READY FOR ADMISSION

You have chosen hip resurfacing arthroplasty and have fixed a date for the operation. While waiting, you can help to make sure that the operation goes smoothly. It is important that you are admitted to hospital in the best possible physical conditions. If overweight, now is the time to do something about it. Every kilo lost before the operation can significantly lighten the load on your new joint. Moderate exercise before the operation can help to strengthen the muscles, allowing faster mobilization after the operation. It is also advisable to stop smoking, particularly before the operation, so you should seriously attempt to stop. This will permit a faster recovery. Prepare a list of medication that you take regularly. Your doctor will be able to tell you which medicines you must stop taking before the operation and how much in advance. If available, bring the clinical records of previous admissions with you.

IN THE HOSPITAL

What should I bring to the hospital?

• Information on previous examinations, for example X-rays
• Health insurance card
• Medicines taken on a regular basis
• Allergy passport
• Pyjama or night gown
• Bathrobe
• Toiletries
• Tracksuit with wide legs
• Flat, closed shoes with anti-skid soles
• Sturdy sneakers, ideally with velcro closures
• Shoehorn with long handle
• Crutches
• Addresses and telephone numbers of relatives and friends

If you suffer from allergies – for example to metals such as nickel or chromium, or to pharmaceuticals – communicate this fact. Unlike with traditional prostheses, much less bleeding occurs during hip resurfacing surgery, as the bone is not cut. Pre-operative blood deposition is therefore not necessary.

As a general rule, you must not eat, drink or smoke on the day of the operation, that is to say, after midnight the day before the operation. If you are taking medicines, the anaesthetist will decide which ones you can continue to take before the operation. Which type of anaesthetic will I be given? Hip resurfacing can be carried out under either local or general anaesthetic. Often the operation is performed using «spinal anaesthesia», that is to say that the patient is conscious but cannot feel pain. The field of view is closed off by a special curtain. During a general anaesthetic, on the other hand, the patient goes into a deep sleep. Also in this case, no pain is felt. In both cases, the anaesthetist will keep you under observation.

General surgical risks, such as the formation of blood clots, are treated with anticoagulants during the operation. In addition, for a certain amount of time after the operation, many patients must wear elastic socks and take anticoagulants.

After the operation: First steps with your new joint

For your safety, after waking up from the anaesthetic, you will be in a recovery room where the staff will look after you, closely monitoring your progress. This is perfectly normal. Usually after a few hours you will be transferred to a bed on the ward. The operated leg will be supported by a brace or placed over a cushion. A drain will eliminate the secretions from the wound, preventing the formation of hematomas. A few days after the operation, the drainage tubes will be removed. You will be given painkillers to keep the pain to a minimum and to help you rest and recover physically. After the operation you must continue to take the anticoagulants to prevent the formation of blood clots. Much like clinical conditions, rehabilitation also varies from patient to patient. In general, you will be able to get up with the help of staff the day after the operation and you can also begin to walk. To guarantee that your hip functions perfectly from day one, physiotherapy is vitally important, together with your active collaboration. A few days after the operation you will be assessed and you will follow a physiotherapy program. This includes passive mobilization with an electrically powered machine for exercise, together with walking exercises with crutches. The physiotherapist will explain how much weight-bearing is allowed. Unlike with traditional prostheses, with hip resurfacing, there is no risk of dislocation and hence recovery is much faster. The patient is able to move the hip immediately. In any case, it is not recommended to flex the hip more than 90 degrees for the first three weeks after the operation, not because of the risk of dislocation, but to allow the scar to heal properly. The stitches will be removed 10-14 days after the operation.

RETURNING HOME

Approximately 4 weeks after the operation, you can stop using your crutches, return to work and drive. As a precaution, do not sleep on the operated side for several weeks as the surgical scar will be sore. You must continue to carry out the recommended exercises in order to strengthen the muscles and regain movement. It is advisable to use an exercise bike and to go swimming. It is essential to be checked at the outpatients’ clinic 1 month, 3 months, 6 months and 12 months after surgery and then every 2 years. At these visits you will be clinically assessed and X-rays will be taken. In this way, potential problems related to the implant can be identified in good time, thus preventing any damage. The longevity of the implant depends on the surgeon’s skills, the quality of the implant and very much on your contribution. Sometimes, especially in women, it is also advisable to check the quality of the bone using densitometry.

With hip resurfacing arthroplasty, it is possible to resume all kinds of sports, even at a competitive level. Low impact sports can be resumed 3 months after the operation, while high impact sports can be resumed after 6-8 months.