How to Prepare for Hip Replacement Surgery

Staying hip

Hip replacement surgery is becoming increasingly common, as waves of aging baby boomers desire to remain active well beyond their golden years. According to the American Academy of Orthopaedic Surgeons, more than 320,000 hip replacement procedures are performed annually, most of them to alleviate severe arthritis pain. Surgeons say many patients come into pre-operative appointments with questions and concerns. Here are eight of the most common:

How should I educate myself about hip replacement?

Visit websites of institutions specializing in the surgery, says Michael Parks, associate attending orthopedic surgeon at the Hospital for Special Surgery in New York City. And talk to other patients who have undergone the procedure, adds Lynda Huey, president of Complete PT Pool & Land Physical Therapy in Los Angeles. "Ask your surgeon to [connect you with] a patient of the same age, gender and activity level," Huey says.

How should I prepare my body for surgery?

"Think of yourself as an athlete getting ready for an event," says Huey, who helps former athletes prepare for hip replacement surgery needed after years of wear and tear. Her patients typically undergo "prehab," which involves muscle-strengthening exercises in deep water to offset the stress the hip region will undergo during surgery. "Your muscles absorb more of the shock [instead of your joints]," Huey says. "Meanwhile you're strengthening all of your muscles so that your whole body gets stronger."

Are there alternatives to surgery?

Most patients who undergo hip replacement surgery have already exhausted the alternatives, including physical therapy and anti-inflammatory injections to help cope with pain and mobility issues. If symptoms haven't improved despite exploring other avenues, surgery may be a strong option. "The natural history of hip and knee arthritis is that it gets worse," Parks adds. But if surgery is the chosen route, Parks encourages patients to schedule the procedure while they're still young enough to enjoy being active.

What are the major complications of hip replacement surgery?

Infection, nerve damage, blood clots, anesthesia side effects, bone fracture and blood vessel injury, Parks says. In general, these complications occur in only 1 percent of cases, Parks says, and great measures are taken to prevent them. At the Hospital for Special Surgery, patient Valerie Lancaster Beal recalls the surgery team operating in what looked like "space suits" to stave off hospital-acquired infections, which strike 1 in 25 hospital patients annually, according to the Centers for Disease Control and Prevention. Blood clots are the most common complication of hip replacement surgery, so physicians routinely prescribe blood thinners to patients.

Is the surgeon's experience more important than the surgical technique?

Parks says a surgeon's skill and overall approach to patient care trump the specific technique used to carry out the surgery. While anterior hip replacement is the latest, most talked-about technique, in which a small incision is used in the front of the hip, sparing the patient the pain of sitting on the incision site, this newer approach isn't necessarily better than other methods. "Rather than going with the latest [technique], ask about the surgeon's track record." A track record of at least 100 surgeries per year is a good range, experts say.

What is recovery like?

Recovery is a very individual process and is influenced by a patient's general fitness level and the presence of other health conditions. "Most people are terrified of how much pain they will feel," Parks says, but pain medications can effectively be tailored to each patient, helping keep discomfort at bay. Beal was also anxious about taking pain pills, but says medication helped her feel well enough to get up and walk to the bathroom the night after her morning surgery. She was also able to take a shower and start physical therapy the next day. After three nights in the hospital, she went home.

How should I prepare my house for my discharge?

The AAOS recommends making changes to your home to ensure it's safe after surgery. "Before I went in, we sort of structured the house to be safe," Beals says. That included buying a raised seat, a reacher, a walker and a handheld shower head. Beals also made sure all the rugs were tacked down and that her toiletries were on the upper cabinets.

What will I be able to do after surgery?

Patients typically need physical therapy for at least two months following surgery, experts say. Beals did in-home physical therapy for three weeks after getting her new hip, and then outpatient physical therapy. Now, six weeks after surgery, she does exercises every morning and evening, and she's back to walking at the YMCA. "I'm getting my pace back," she says. Her two measures of success, she adds, are: "Being back in my high heels, and being able to play doubles [tennis] this summer."

Kristine Crane is a Patient Advice reporter at U.S. News. You can follow her on Twitter, connect with her on LinkedIn or email her at kcrane@usnews.com.