Questions to Ask Before Hip Replacement Surgery
Questions for your consultation with an orthopaedic surgeon about hip replacement, covering whether to operate now, which implant and approach, the risks, the hospital stay, rehabilitation, and the help you will need at home.
The questions
Open any question for the note
What did my imaging 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
Ask what specifically worsens with delay. Some surgeons will say very little changes; others will point to muscle loss, bone quality, or your ability to rehabilitate, which is a concrete reason rather than a general one.
What non-surgical options are left that I have not tried?
Why ask it
Weight, targeted physiotherapy, walking aids, and injections all sit ahead of surgery for some patients. A surgeon who dismisses all of them without reference to your case is worth a second opinion.
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.
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.
How many of these do you do a year, and what happens to your patients who need a second operation?
Why ask it
Volume and revision rates are the two figures that most reflect outcomes. A surgeon who tracks their own numbers will answer readily; one who has never looked has told you something either way.
What are the main risks, and what are the numbers for someone my age and health?
Why ask it
General risk lists are less useful than your own. Infection, clots, dislocation, fracture, and leg length difference all carry different odds depending on weight, diabetes, smoking, and previous surgery.
Is there anything about my health you would want improved before we go ahead?
Why ask it
Blood sugar control, anaemia, dental infection, smoking, and weight all change complication rates, and there is often a window to act on them. This question invites the surgeon to be direct about it.
What kind of anaesthetic is planned, and will I meet the anaesthetist beforehand?
Why ask it
Spinal and general anaesthesia carry different side effects and different recovery in the first hours. Any history of reactions, sleep apnoea, or difficult airways belongs in that conversation, not this one.
What will the first two days after the operation involve?
Why ask it
Ask when you will first stand, what the drains and catheters are for, and what pain to expect as normal. Knowing the ordinary version makes it easier to notice the version that is not.
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. Knowing the criteria lets you work towards them rather than wait to be told.
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. Opioids after joint replacement are meant to be short term, and the patients who struggle most are usually the ones who left without a plan to stop.
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 affect bleeding and healing. Take in the actual boxes, since lists written from memory are where errors happen.
What should I sort out at home before the operation?
Why ask it
The practical list usually includes clearing trip hazards, moving what you use to waist height, arranging a raised toilet seat, and stocking food. Doing it beforehand is far easier than arranging it on crutches.
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 this is the advice most often misremembered.
When does physiotherapy start, how often, and who arranges it?
Why ask it
Find out whether the referral is made for you or left to you, and whether sessions are in person or a printed programme. Gaps between discharge and the first appointment are common and slow recovery.
Week by week, when can I expect to walk unaided, drive, climb stairs, and go back to work?
Why ask it
Timelines differ with your job and your car more than most people expect. Driving in particular depends on being able to perform an emergency stop, and on what your insurer requires.
What symptoms mean I should ring you, and what means going straight to hospital?
Why ask it
You want two clear lists. Fever, spreading redness, wound discharge, sudden calf pain, breathlessness, and an inability to bear weight belong in the urgent one, and knowing that in advance saves hesitation.
How much help will I need at home, and for how many weeks?
Why ask it
Ask about washing, dressing, cooking, and being alone overnight, separately. Most people plan for the first week and are caught out by the third, when help has gone home but stamina has not returned.
What does this cost me, and what has been approved by my insurer?
Why ask it
Surgeon, anaesthetist, implant, hospital, and physiotherapy are often billed separately, and one of them can fall outside your cover. Ask for the written estimate rather than a verbal reassurance.
How long do these implants usually last, and what does a revision involve?
Why ask it
This matters most if you are younger, since a second operation is harder than the first and bone stock is finite. Ask what would raise the chance of needing one earlier in your case.
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. Function persuades more than pain scores.
- 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 you will not remember most of a twenty minute consultation.
On second opinions and timing
A second opinion is routine
Asking for one is normal practice for elective joint surgery and does not offend most surgeons. 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
Hip replacement for arthritis is elective. 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. Vagueness here usually means the option has not been considered for you specifically.
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.