Pre-Op Prep for Hip Arthroplasty (Replacement)

Helpful Highlights

• Go to the orthopedic pre-op evaluation appointment prepared with questions. This guide will help you formulate those.

• The pre-op appointment includes an evaluation of not only physical status but mental/emotional and home support statuses, as well.

Based on the results of the pre-operative evaluation and tests by the orthopedic surgeon, clearance is or is not given for the surgery. The pre-op evaluation appointment will allow you to ask questions about the procedure, as well as pre- and post-surgical expectations, so be sure to come prepared.

Pre-operative visit

Not long before the date of the hip arthroplasty (replacement) surgery, the orthopedic surgeon will perform thorough physical, mental, and emotional examinations, as well as evaluate your loved one's post-op support at home. The surgeon will likely:

• Ask about medical history and current medications (be sure to bring a list of ALL medications - with names, doses, and times - including over-the-counter)

• Examine the problem hip, noting the range of motion in the joint and strength of the surrounding muscles

• Order blood tests 

• X-ray of the hip and pelvis to assess the status and structure of the hip joint, and occasionally advanced imaging (CT or MRI) may be needed to assist in surgical planning

• Order an electrocardiogram ("ECG" or "EKG") to establish heart rhythm

• Review what is required in the 24 hours before surgery

The surgeon will also work closely with other providers, like your loved one's cardiologist, to determine what medications they may need to stop taking before surgery (and when) to decrease the risk of complications, as well as when it will be safe to resume taking these medications.  This may include stopping blood thinners, aspirin, or supplements like fish oil, as these medications slow blood clotting, which could lead to an increased risk of blood loss during surgery or bleeding after surgery.

Before surgery, medical risk is assessed. The surgeon needs to make sure that the risks of hip arthroplasty (replacement) don’t outweigh the benefits. They will check for:

• Anxiety and stress levels around the surgery

• How well your loved one's body may tolerate blood loss

• How well your loved one tolerates anesthesia

• How your loved one will manage the rehabilitation process (making appointments, participating in the program, performing the recommendations)

• How other medical problems may affect their healing

• How active they are

• How their current weight will factor in

Their lower extremities will also be evaluated before surgery. The surgeon will conduct the following:

• Muscle testing

• Nerve and vascular status testing

• Palpation testing

• General inspection

• Range of motion testing

• Straight leg raise test

• Measure leg length

• Trendelenburg sign ("positive" when, while standing on one leg, the pelvis drops toward the unsupported side, and "negative" when the pelvis remains level - it indicates weakness in the hip abductor muscles)

Visit the dentist before surgery

It’s better to have any dental work done either well before surgery or no less than three months after. The surgeon may recommend antibiotics before any dental procedure once your loved one has had a joint replacement.