Questions to Ask Before Hip Replacement Surgery
These are questions to ask your doctor before hip replacement surgery, whether that is the family doctor referring you or the orthopedic surgeon who would operate, with a few for whoever will be helping at home. The 60 questions run in the order the appointments usually come: deciding whether to go ahead, the surgeon and the implant, the risks, getting ready, the hospital stay, and recovery. No single visit covers all six, so mark the ones that belong to the person you are about to see.
The questions
Each question, and why to ask it
Deciding
What does my x-ray show, and how much of my pain does it explain?
Why ask it
Hip pain can come from the spine, the pelvis, or soft tissue as well as the joint. If the x-ray damage does not match the pain you describe, a replacement may not relieve all of it, and it is better to hear that now.
Why operate now rather than in a year, and what changes if I wait?
Why ask it
The useful answer names what gets worse with delay. Some surgeons will say very little changes; others will point to muscle loss, bone quality or how well you would manage rehabilitation later, and that is a reason you can weigh.
What non-surgical options are left that I have not tried?
Why ask it
Losing weight, targeted physiotherapy, walking aids and injections all sit ahead of surgery for some patients. If every one of them is dismissed without reference to your own case, that is a fair moment to seek a second opinion.
What should I be able to do in a year that I can't do now?
Why ask it
This makes the benefit concrete: stairs, sleeping through the night, walking a particular distance, a specific activity you miss. Naming your own priorities also gives the surgeon the chance to correct an expectation that will not be met.
What will I have to give up permanently?
Why ask it
Running, contact sport and heavy repetitive lifting are the usual subjects, and advice varies by surgeon and implant. Name the thing you would miss most, so the answer is about that and not a general list.
How bad does a hip have to get before you would replace it?
Why ask it
Many surgeons go by what the hip has taken away: sleep, walking distance, reaching your own feet. Find out which of those this one weighs most, then hold your last month against it, not your worst day.
Would a numbing injection into the joint help show whether the hip is the source?
Why ask it
Some surgeons use one as a test when the pictures and the pain disagree. If it is offered, check whether an injection means waiting a set time before an operation, since practices set their own gap.
Does my age or my weight change what you would recommend?
Why ask it
Better asked in the room than wondered about on the way home. If the clinic has a weight limit or a blood test threshold for operating, ask what it is, how far off you are and what help there is to reach it.
Both hips are worn. Which would you do first, and how long would I wait for the second?
Why ask it
The worse hip on the x-ray is not always the one that hurts more, so have the surgeon explain the order. Some units do both in one operation for some patients; if this one does not, the thing to plan for is the untreated side carrying you through the first recovery.
Is a total hip replacement the only option, or could resurfacing or a partial replacement suit me?
Why ask it
People read about all three and arrive unsure which one they are being offered. Have the surgeon name the operation, say what rules the others out for your hip, and write the name down for your insurer and for anyone giving a second opinion.
If I want a second opinion, how do I get my x-rays and notes to another surgeon?
Why ask it
Put this way it is a question about paperwork, which is how most surgeons hear it. Find out whether images travel electronically or on a disc and how long that takes, then check how your insurer or health service treats a second visit.
What will this cost me, and what has my insurer or health service agreed to cover?
Why ask it
Where you pay or claim, the surgeon, anaesthetist, implant, hospital and physiotherapy may each be billed separately, and one of them can fall outside your cover, so get the estimate in writing. In a public system the same question is about what is funded afterwards, such as physiotherapy and equipment.
If I say yes today, how long is the wait, and what should I do in the meantime?
Why ask it
Waiting times vary a great deal, and a date can move. Three things to leave with: what to do if the hip gets much worse while you wait, whether there is a cancellation list, and which appointments fall between now and the day.
Surgeon and implant
Which surgical approach will you use, and does it change my restrictions afterwards?
Why ask it
Anterior, lateral, and posterior approaches differ in early restrictions and in which muscles are disturbed. The claim worth checking is not which is best in general but which one this surgeon does most often.
Which implant do you recommend for me, and why that one?
Why ask it
You are listening for reasoning tied to your age, activity, and bone quality rather than to habit. It is reasonable to ask whether the implant has long-term registry data behind it.
How many of these do you do a year, and what happens to your patients who need a second operation?
Why ask it
Someone who replaces hips most weeks can usually give a number without looking it up. The second half matters as much: whether redo operations are tracked, who performs them, and whether the figures go to a joint registry where you live.
How many hip replacements does this hospital do, and is there a ward or team set up for them?
