Total Hip Replacement

Your doctor will determine which type of surgery is best for you and how long you need to stay in the hospital or surgical center based on a variety of factors. These include your diagnosis, age, medical history, general health, and possibly your personal preference. Learn about the different total hip replacement procedures and ask why your doctor will use a particular type of procedure for you.

Types of anesthesia that may be used

Your surgeon will perform a total hip replacement using a nerve block or general anesthesia, depending on the specific procedure.

• General anesthesia is a combination of intravenous (IV) medications and gases that put you in a special type of sleep. During general anesthesia, you are unaware of the procedure and will not feel any pain. In some cases, you may also receive a peripheral nerve block infusion in addition to general anesthesia. This type of anesthesia involves an injection or a continuous drip of a liquid anesthetic, which flows through a tiny tube inserted near your surgical site to control pain during and after surgery.
• A nerve block is also known as regional anesthesia, an epidural, or spinal anesthesia. For regional anesthesia, your anesthesiologist or nurse anesthetist will inject an anesthetic medication around certain nerves in the spine so you do not feel anything from the waist down. You will be awake, but kept as comfortable as possible during the procedure. You may receive sedation to help you relax and stay comfortable.

What to expect the day of your total hip replacement

The day of your surgery, you can generally expect:

• To talk with a pre-operative nurse. The nurse will perform an exam and ensure that all needed tests are in order. The nurse can also answer questions and will make sure that you sign the surgical consent.
• To remove all clothing and jewelry and dress in a hospital gown. It is a good idea to leave all jewelry and valuables at home or with a family member if possible. The surgical team will respect your privacy and give you blankets for modesty and warmth in the surgical suite.
• To talk with the anesthesiologist or nurse anesthetist about your medical history and the type of anesthesia you will receive.
• A surgical team member will start an IV.
• The anesthesiologist or nurse anesthetist will start your anesthesia.
• For general anesthesia, your anesthesiologist or nurse anesthetist will place a tube in your lungs to protect and control your breathing. A team member will also insert a catheter into your bladder to drain urine and monitor kidney function. You will not feel or remember these procedures or the surgery.
• The surgical team will monitor your vital signs and other critical body functions. This occurs throughout the procedure and your recovery until you are alert, breathing effectively, and your vital signs are stable.

What are the risks and potential complications of a total hip replacement? 

Any surgical procedure involves risks and potential complications. Complications may become serious and life threatening in some cases. Complications can develop during the procedure or throughout your recovery. 

General risks of surgery

The general risks of surgical procedures include:

• Adverse reaction or problems related to anesthesia, such as an allergic reaction and problems with breathing
• Bleeding, which can lead to shock or the need for blood transfusions.
• Blood clots, in particular a deep vein thrombosis that develops in the leg or pelvis. A blood clot can travel to your lungs, heart or brain and cause a pulmonary embolism, heart attack, or stroke. Blood clots in the legs or pelvis are the most common complication of a total hip replacement. To prevent this, your doctor may prescribe blood thinning medication, support hose, inflatable leg coverings, or ankle pump exercises.
• Infection and septicemia, which is the spread of a local infection to the blood. This includes pneumonia.

Potential complications of a total hip replacement