The Procedure

Once in the operating room, you'll be moved from your gurney onto the operating bed. If the operating room feels cold, it is - the temperature is intentionally kept cool to help prevent infections. Don't worry, though. Your nursing team will cover you with blankets to keep you warm.

EKG electrodes will be placed on your chest and sides to monitor your heart rhythm during surgery. Then the anesthesiologist will inject medication through your IV line to put you to sleep (general anesthesia) or block feeling from the waist down (spinal anesthesia). After you are asleep, a nurse may insert a urinary catheter - a thin, sterile tube inserted into your bladder to drain urine.

The surgery itself generally takes between 45 minutes to 2 hours.

In the operating room, your surgeon determines what length of incision will be needed in order to do a good job. If your surgeon chooses a minimally-invasive surgery technique for your hip replacement, you will have a much smaller incision (on average 2-3 inches, as opposed to the traditional 6-8 inches of a traditional hip surgery), thus preserving vital muscle and tendon groups. This offers patients many benefits including less pain, less scarring, less blood loss, and increased function immediately after surgery.

Your incisions, depending on the surgical method chosen, will usually be 4 to 12 inches long. Staples or sutures will keep your incision closed (some internal sutures may be naturally absorbed by the body). There is a lot of talk about small incisions and different techniques. The special equipment and instruments provided to your surgeon makes it possible for them to use the appropriate incision to do the best job for you, limiting damage to the muscles and tissues around the hip. It does not make a difference on the size of your incision, but on how the surgeon treats the tissues that are cut through. A hemovac may also be placed in the incisional area to help drain post-operative bleeding for a couple of days after surgery.

In the Recovery Room
You'll awaken slowly in the recovery room, where you'll spend your first hour or two after surgery. Your nurse will constantly monitor your progress to ensure that your vital signs are stable.

After Surgery
Following your short stay in the recovery room, you'll be taken to your hospital room. You'll notice a bulky dressing over the surgical incision and may have a drain in place to help decrease swelling of your hip.

Your heels will be elevated to decrease pressure on the surgically repaired hip. Support and compression stockings on your legs will help improve circulation and decrease your risk of blood clots. A foam wedge (or pillows) will be placed between your legs to prevent them from crossing.

You'll also be hooked up to an IV line, through which you'll receive fluids and medication (including an antibiotic). Your nurse will show you how to use a pump to dispense pain medication to yourself. If you continue to experience severe pain, tell your nurse immediately.

The combination of anesthetic, pain medication and unfamiliar surroundings affects every patient differently. You and your family may even notice some behavioral changes, including confusion, especially during the hours immediately following the surgery. These symptoms are temporary and should dissipate relatively quickly. If they do occur, please discuss your concerns with your nurse.

Once an hour (while you're awake), you'll be prompted to use the incentive spirometer next to your bed. The spirometer is a special machine designed to help you keep your lungs free of fluid after surgery through focused, regular deep breathing. Your nurse will also remind you to move your legs every hour or so when you're awake. You may receive oxygen overnight.

You'll remain in bed the whole day, sitting up with your nurse's assistance only on the night following your surgery (depending on what time you returned to your room). Your nursing team will regularly turn you and provide skin care - be sure to tell them if you experience any tender or burning areas.

You may start your home medications as soon as you can tolerate liquids. Although your diet will be initially limited, the range of foods available to you will increase as your appetite returns. Medications will help reduce any nausea you may experience.

A technician will draw a sample of your blood for testing. If necessary, you may also receive a blood transfusion.

Next: Hospital Stay

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