Primary joint reconstruction is the treatment of choice for patients suffering from degenerative joint disease that has failed conservative treatment. Total hip arthroplasty is the reconstruction, or replacement, of the hip joint. This is often done for those with osteoarthritis, rheumatoid arthritis, or avascular necrosis. In a total joint arthroplasty, the damaged joint is removed and then replaced with an artificial joint. The objective of total joint replacement is to relieve the pain in the joint caused by the damaged cartilage. Since stiffness is a common symptom associated with joint disease, having one’s joint replaced will allow a better range of motion.
We have created a packet that includes all of the information you will need to plan your surgery.
In a total hip arthroplasty, the cartilage that lines the hip joint is a source of pain and is thus removed. The damaged ball of the hip joint is replaced with a metal ball that is attached to a metal stem, which is fitted in the femur. The socket of the hip (acetabulum) is replaced with a metal cup that has a plastic liner.
Dr. Snibbe performs a minimally invasive total hip replacement through a posterior approach. The fundamental difference between his technique and traditional posterior approaches is that he does not cut any muscle to enter the hip. One tendon is cut called the piriformis tendon. This is then repaired at the end of the case. This soft tissue sparing approach creates less tissue damage and less bleed which allows for a very accelerated recovery. Approximately 50% of Dr. Snibbe’s patients go home the next day after surgery due to this advanced technique.
During the surgery Dr. Snibbe takes x-rays of your pelvis which allow for the most accurate assessment of leg lengths. This is the gold standard for assuring that your leg lengths are even and stable. Dr. Snibbe also uses the largest ball and socket combination which allows for excellent range of motion and stability. That is why after the surgery he does not impose any range of motion restrictions on your leg. You are able to take you leg into any range of motion that is comfortable.
The implants are wedged into the bone with precise accuracy and measurements. The implants are stable immediately after the surgery. Therefore, you can walk on your hip right after the surgery. It takes 6 weeks for the bone to grow into the implant but the hip is stable from day one.
- You can put your full weight down on your operative leg immediately after surgery and use a walker or cane for assistance initially. Please remember that with the type of hip replacement you have had, there are NO HIP PRECAUTIONS. This means that you can bend down, squat, put on your shoes/socks, and move your hip in any direction you choose without worry of dislocation. The only limitation you have is pain. If you move your hip in a certain position and it hurts, ease up until you find a position that is comfortable for you.
- An ice machine will be provided to you prior to your surgery. This will help decrease swelling and pain after your surgery. Use the ice machine as much as possible when you get home at intervals of 30 minutes on and off. The more you do it, the better you will feel. You should keep the ice machine for approximately two weeks. Do not use the ice machine while you are sleeping.
- It is great for you and your new hip to go for a walk 3-4 times a day. However, don’t overdo it. Increase your activity level by small increments daily. You should end every day feeling like you could have done more and not like you did too much. If the next day you walk for longer and have pain, then you are doing too much. Every day you should feel a little better and experience a little less pain.
- Arrangements will be made by our office to have a physical therapist come to your house 2 times a week for the first two weeks after surgery. If you go to a rehab center, a therapist there will work with you. Once you come into the office for your post-op visit, we will give you a prescription for outpatient physical therapy. This will be twice a week and for approximately 6-12 weeks.
- While you are at the hospital your pain will be managed with IV and oral medications. When you go home, you will be given a prescription for pain medication (e.g. Percocet). This will prevent you from having severe pain. If you are not in pain, you do not need to take any.
- Once you are home, you can take 600 mg of Ibuprofen (Advil/Motrin) every 6 hours to help with inflammation and pain. This medication will help cut down the use of narcotic-based pain medication. However, if you still have pain after taking the Ibuprofen, continue taking the pain medication every 4- 6 hours as needed.
- A sleeping medication (e.g. Ambien) is also provided to help you sleep at night. Take one tablet 30 minutes before you plan to sleep.
- A blood thinning medication will also be ordered for you. You will be giving yourself a small injection once a day for 10 days after you are home. This medication will be supplied to you by Complete Infusion Care. They will contact you with the information.
- Your hip dressing is waterproof. You may shower the next day after surgery, but do not take a bath or
- submerge your hip in water until your incisions are checked at your first post-op visit. § Your stitches are buried under the skin and will dissolve away over time. § You may have bruising around your hip that can track down your leg. If you notice that there is
- bruising on your thigh, knee, calf, ankle, or foot (and you don’t have pain in these places), then don’t worry, this is normal.
- You may drive 5 to 7 days after surgery if you are not taking pain medication. If your right leg is the operative side, then you must have good control of your leg prior to driving.
- Please call the office prior to, or immediately following, your surgery in order to schedule a postoperative appointment. This should be scheduled 7-10 days after surgery. At that visit your stitches will be removed and you will be given a prescription to begin physical therapy.
If you have any questions or concerns, please contact our assistant at (310) 659-2910 extension 3048.
Day of surgery: Arrive one to two hours prior to surgery. Procedure will take approximately one to one and a half hours, and recovery time is one hour. For immediate post-op instructions, download the instruction sheet.
One week post-op: First follow-up visit with Dr. Snibbe/Jennifer. Your dressing will be removed and stitches will be taken out. You will start icing the surgical area two to three times a day (or more if needed). Discontinue crutches as tolerated. Physical therapy will be prescribed. Start physical therapy immediately to work on range of motion.
Four weeks post-op: Second follow-up visit. Range of motion and strength test. Physical therapy will continue to improve range of motion. Mild stiffness is still common. You can start foam roller exercises for IT band stretching.
Eight weeks post-op: Third follow-up visit. Range of motion and strength testing. If additional range of motion or strength training needed, continue physical therapy to work on these. Pain should be mostly resolved at this point. Near full recovery is expected at this time.