Before Hip Surgery

ATTENDING THE PRE-OPERATIVE JOINT REPLACEMENT CLASS

It is very helpful for patients and their caregivers to attend the Sutter General Pre-operative Joint Replacement Class. This is held every Tuesday at the hospital from 1-4PM. This will give you a chance to meet some of the nurses and therapists. They will go over everything that you will need to know about your hospital stay and planning for discharge. We strongly encourage you to attend.

PRE-OPERATIVE EVALUATION AND TESTING

Your surgery will usually take place approximately 4-8 weeks from the time of scheduling. During this time, you will be busy having blood tests, urine tests, x-rays, and possibly some special studies such as a hip aspiration, bone scan, indium scan, and/or CT scan. You normally will also require a chest x-ray and electrocardiogram. Some of these tests will be ordered either by your surgeon or can be performed by your internist.
You will be given the opportunity to donate your own blood pre-operatively. A 20 year-old law requires this, but it is rarely needed anymore as there are newer techniques for minimizing blood loss and salvaging blood during and after the surgery. Please discuss this with your surgeon. If you elect to donate your own blood, arrangements will be made at a local Blood Bank to donate blood beginning 4 weeks pre-operatively. Regardless of whether you donate your own blood, you will be asked to take iron pills to ensure that your body has enough iron stores prior to surgery.
You will need to have a complete history and physical examination performed by an internist or family practitioner. This can either be your own private physician or one that your surgeon recommends. It is usually best if this physician has privileges at Sutter General so that he/she can be available to manage any medical problems that may arise after surgery. The purpose of this visit will be to determine if you are medically able to undergo the surgery. Some additional consultations may be required from other specialists such as cardiologists, pulmonary specialists, and anesthesiologists. These will also be arranged prior to your surgery if they are needed.
Certain medicines (typically aspirin, anti-inflammatories, blood thinners, and some rheumatoid medications) will need to be stopped 1-2 weeks prior to surgery. Your doctor’s nurse will let you know when to stop taking these, and when it is safe to resume these medicines. Many of the nutritional supplements have some blood thinning properties. We recommend stopping these one week before surgery.

THE PRE-OPERATIVE VISIT

Within one week prior to your surgery you will return to see your surgeon. During this visit he will review all of the laboratory data and consultations from other physicians to ensure that all is well for the surgery. Some laboratory tests will need to be repeated at this visit. Most importantly your surgeon will obtain your consent for surgery. This will involve reviewing the potential benefits, risks, and alternatives to the planned treatment.

PRE-OPERATIVE TESTING

After you see your surgeon for your pre-op visit you will go to the hospital for pre operative tests and pre-registration. You will hand carry the doctors orders and present them to the reception desk in the foyer of the hospital. You will be directed to the admitting office for preliminary registration and then escorted to the laboratory on the 3rd floor. Following the completion of these tests you can return home.

BEFORE COMING TO THE HOSPITAL

The night before surgery please take a shower and use the suppository given at your pre-op visit. It is important to clean out the lower bowel prior to surgery because initially after surgery the bowels do not function normally. You usually will not have a bowel movement for 3days after surgery, which is normal. Therefore to avoid constipation and impaction, it is important to use a suppository before surgery.

The morning of surgery please take another shower. This will help to decrease the bacterial count on your skin at the time of surgery.

You may have nothing to eat or drink for 8 hours prior to surgery with the exception of certain medications that you take daily. Routine medicines (blood pressure, cholesterol, etc.) can typically be taken with a small amount of water. Diabetic medicines typically are not taken. Please ask your doctor’s nurse or your doctor to review these with you.