Why ask it
The surgeon is one link in a chain that includes the anaesthetist, the ward nurses and the physiotherapists. A unit that handles joint replacements every week will often have a written routine for each day of the stay, and you can ask to see it.
Will the implant be cemented or press-fit, and what about my bone decides that?
Why ask it
Either the stem is fixed with bone cement or the bone is left to grow onto it, and surgeons choose differently. You are not being asked to pick; the point is to hear what on your x-ray settled it.
What will the ball and the socket lining be made of?
Why ask it
Ceramic, metal and hard plastic are paired in several ways. The follow-ups worth having are why that pairing suits someone as active as you are, and whether it would change if jewellery or a watch strap has ever given you a rash.
Do you use a robot or computer navigation, and what difference would it make to my operation?
Why ask it
Opinion is divided on how much the equipment changes the result, so ask about this surgeon's own experience with it. Check whether it means an extra scan beforehand, a different hospital or a higher bill.
Who else will be operating, and which parts do you do yourself?
Why ask it
In a teaching hospital a trainee commonly assists, and in some systems the named consultant may supervise instead of operating. If it matters to you who does the main steps, say so now, because the consent form may not spell it out.
How do you plan for leg length, and how is it checked during the operation?
Why ask it
Legs that feel uneven afterwards are a common worry, and planning for it usually starts on the x-ray. Mention it if one leg already feels shorter, and ask what would be offered if they feel different once you are walking, such as a shoe raise.
How long do these implants usually last, and what does a revision involve?
Why ask it
The younger you are, the more this matters, because the hip may need redoing in your lifetime and a revision is generally a bigger operation than the first. Any figure you are given is an average, so find out what would shorten it for you.
Risks
What are the main risks, and what are the numbers for someone my age and health?
Why ask it
A general list of risks tells you less than your own. Infection, clots, dislocation, fracture and nerve injury carry different odds depending on things like weight, diabetes, smoking and previous surgery, so have the surgeon say which one worries them most for you.
What do you do to prevent infection, and what is my part in it?
Why ask it
The hospital's side is usually a routine of antibiotics around the operation and skin preparation. Yours starts earlier, so ask what to do about a cut on that leg, a leg ulcer, a tooth abscess or a urine infection in the weeks before.
What will I take to prevent blood clots, and for how many weeks?
Why ask it
Find out whether it is a tablet, an injection you give yourself or stockings, and who teaches you if it is an injection. A previous clot, in you or in the family, is something to bring up here and again at the pre-assessment.
What is the chance of the new hip dislocating, and what would I do if it happened?
Why ask it
The first half is what makes it more likely with the approach planned, and for how many months the risk is highest. The second is practical: what it feels like, whether to phone the team or an ambulance, and whether one dislocation makes another more likely.
Might I need a blood transfusion, and is there anything to do about that beforehand?
Why ask it
Raise anaemia, or any objection to receiving blood, at this visit and not on the morning of surgery. Ask whether your blood count is checked ahead of time and what the team does when it comes back low.
Could I be left with a limp, a numb patch or thigh pain that does not settle?
Why ask it
These get less attention than infection and clots, and a surgeon should be able to describe them calmly. Which of them goes with the approach planned for you, and how long the team would wait before investigating, are the two things to pin down.
Which symptoms mean I should ring you, and which mean going straight to hospital?
Why ask it
You want two clear lists, written down. Fever, spreading redness, a leaking wound, sudden calf pain, breathlessness and suddenly not being able to stand on the leg are the ones to ask about by name, so nobody is deciding at midnight which list they are on.
Getting ready
Is there anything about my health you would want improved before we go ahead?
Why ask it
Blood sugar, anaemia, a dental infection, smoking and weight are the things surgeons most often ask patients to work on first. The question lets the surgeon be direct, and the answer tells you whether there is time to act before a date is set.
Which of my current medicines and supplements should I stop, and how many days before?
Why ask it
Blood thinners, some diabetes and arthritis drugs, and a few supplements can affect bleeding and healing, and the instructions differ for each. Take in the actual boxes, and do not stop anything until you have been told which day.
Do I need a dental check, blood tests or clearance from another doctor before you set a date?
Why ask it
Each of these can take weeks to arrange and can push the operation back. Leave with the whole list, who books each item and where the results have to be sent.
Is there anything I can do to strengthen the hip before the operation?
Why ask it
A helpful reply is a short list of exercises or a referral, not a general instruction to keep moving. It is also worth practising with crutches and on stairs now, if the team will lend a pair, before there is a wound to think about.
