Pre-Operatively Guidelines

1.      What happens when you arrive at the hospital?

You will be examined thoroughly before the operation so that any pos­sible risks are identified early.  This will also allow the medical staff to take the necessary prophylactic measures and your doctor will inform you about the drugs and anesthetics to be used.

2.      The most common questions and items of information during your examination include the following:

• Do you suffer from cardiovascular pro­blems or high blood pressure? If yes are you under certain medications?
• Are you prone to infection? Are you aware if you suffer from diabetes?
• Are you over­weight? As the success of the operation is influenced partly by your weight, in case that you are overweighed you may be offered a session with a nutritionist.
• Do you smoke?
• Do you take anticoagulant or platelet-inhibiting drugs such as Aspirin®, Falithrom®, etc? If yes, you should not take any kind of these drugs approximately ten days prior to the opera­tion. 
• Your doctor along with the anesthetist will inform you about the best form of anesthesia for you according to your medical history and health status.
• You should form a list with your own questions and address them to the operating surgeon or to a ward physician.

3.      The Operation

The operating method is performed in four steps and in simple words what happens is that the diseased bone and tissue parts are removed and the remaining bone is shaped with the operating instruments to allow the prosthetic components to fit exactly and be affixed. 

Step One

The surgeon performs a skin incision on the femur to gain access to the hip joint and removes a part of the joint capsule to visualize the diseased hip joint.  Then, with the use of an electric saw or a compressed air-driven saw, removes the femoral head from the femoral bone. This allows the socket to be easily visible. Then, the surgeon removes the old capsular and cartilaginous tissue and uses a hemi­spherical reamer to prepare the socket in such a way that the healthy bone tissue becomes visible. This is essential for ensuring a firm anchoring of the artificial cup.

Step Two

Then, the surgeon with the usage of a rasp, prepares the interior of the femoral bone (medullary space) for the implantation of the stem. Depending on the situation and the condition of the bone, the implan­tation can be made with or without bone cement. In general, there are no qualitative differences in the treatment. The body tolerates very well the bone cement, which at the beginning is in liquid form and then hardens. Hence, the implanted prosthesis can sustain full weight bearing not long time after the opera­tion.

Step Three

After the implantation of the cup and the stem, the surgeon affixes the prosthetic head of pre-determined size and length to the stem before reducing the joint.  The size (inner and external diameter) of the head is pre-determined.  The head helps in the creation of a mo­bile connection between the stem and the cup that allows the hip to move normally. Then, the surgeon performs a final verifi­cation of the function of the joint.

Step Four

In the end the surgeon stanches possible hemorrhaging. To drain off any bleeding, several drains are inserted into the wound. The last step is completed when the surgeon sutures the cut layer by layer and then applies a compression dressing.

A couple of days after the operation, an X-ray is essential to be taken in order to check the fitting of the implant.