Preparing for a hip replacement (total hip arthroplasty) is a proactive process. The procedure alleviates chronic pain and restores mobility by replacing damaged bone and cartilage with prosthetic components. Avoiding specific missteps before surgery is crucial for optimization. Careful preparation ensures a smooth surgical experience and successful recovery.
Mistakes Regarding Pre-Surgical Medical Requirements
Stopping or altering prescribed medications without consulting the surgical team is a dangerous pre-surgical mistake. Blood-thinning medications (e.g., warfarin, apixaban, or clopidogrel) are particularly concerning. Stopping them too soon risks a dangerous clot, but continuing them increases the risk of excessive surgical bleeding. The surgeon and prescribing physician must coordinate a detailed plan for tapering or temporarily stopping these drugs days before the procedure.
Many over-the-counter medications and supplements can also interfere with blood clotting. Non-steroidal anti-inflammatory drugs (NSAIDs) like ibuprofen and naproxen must typically be stopped at least seven days before surgery, as they inhibit platelet function and increase blood loss risk. Herbal remedies and supplements with anti-platelet properties must also be discontinued, often up to two weeks prior. Failing to disclose all supplements, vitamins, and herbal remedies can compromise anesthesia or increase surgical bleeding.
Failing to address existing infections can jeopardize the new joint. Any active infection, including dental abscesses or gum disease, must be resolved before surgery. Bacteria can enter the bloodstream and travel to the joint, leading to a severe prosthetic joint infection. Pre-operative testing (e.g., blood work, chest X-ray, and EKG) should not be delayed. These tests confirm the patient’s fitness to withstand the stress of a major operation, and ignoring them can result in the last-minute cancellation of the scheduled surgery.
Activities That Risk Injury or Strain
Engaging in physical activities that place unnecessary strain on the compromised hip joint is a common mistake. High-impact sports, such as running or skiing, must be avoided due to the risk of a fall or fracture. Such an injury could lead to emergency surgery or postponement of the planned procedure. Eliminate any activity that involves twisting, sudden pivoting, or jumping from the daily routine.
Patients should refrain from lifting heavy objects, generally defined as anything over 10 to 15 pounds. Lifting increases hip pain and can cause further joint damage. Overexertion also includes ignoring increased pain signals in an attempt to “stay active.” While a physical therapist may recommend pre-operative strengthening exercises, the intent is only to maintain muscle tone, not to push the body.
Ignoring the need for mobility aids is a risk-taking mistake that can lead to injury. If hip pain or instability is significant, patients must use a cane, walker, or crutches to prevent a fall. A fall could fracture the femur or pelvis. This instantly turns an elective procedure into an urgent, complicated scenario, delaying the intended hip replacement.
Continuing Habits That Compromise Recovery
Maintaining systemic habits that degrade the body’s ability to heal compromises long-term recovery. Continuing to smoke is detrimental, as nicotine restricts blood flow essential for wound and bone healing. Smoking significantly increases the risk of wound-related complications and can elevate the risk of a prosthetic joint infection.
Patients should stop all nicotine use at least four to six weeks before surgery. This time frame allows the body to improve oxygen delivery and immune response, as nicotine acts as an immunosuppressant. Furthermore, excessive alcohol consumption must be curtailed. Alcohol can interfere with anesthesia, increase the likelihood of bleeding, and cause dehydration, complicating the immediate post-operative period.
Ignoring nutritional advice or attempting extreme dieting before the procedure is a mistake. While weight loss is often encouraged to reduce the load on the joint, rapid weight loss or gain can be counterproductive. Crash dieting depletes necessary nutrient stores required for tissue repair. Focus instead on a healthy, balanced diet and maintaining stable blood sugar levels for optimal healing.
Failing to Organize Post-Operative Support
A common logistical mistake is assuming immediate self-sufficiency upon discharge. Patients must secure a dedicated caregiver for the initial post-operative period. Assistance will be required for daily tasks like dressing, bathing, and meal preparation for at least the first week. Transportation arrangements must also be finalized in advance, as the patient will not be permitted to drive for several weeks.
Patients frequently fail to acquire necessary medical equipment until the last minute. Essential aids are necessary to comply with hip precautions and avoid bending or twisting motions. Using a low toilet seat, for instance, can violate precautions and increase the risk of joint dislocation. These aids include:
- A walker or crutches
- A long-handled grabber
- A raised toilet seat
Neglecting to modify the home environment to prevent falls is a critical error. Patients must remove all tripping hazards, such as loose rugs, electrical cords, and clutter from walking paths. Moving frequently used items to waist-level shelves and arranging a temporary recovery station on the first floor reduces the need for bending, reaching, and navigating stairs. This ensures a safer transition back home.