The surgical patient’s journey
Surgery has been decided. Below you can see, step by step, what happens a few weeks before, on the day of surgery and afterwards up to one year. Every timing describes the usual course and is not a promise: your doctor will adjust it to you.
Surgery has been decided
You made the decision together with your doctor, based on the X-ray, your symptoms and how much the pain limits your life. Now preparation begins.
Next: Preparation ↓Preparation
Smoking
Stop at least four weeks before surgery, ideally four to six weeks before, and stay off cigarettes for at least four weeks afterwards. Studies show that stopping for only two weeks makes no difference.
A blood thinner is stopped only on your doctor’s instruction. The timing is set individually by your cardiologist or treating doctor.
| Medicine | Usually stopped |
|---|---|
| Warfarin | 5 days before |
| Direct-acting anticoagulants (Xarelto, Eliquis, Pradaxa) | 1-2 days before |
| Clopidogrel (Plavix) | 5-7 days before |
| Aspirin (Cardiomagnyl, Aspirin Cardio) | 2-3 days before |
These are general timings. Your doctor will tell you yours.
Home
Move rugs and cables out of the way, light the way at night and have a firm chair with armrests ready.
Hospital bag
Documents, a list of your medicines, shoes with a closed heel, loose clothing.
Come to the doctor’s office at nine in the morning, on an empty stomach
Come to the clinic at nine in the morning without eating. On this day blood tests are taken and the pre-operative consultations take place.
Next: The day of surgery ↓Come to the Emergency department reception at eight in the morning, on an empty stomach
After admission and preparation you are taken to the operating theatre. The anaesthesia is spinal and usually lasts two and a half to four hours.
The operation takes about an hour and a half on average. With the anterior approach the muscles are not cut but moved aside. The bikini incision is 5-6 cm long.
The damaged head of the femur is removed. A cup is placed into the acetabulum, with a liner inside it; a stem goes into the femur, and a head sits on the stem. The head turns inside the liner, just like a natural joint.
The dressing on the wound is transparent: the wound can be seen without removing it.
Feeling and movement come back first in the feet, then higher up. You stand up for the first time on the day of surgery, within a few hours.
Next: In hospital ↓In hospital
You walk with a walking frame together with the physiotherapist, and the distance grows every day. Pain is managed with medication.
Discharge is usually within two days at most. On discharge you receive written instructions, a medication plan, exercises, the date of your check-up visit and contact numbers.
Next: At home ↓At home
Walk often and in short stretches, rest, and do not sit still for long. You will usually need the walking frame for at least two weeks; some people need it for three.
- your temperature is above 38 °C, especially with chills;
- there is discharge from the wound, redness, warmth or an unpleasant smell;
- pain suddenly and sharply increases and does not respond to painkillers;
- one calf is swollen, painful or red;
- you fall or are injured, even if the pain is not severe.
For shortness of breath or chest pain, call 112, or the emergency number of the country you are in.
If you travelled from abroad: flying is usually possible after one week, with your doctor’s confirmation.
Next: Two weeks ↓Your first visit to the clinic
If a result needs treatment, a follow-up test is arranged a few days later.
After this, as a rule, a walking stick replaces the walking frame.
Next: Six weeks ↓Second visit and everyday life
| What | Usually when |
|---|---|
| Driving again | 6 weeks on average |
| Kneeling | about 1.5 months |
| Intimate life | about 1.5 months |
| Planned dental treatment | after 1.5 months |
By six weeks you usually no longer need the walking stick.
Every timing is individual and is confirmed at the visit.
Next: Three and six months ↓Everyday life
By three months most patients are back to their usual life: walking, swimming, cycling.
Running, jumping and contact sports are discussed individually. This is not a ban: it is a conversation about the life of the implant and about your priorities.
Next: One year ↓The first year of your new joint
The scar takes its final shape over a period of months, and the process continues after the first year.
How long does a hip replacement last? According to a pooled analysis of international registries, about three quarters of hip replacements are still working after twenty years, and more than half after twenty-five. This is an average and does not translate directly to any one person.
The whole journey in one table ↓The whole journey in one table
| What | When | Note |
|---|---|---|
| Before surgery | ||
| Stopping smoking | at least 4 weeks before | ideally 4-6 |
| Blood thinners | only on your doctor’s instruction | timing set by your cardiologist or treating doctor |
| The day before | 09:00, empty stomach | tests, consultations |
| Surgery and hospital | ||
| Surgery | 08:00, empty stomach | about 1.5 hours on average |
| First time on your feet | the same day | within a few hours |
| Discharge | within 2 days at most | usually |
| Walking and daily life | ||
| Walking frame | at least 2 weeks | some people 3 |
| Walking stick | from 2 weeks | usually no longer needed by 6 weeks |
| Driving | 6 weeks on average | |
| Kneeling, intimate life | about 1.5 months | |
| Flying | after 1 week | with your doctor’s confirmation |
| Clinic visits | ||
| 2 weeks | stitches, X-ray | laboratory tests |
| 1.5 months | X-ray | laboratory tests if needed |
| 3 months | X-ray | |
| 6 months | X-ray | |
| 1 year | X-ray | then every year |
Every timing describes the usual course and is not a promise.
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