Evaluation before THR

This is a screening to ensure fitness for surgery. The doctor will explain what is done during the surgery, follow up and post-operative advise, and when you are likely to be fit for surgery, before taking your consent for surgery. Physiotherapy and occupational therapy requirements will also be explained.

Advice Before Surgery

Some medicines like hormone replacement therapy, contraceptives etc will be stopped at least 6 weeks before surgery. 

One needs to stop smoking for at least 6 weeks before surgery, as this causes changes in blood flow patterns, delays healing and slows recovery

Weight reduction: BMI > 30 increases the risk of anesthesia and surgery. It also reduces the life span of the artificial hip

Address dental problems before surgery in order to prevent any post-operative infection being triggered. 

Practice sleeping on your back as sleeping on the side is uncomfortable for at least 6 weeks after THR

Orthopedic Evaluation:

• A medical history of the current symptoms, extent of pain and range of movements, functional disability and current level of activity
• A history of associated diseases like diabetes, asthma, obesity and treatment is taken
• History of allergies 
• Treatment taken previously for the hip joint problem
• A physical examination to assess hip mobility, stability, strength and alignment
• X rays to determine the extent of damage and deformity in the hip
• Routine blood tests like complete blood count, blood sugar level, routine urine test, chest x-ray, ECG and ECHO if needed.
• Depending on the age and associated diseases like diabetes, hypertension, one may be advised for clearances by a cardiologist, diabetologist and others.
• Those with urinary issues should have a urological evaluation as this may be a source of infection later. 
• In some cases an MRI may be done to determine the condition of the bone and soft tissues of the hip

A pre-anesthetic check will be done and the anesthetist will inform you of the type of anesthesia to be given and all risks associated with it. One is asked not to eat or drink anything for 6 hours before surgery. Advice on what medicines you may take on the day of surgery from your regular medicines will be told to you by the anesthetist. You may be asked to stop some medication like blood thinners, a few days before the surgery. An informed consent will be taken for performing the procedure. Your doctor will explain in detail about the surgery and post-operative requirements, including rehabilitation at home.