STEP 1: MAKE DECISION for THA WHEN quality of life is impaired by hip arthritis.
STEP 2: MEET DR. GALLAGHER IN CLINIC to discuss THA.
PICK A DATE FOR SURGERY: Mondays, Thursdays, sometimes Wednesday PMs
STEP 3: GET LABWORK DONE: lab work and office visit needed within 30 days of your desired surgery date. Lab work is either done at the hospital, CPL, or by your PCP. Some labs are only available at the hospital ie nasal swab to see if patient is a carrier of Staph (MSSA or MRSA).
ATTEND TOTAL JOINT CLASS at SETON: Not everyone wants to do this but patients find the information helpful. Getting labs done and the class done ends up making it a half day affair.
STEP 4: GO TO PHYSICAL THERAPIST visit for post-op rehab instruction/exercises to do after discharge home.
Another resource by Bob and Brad: https://www.bobandbrad.com/total-hip-replacement-program
STEP 5: DAY OF SURGERY
Show up to hospital/surgery center 2 hours prior to surgery. You’ll check in, get changed into a gown (ok to leave on lower undergarments), get an IV from the pre-op nurse, take pre-op pain medicine (usually celecoxib(Celebrex) 400mg, acetaminophen(Tylenol) 1000mg, gabapentin(Neurontin) 150mg).
NEXT – DR. GALLAGHER will visit the patient in PREOP and MARK the CORRECT HIP with a PEN.
THEN you will be wheeled into the OR. The OR table is in the center of the room and is well padded but very narrow. You’ll be asked to transfer over to the OR table and sit on the edge of the table so the anesthesiologist can place the spinal. Spinal anesthesia is preferred over general anesthesia as overall complications are diminished with the spinal. You don’t have the cognitive delay you get with the general and spinal anesthesia does not affect your driving ie braking response time.
ARCH YOUR BACK LIKE YOU’RE
CANNONBALLIN’ INTO A POOL!
AN ANGRY CAT!
NEXT: YOU LIE DOWN AND GENTLY DRIFT OFF TO SLEEP AND TAKE A 1.5 HOUR NAP.
THE PROCEDURE: The SuperPATH or Superior approach is used.
The implant make and model I usually use is the Biomet G7 cup and Echo Bimetric stem. They are made of titanium alloy. The cup has a polyethylene liner (plastic) and the stem has a ceramic or metal ball attached.
These implants have not had any recall to date. If you search online for any orthopedic implant, a list of lawyer pages will result from legal firms fishing for unhappy patients.
There will be a “FANCY BANDAID” (Mepilex Border Dressing) covering the incision for 7 days.
Press ‘n’ Seal Seran Wrap is used to cover this “waterproof” bandage during showers to prevent any moisture from getting on the incision. NO SUBMERSION UNTIL SCAB GONE! (about 4 weeks)
RECOVERY ROOM ie PACU (POST-ANESTHESIA CARE UNIT):
Here you wait for the SPINAL to wear off and legs to start moving/wake up. AVOID narcotics if offered by nursing as they will cause nausea/vomiting/constipation/dizziness with standing and delay going home.
VISIT with PHYSICAL THERAPY for gait training with walker.
The therapist will get you up and walk with you with a walker. The walker will be provided. FULL WEIGHT, NO RESTRICTIONS.
WALK 150 FEET AND GO HOME! The most common reason patients are unable to hit this target is due to nausea/vomiting/dizziness. This is usually from narcotic pain medication (oxycodone). Better to ask for toradol (10mg IV) if required for breakthrough pain.
DISCHARGE HOME PAIN Control REGIMEN here.
DISCHARGE HOME SELF-DIRECTED PHYSICAL THERAPY AND POSSIBLE HOME-HEALTH AGENCY PT at home.
Some PT videos by Bob and Brad: https://www.bobandbrad.com/total-hip-replacement-program