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Pre-operative FAQ’s


Q: Is there a better time of year to have the surgery?

A: This is a personal decision; some patients like to have the surgery in good weather so that they may walk outdoors as part of their recovery; others prefer to do the surgery in the winter so that they may recover in time to participate in springtime activities.


Q: Which Hip resurfacing implant does Dr. Ihekweazu use? Does he use metal on metal?

A: Dr. Ihekweazu uses implants from Smith and Nephew. The Birmingham Hip is a metal on metal hip resurfacing implant. The Birmingham Hip Resurfacing from Smith and Nephew, is an FDA approved implant with a 20-year track record.  While there has certainly been a lot of negative media attention on metal on metal implants it is important to understand that the problems seen with metal on metal implants were seen only with certain implants systems that are no longer able to be used in surgery. The Birmingham Hip system that Dr. Ihekweazu uses has an excellent record and when used appropriately has excellent results.  Dr. Ihekweazu is happy to share the research with you is you ask!


Q: What if I develop an infection prior to surgery, like an ingrown toe nail or tooth abscess?

A: Since infections of the hip and knee implants are devastating for the outcome of these procedures, any preoperative infections in your body must be cured prior to joint replacement surgery. Please let us know about any areas of concern prior to your scheduled day of surgery


Q: Should I donate a pint of blood prior to surgery?

A: Most patients who are healthy and have no history of heart trouble will not require a blood transfusion. However, if you want to make sure that you don’t need blood from anyone else, you can discuss pre-donating a pint of your own blood prior to surgery with the anesthesia team at your pre op appointment.


Q: Should I be tested for an allergy to the metal?

A: This is a good question. Currently, there are no proven tests that correlate with the development of an allergy to the implant. However, if you have a history of a reaction to dental fillings, implants, or cement, please do mention this to the doctor at the time of your consult.


Q: Is hip resurfacing surgery “Minimally Invasive”?

A: The surgery is minimally invasive to your bone, as compared to a total hip replacement. However, the incision is longer that for a total hip due to the need to preserve the femoral head. There are no major muscles cut; the muscles are pushed aside for the surgery. The only muscles that are cut, are the short external rotators, which are very small tendons at the back of the hip joint. They are about the size of your pinky finger, and are reattached to the bone at the conclusion of the operation. So, the surgery is also minimally invasive in the handling of your muscles.


Q: How long is the incision?

A: The incision length will vary depending upon how much tissue you have between your skin and the hip or knee joint, how muscular you are, and how stiff your hip or knee is. We use the smallest incision necessary to safely perform your procedure.


Q: When should I stop taking my medications?

A: You can continue taking most medications up until the day of surgery, with the exception of anti-inflammatories like ibuprofen and naprosyn. You should discontinue any blood thinners about 1 week prior to surgery. This will be reviewed with you during your preoperative consultation with the medical doctor, as well as in your preoperative education class.


Q: Do I need the raised toilet seat, grasper, and high chair after hip surgery?

A: These items may help you stay comfortable in the first few weeks of your recovery, although they are not required. You can see how you feel after surgery, while in the hospital.


Q: Should I be doing any special exercises for the hip or knee preop? Should I go to physical therapy?

A: No, there are no special things to do preoperatively, however, staying in your best shape prior to surgery is important. Just try to keep walking and as flexible as possible. Cycling and yoga are good ways to achieve these goals. If you really want to try to speed up your recovery, you can strengthen the abductor muscles at the side of the hip by performing side-leg raises. Formal physical therapy is not necessary, and often it can be painful with an arthritic hip.


Q: Should I take any supplements to help strengthen my bones preop?

A: I recommend calcium and vitamin D supplements to keep the bones strong. 1000-1500 mg of calcium citrate and 400 IU of vitamin D should be adequate.


Q: Should I have a bone density test preoperatively?

A: Generally, for men, this is not necessary. For women, if your bone density is in question, Dr. Ihekweazu may ask you to obtain a DEXA bone density scan.


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