Is there a pre-operative class or assessment visit, and should my helper come?
Why ask it
Many joint units run a session on what to bring, when to stop eating and how to use the crutches. The person helping you hears the instructions first-hand there, which saves you relaying them from a hospital bed.
What would make you postpone on the day?
Why ask it
A chest infection, broken skin near the hip, a high blood sugar reading or a missed instruction about food and drink are typical reasons. Get the number to phone, and how early to use it, if something like that appears in the final week, so the theatre slot is not lost on the morning.
What should I sort out at home before the operation?
Why ask it
A bed on the ground floor, a chair with arms that is high enough to rise from, and everyday things moved up from low cupboards are typical answers. Describe your home, stairs included, so the list fits your house and not a leaflet's.
Which equipment does the hospital lend, and what do I have to buy or hire?
Why ask it
Raised toilet seats, perching stools, grabbers and crutches are supplied in some places and left to the patient in others. Someone has to measure your chair, bed and toilet heights, so find out whether an occupational therapist visits or goes by figures you bring in.
How much help will I need at home, and for how many weeks?
Why ask it
Take washing, dressing, cooking and being alone overnight one at a time, because the answers differ. Plan past the first week too: it is easy to arrange help for the homecoming and have none left when you are still tired a fortnight later.
What if I live alone, or the person helping me also has to work?
Why ask it
Say this plainly and early, not on the day of discharge. Whether carers, home visits or a few extra nights can be arranged depends on where you live and who is paying, and every one of them needs notice.
Hospital stay
Will I be asleep or have a spinal, and when do I meet the anaesthetist?
Why ask it
Spinal and general anaesthesia carry different side effects and feel different in the first hours afterwards. The anaesthetist is the one who needs to hear about past reactions, sleep apnoea or a relative who had trouble with an anaesthetic, so find out when that conversation happens.
Could this be done as a day case, and what would make me suitable?
Why ask it
Going home the same day is offered in some places to some patients. Ask what the criteria are, who has to be in the house with you that night, and what happens if you are not ready by the evening.
How long does the operation take, and who tells my family when it is over?
Why ask it
This one belongs to whoever will be waiting. Check whether the time quoted includes the anaesthetic and the recovery room, and whether the surgeon phones, comes out or leaves the news to the ward.
What will the first two days after the operation involve?
Why ask it
Standing for the first time, any drip, drain or catheter, and how much pain counts as normal are the parts to have described. Knowing the ordinary version makes it easier to notice the version that is not.
How will pain be managed, and what is the plan for coming off the stronger medication?
Why ask it
Ask for the taper, not just the prescription: which drug comes down first, over how many days, and who renews it if you run short. Mention anything that has disagreed with you before, such as nausea or constipation on strong painkillers.
How long will I be in hospital, and what has to be true before I can go home?
Why ask it
Discharge usually depends on specific milestones such as walking a set distance, managing stairs, and pain controlled on tablets. With the criteria in hand you can work towards them instead of waiting to be told.
Will I go straight home, or to a rehabilitation unit first?
Why ask it
Stairs up to the only bathroom, a partner who is also unwell or an empty house are the usual reasons this comes up. Funding and availability differ by country and by insurer, so ask who decides, when the request has to go in and what the fallback is if it is refused.
Recovery
How much weight can I put through the leg straight away?
Why ask it
Often the answer is as much as is comfortable, though it can change with how the implant is fixed or with something found during surgery. Knowing the default and what would alter it means a different instruction on the ward does not alarm you.
Which movements or positions must I avoid, and for how long?
Why ask it
Restrictions vary by approach and surgeon, from strict limits on bending and crossing your legs to almost none. Get the specific list in writing, because advice given on the ward is easy to misremember at home.
When does physiotherapy start, how often, and who arranges it?
Why ask it
Sometimes the referral is made for you and sometimes it is left to you, and sessions may be in person or a printed programme. If there will be a gap between going home and the first session, ask what to do on your own in those days.
How long will I be on a frame, crutches or a stick?
Why ask it
Expect to be given a sign to look for, such as walking without a lurch, more often than a date. Ask who decides each step down, and which hand a single stick goes in, because that is easy to get wrong.
Week by week, when can I expect to walk unaided, drive, climb stairs, and go back to work?
Why ask it
The dates shift with your job, your car and which hip it is. Rules on driving after surgery differ by country and insurer, so ask what the surgeon needs to see first and whether your insurer wants it in writing.
How should I sleep, and when can I lie on the operated side?
