Inpatient Hip Replacement

Inpatient Hip Replacement

What is Inpatient Hip Replacement?

Inpatient hip replacement surgery refers to a hip replacement or hip arthroplasty surgery where the patient stays in the hospital for at least one or more nights post-surgery. The procedure typically involves replacing the damaged or diseased parts of the hip joint with prosthetic components to alleviate pain and improve mobility. Inpatient hip replacement is typically performed on patients who have more complex cases, underlying health conditions, or a need for extended monitoring during recovery.

Indications for Inpatient Hip Replacement

Inpatient hip replacement surgery is typically indicated for conditions that can damage the hip joint, such as:

• Severe Osteoarthritis: Advanced cases where the hip joint is significantly damaged, causing chronic pain and restricted mobility, may necessitate an inpatient procedure to ensure optimal recovery.
• Rheumatoid Arthritis: Patients with inflammatory joint diseases often have more complex needs, making an inpatient setting preferable for post-operative care.
• Hip Fractures: Hip fractures, particularly in older patients, often require inpatient hospitalization due to the complexity of the surgery and the increased risk of complications like blood clots or infections.
• Avascular Necrosis: This condition, where the blood supply to the femoral head is compromised, may lead to severe bone damage and the need for inpatient hip surgery.

Candidates for inpatient hip replacement include:

• Those with significant comorbidities, such as heart disease, diabetes, or respiratory conditions.
• Elderly or frail patients who may require extended recovery time.
• Patients undergoing complex or revision hip surgeries.

Preparation for Inpatient Hip Replacement

Preparation for inpatient hip replacement may include the following:

• A comprehensive medical evaluation, including blood tests and imaging studies to evaluate the patient's overall health, hip anatomy, and the extent of any joint damage, and to help plan the procedure
• Informing your doctor of any allergies to medications, anesthesia, or latex
• Providing your physician with a list of any medications or supplements you are taking
• You may need to adjust or temporarily stop taking certain medications - especially those that can affect blood clotting
• Disclosing any recent illnesses or other medical conditions you may have
• Stopping smoking, as it can impact the healing process and increase the risk of complications
• Abstaining from food or drink for at least 8 hours prior to the surgery

Procedure for Inpatient Hip Replacement

Inpatient hip replacement surgery is usually performed under general or regional anesthesia and involves the following steps:

• The surgeon makes an incision over the hip joint. The length of the incision depends on whether traditional or minimally invasive techniques are used.
• The surgeon removes the damaged sections of the hip joint, which typically includes the femoral head (ball of the joint) and the acetabulum (hip socket).
• The surgeon replaces the hip socket with a prosthetic cup, made of metal, plastic, or ceramic.
• The femoral head is replaced with a metal or ceramic ball attached to a stem, which is inserted into the thighbone (femur). This may be cemented into place or press-fit to allow the bone to grow into the implant.
• After placing the prosthetic components, the surgeon checks for proper alignment and range of motion.
• The incision is closed with sutures or staples, and a sterile dressing is applied.

Postoperative Care and Recovery

Postoperative care and recovery after inpatient hip replacement may include the following:

• After hip replacement, the patient is typically placed in assistive devices such as casts, slings, crutches, or walkers to promote healing and facilitate mobility.
• Early mobilization is encouraged, often on the same day or the day after surgery to prevent complications such as blood clots or deep vein thrombosis (DVT).
• The patient may experience pain, swelling, and discomfort in the treatment area. Pain and anti-inflammatory medications are provided as needed to address these.
• The hospital stay typically lasts 2 to 4 days, but this can vary based on the patient's progress and overall health.
• Activity guidelines are provided including refraining from lifting heavy weights and high-intensity activities for a defined period. 
• A physical therapy protocol is started to restore range of motion, strength, and function to the hip joint.
• Regular follow-up visits with the surgeon are scheduled to monitor progress and address any concerns.

Risks and Complications

Risks and complications associated with inpatient hip replacement include:

• Infection
• Bleeding
• Pain
• Blood clots or deep vein thrombosis (DVT)
• Implant loosening or failure
• Nerve damage
• General anesthesia risks