St Georges Joints - Senior Consultant Orthopaedic Surgeons Mr Philip Mitchell and Mr Simon Bridle

'St George's Joints'

Welcome to the South West London Hip Clinic

How will I be looked after?

Following clinical examination and X-Rays a decision will be made that you are a candidate for total hip replacement. Your surgeon will then discuss the options for treatment and offer you a hip replacement. He will also discuss very carefully with you the potential risks and complications of this surgery, as well as the realistic goals. If you are keen to go ahead then a date for surgery will be arranged. Approximately 2 weeks prior to surgery you will attend the hospital for a pre-assesment visit. Here you will have the opportunity to meet members of the hospital staff who will be looking after you and the process of care will be carefully explained. Blood tests, a urine sample, a heart trace (ECG), skin swabs and X-Rays if necessary will be performed to optimise any aspects of your care that need to be attended to prior to your admission.

You will be admitted either the evening before or on the morning of your surgery. There is no need to be in hospital for longer than this prior to your surgery when pre-assessment has been performed unless there is a special reason. Some patients with diabetes and some on certain medications, such as blood thinners, may have to be admitted earlier.
In most cases your surgery will be performed under a combination of spinal anaesthetic and sedation. Spinal anaesthetic has many advantages over general anaesthetic for patients under-going joint replacement, such as less bleeding, lower chance of thrombosis and easier post-operative pain control. However, not all patients are suitable for spinal anaesthetic and your anaesthetist will discuss with you prior to surgery what the best option for you is.

The day after your surgery, X-Rays and blood tests are performed and you will be started on your rehabilitation pathway by the nurses and therapists. We expect you to be walking on the first post-operative day, usually with a frame and then will progress to walking with crutches. When you are independently safe walking and can manage stairs if you need to then you will be ready for home. Generally you will have been told prior to surgery when we expect you to go home, but of course this is not set in stone. Some patients are ready sooner, some later. On average now, most patients are ready for home on the 4th or 5th post-operative day after a routine total hip replacement. Patients who have more complex problems or who are more frail will often take slightly longer. Most patients go straight to home after their hip replacement, but if this is not suitable/appropriate then patients may be discharged to a rehabilitation facility. The need for this will usually be identified at the pre-assessment clinic.