Why ask it
Many people find the nights harder than the days at first. A pillow between the knees, whether your own bed is high enough to get out of, and when turning onto either side is allowed with this surgeon's approach are the details to get.
When will the wound be checked, and when can I shower, bathe or swim?
Why ask it
What closes the skin, which dressing goes over it and whether it can get wet all vary. Having clips or stitches removed may mean a trip to a nurse you cannot drive yourself to, so ask where and on which day.
How much swelling and bruising down the leg is normal, and for how long?
Why ask it
Bruising can show up well below the wound, and it startles people who were not warned, so ask how far down the leg is ordinary. With that description in hand, a calf that turns hot, tight and painful is easier to recognise as something to report.
When is it safe to fly or sit through a long car journey, and will the implant set off airport scanners?
Why ask it
Give the date of any trip already booked, since it may affect when the operation should be. For the journey itself, the team can say how often to get up and move, and whether they issue an implant card to show at security.
Once the hip is in, do I need to tell my dentist or take antibiotics before dental treatment?
Why ask it
Advice on this differs between countries and between surgeons, and it has shifted over the years. Get this surgeon's rule in writing and hand it to your dentist, so the two are not left to disagree through you.
What will you put in writing for my employer about time off and what I can do when I return?
Why ask it
Describe the working day and not the job title: hours standing, ladders, lifting, driving, how low the chair is. Sick pay and leave rules depend on your employer and your country, so ask the clinic who completes the forms and how long they take.
When do I see you again, and will the hip be x-rayed in the years after?
Why ask it
Follow-up ranges from a single visit to checks every few years. Ask who to contact if the hip starts to hurt long after the clinic has discharged you, since a fresh referral can be slow.
Who do I contact between appointments, and how quickly do they usually reply?
Why ask it
Recovery generates questions at awkward hours. A named nurse or coordinator with a working number is worth more than a general switchboard, and it is easier to establish before the operation than after.
Getting the most from the consultation
Practical guidance for the conversation itself
Before you go in
- 1Write down what you can no longer do, with examples: distance walked, stairs, sleep interrupted, socks and shoes. What the hip stops you doing is easier for a surgeon to weigh than a number out of ten.
- 2Bring the actual packets of everything you take, prescription and otherwise.
- 3List previous operations, anaesthetic problems, and any infections including dental work.
- 4Note who is at home with you and whether your bathroom and bedroom are upstairs. This changes the discharge plan.
- 5Bring someone with you and ask them to take notes, since a short consultation about an operation is hard to recall in full by the time you are home.
Which questions for which appointment
Questions to ask your doctor about a hip replacement
With the family doctor who refers you, the Deciding group is the one that counts: what the x-ray shows, what has not been tried, whether waiting costs you anything. Ask as well what the referral letter will say about your other conditions, since the surgeon reads it before meeting you.
Questions to ask your orthopedic surgeon about hip replacement
At the first surgical visit, work through Deciding and Surgeon and implant, then the opening question under Risks. Mark about ten before you go and put the three you most need answered at the top, because the appointment will not stretch to all of them.
Once you have a date
The pre-assessment nurse, the anaesthetist and the physiotherapist are usually the people to ask about Getting ready, Hospital stay and Recovery, more than the surgeon. Take the list to each of them, and beside every answer write who gave it.
If you are the one who will be helping
Several of these are yours to ask: who phones when the operation is over, how many nights someone must stay, what equipment arrives and when. Say plainly what you cannot do, such as lifting or taking weeks off work, while the hip team still has time to plan around it.
On second opinions and timing
A second opinion is routine
Surgeons are asked for one often, and for a planned joint operation most treat the request as ordinary. It is most worth doing if you were offered surgery at a first appointment without imaging being discussed in detail.
There is usually no rush
A hip replacement for arthritis is normally a planned operation and not an emergency, though your surgeon can say if your case is different. If you feel pressed to decide in the room, it is reasonable to say you will confirm in a week.
Ask what happens if you decline
A surgeon who can describe the non-surgical path clearly is giving you a real choice. If the answer is vague, ask again with your own case in it: your age, your x-ray and what you have already tried.
Practical things people wish they had arranged
- A raised toilet seat, a long-handled shoehorn, and a grabber, in the house before the operation rather than ordered after it.
- Loose clothing and shoes you can put on without bending, since this is the daily obstacle for the first few weeks.
- Meals in the freezer and a clear path between bed, bathroom, and kitchen with rugs and cables removed.
- A written copy of your restrictions on the fridge, because you will be asked by visitors and will not remember the details.
- Confirmation of who is driving you to and from hospital, and who is staying the first night.