Total Hip Replacement (Direct Anterior Approach)

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What is

Treatment

Pre-Surgery

Post-Surgery

Other Information

What is - Total Hip Replacement (Direct Anterior Approach)

The Hip

The “hip” is a ball and socket joint, consisting of a ball at the top of the thigh bone (femur) and a rounded socket (acetabulum) in the pelvis. It allows the upper leg to bend and rotate at the pelvis. A healthy joint has cartilage at the ends of the bones that acts as a cushion. It allows the joints to move smoothly and painlessly.

Osteoarthritis

When cartilage begins to wear out, the underlying bones begin to rub together, which results in pain when walking. This condition is known as osteoarthritis.

In severe osteoarthritis, it limits a person’s functional abilities and affects their lifestyle.

Treatment for Total Hip Replacement (Direct Anterior Approach)

Total Hip Replacement

The primary reason is to relieve the painful symptoms and improve your quality of life.

The surgeon will makes an incision over your hip. Damaged cartilage is removed and replaced with artificial parts. The artificial parts are usually made up of metal, ceramic or polyethylene (high grade plastics). One part of the implant will fit over the pelvic bone and the other over the thigh bone (femur).

Risks of Surgery

Complications will be explained to you by your surgeon before surgery. You will be required to sign an informed consent prior to surgery.

The potential risks are:

Infection - Deep Vein Thrombosis
Stiffness - Leg Length Discrepancy
Nerve and blood vessels injury - Dislocation
Loosening and wear of prosthesis - Periprosthetic Fracture

Duration of Hospital Stay

This could be either a day surgery with discharge on the same day
May require 1-2 days of hospitalisation

Pre-Surgery Preparation for Total Hip Replacement (Direct Anterior Approach)

Fasting Instructions

Fasting is essential prior to surgery. In the event you did not follow the instructions, the surgery will be rescheduled. No food or drinks (except plain water) after midnight or as instructed. Last drink allowed is half a cup (100ml) of plain water.

Medicine

Certain medications need to be stopped in preparation for the surgery. Please inform your doctor of all medications you are on, especially blood thinners or herbal medications.

Special Instructions

Any recent infection, be it involving the throat, lung, urinary tract or skin must be highlighted to the surgeon prior to surgery. Your surgery might have to be postponed.
Have a parent / legal guardian to give consent if you are below 21 years old.

Pre-Operative Assessment

Financial counselling for estimated bill for hospital stay and surgery will be discussed.

You would be asked to come to the Pre operation assessment at least 2 weeks before scheduled surgery date to do tests that determine your fitness for the surgery. Examples include:

Blood tests
Urine tests (if indicated)
MRSA screening
Chest Radiograph
Electrocardiogram

You can request to speak to our patient educator at Pre-admission clinic if you have any queries.

You would be instructed to go to the Orthopedic Diagnostic Centre for assessment if required.

Smoking

Smoking causes breathing problems and impedes the rate of healing.

Try to decrease smoking or seek help to stop smoking.

One day before Surgery

The nurse from Same Day Admission (SDA) Clinic will contact you one working day before your scheduled surgery date. The nurse will inform you on the following:

Time to report to hospital and time of surgery. Please bring along your admission kit.
Instruction to fast before surgery.
Medications to consume before surgery.
Bring all CD / X-rays or any medical notes from doctors on the day of admission and hand them to the nurse.
Safekeeping of personal items and valuables in the hospital. Do not bring valuables to hospital.

Duration of Surgery

Approximately: 1 - 2 hours.

After the Surgery

After your surgery, you will be brought to the recovery room in the operating theatre to be monitor before returning to the ward. In the recovery room, the nurse will frequently monitor your vital signs (blood pressure, heart rate, respiration rate, and temperature and pain level).

Your loved ones are advised to wait at the waiting area. Please be informed that the recovery time varies and may take up to several hours. You may be transferred to the general ward/high dependency unit / intensive care unit / short stay ward depending on your condition.

Post-Surgery Care for Total Hip Replacement (Direct Anterior Approach)

Care after Orthopaedic Surgery

The aim of care after your surgery is to allow you to return to your daily activities. The team will advise you regarding the daily activities and the physiotherapy sessions.

Orthopaedic Team

You are cared by a multidisciplinary team comprising of the Surgeon , Doctors , Advanced Practice Nurses/ Resident Nurses/ Nurses, Physiotherapist, Occupational Therapist, Medical Social Worker & Dietician.

Find out more about Post Surgery Care for Total Hip Replacement (Direct Anterior Approach) here >

Rehabilitation by your Physiotherapist and Occupational Therapist

Total Hip Replacement (Direct Anterior Approach) - Other Information

On the Day of Discharge

You will be given a Patient Education Information pamphlet on how to care for yourself at home.
You may receive an implant card if you had metallic implant inserted during your surgery.
You would have been assessed by a physiotherapist before returning home. You may or may not need a walking aid. Do not rush to buy a walking aid.
An outpatient physiotherapy appointment will be given to you and you will also need an ice pack.
You can call us if any enquires. A hotline number will be given to you.

For more information about Total Hip Replacement surgery at SGH, visit Department of Orthopaedic Surgery website.