle, non-slip floor surfaces or mats, soap bars with a string attached and a long-handled scrub brush. If you live alone, you may want to make arrangements to have a friend or relative stay with your for a short while after your surgery. This is especially useful in meal preparation, carrying various items such as plates and cups, and putting on socks. It may be helpful to wear shirts with pockets and/or to drape a small canvas or plastic bag over your shoulder for carrying smaller items. Occasionally, patients are sent to a rehabilitation facility after their surgery until they are stronger.
Medical Evaluation
Hip replacement surgery is a major procedure and care must be taken that you are in the best medical condition. You must see your regular medical physician within a month of your surgery. He or she will perform the necessary tests. Please arrange to have the this physician send to our office, prior to your pre-operative orthopaedic appointment, all test results as well as a note which clearly states that you may undergo the proposed surgery, fax # 803-933-6754. Your surgery will be postponed if our office does not receive the test results and/or surgical clearance in time. If you do not have a regular medical physician, we can provide a referral. You need to be seen in our clinic within seven days of your surgery. At this time we will review the proposed surgery with you and answer any last minute questions you may have. It is imperative that you not eat or drink anything after midnight (12:00 AM) the night before surgery. This helps to prevent potential nausea and vomiting from occurring during surgery which could cause complications.
What to Bring to Hospital
The Physical and Occupational Therapy Department will provide a walker or crutches, raised toilet seat, and reacher and other equipment needed. If you already have this equipment, please bring it with you. To enhance your postoperative therapy, a knee-length robe or gown is recommended. (Do not bring floor-length robes as they make walking difficult.) Ladies may want to bring a camisole or lightweight cotton shirt to wear under the hospital gown for added warmth. Leave all jewelry at home! A package containing personal care items is provided. Loose fitting pajamas or sweats are useful to wear on the way home. Bring comfortable, sturdy bedroom slippers with non-skid soles and a comfortable pair of shoes to wear for the trip home. Of course, good reading material may help pass the time more quickly.
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