What is Hip Replacement?
Dr. Waldman believes that education is the best way to prepare for surgery. This page is intended to be a brief introduction to modern hip replacement. Below is a list of the most frequently asked questions along with their answers. If you would like a more in depth review, please email or come in and see us.

What is arthritis and why does my hip hurt?
In the hip joint there is a layer of smooth cartilage on the ball of the upper end of the thighbone and another layer within your hip socket. This cartilage serves as a cushion and allows for smooth motion of the hip. Arthritis is a wearing away of this cartilage. Eventually it wears down to bone. Rubbing of bone against bone causes discomfort, swelling and stiffness. Pain is commonly in the groin but may radiate to the thigh, back or knee. Some patients will have pain only in the knee or back.

What is a total hip replacement?
A total hip replacement is an operation that removes the arthritic ball of the upper thighbone (femur) as well as damaged cartilage from the hip socket. The ball is replaced with a metal ball that is fixed solidly inside the femur. The socket is replaced with a plastic or metal liner that is usually fixed inside a metal shell. This creates a smoothly functioning joint that does not hurt.

What are the results of total hip replacement?
96% or our patients experience good or excellent results after the initial healing period. They have little to no pain and are able to enjoy a wide variety of activities with few restrictions. Most can exercise, walk long distance, dance or play golf.

When should I have this type of surgery?
The decision is based on your history, exam and x-rays. There is usually no harm in waiting if conservative, non-operative methods are controlling your discomfort. When these methods no longer control your pain, surgery is usually indicated.

Am I too old for this surgery?
Age is not an issue if you are in reasonable health and have the desire to continue living a productive, active life. You may be asked to see your personal physician for his/her opinion about your general health and readiness for surgery.

How long will my new hip last and can a second replacement be done?
All implants have a limited life expectancy depending on an individual’s age, weight, activity level and medical condition. A total joint implant’s longevity will vary in every patient. the current combination of components used by Dr. Waldman have a 97% 15 year survival rate. Some of these implants may last much longer. If hip implants do wear out, they can almost always be repaired with further surgery

Why might I require a revision?
Wearing of the plastic spacer, used in some hips, may also result in the need for a new liner. However, only 7% of patients nationally ever require a revision and implants continue to improve. Metal on metal hips may last much longer and not require a revision.

What are the major risks?
Most surgeries go well, without any complications. Infection and blood clots are two serious complications. To avoid these complications, we use antibiotics and blood thinners. We also take special precautions in the operating room to reduce the risk of infections. Dr. Waldman’s current infection rate is 0.7% and the symptomatic blood clot rate is 0.1%. Dislocation of the hip after surgery is a risk. Dr. Waldman’s current dislocation rate is 0.3 %.

Should I exercise before the surgery?
Yes, exercise will do no further harm to your hip and will help to make rehab easier after the surgery.

Will I need blood?
The chance of needing blood after the surgery is about 20%. This rate is lower in men and in relatively healthy woman. We generally don’t recommend donating blood because much of it is wasted. Additionally, the community blood supply is in general, very safe. Banked blood is considered very safe and complications are rate.

How long am I incapacitated?
You will probably stay in bed the day of your surgery. However, the next morning most patients will get up, sit in a chair or recliner and should be walking with a walker or crutches later that day. Most patients can try steps the second day after the surgery.

How long will I be in the hospital?
Most hip patients will be hospitalized for three days after their surgery. There are several goals that you must achieve before you can be discharged. Our rehabilitation physicians will evaluate your progress two days after the surgery, and recommend a rehabilitation stay if necessary. This stay may last anywhere from three days to two weeks.

What is the Rubin Institute for Advanced Orthopaedics?
The Rubin Institute is a stand alone hospital attached to Sinai Hospital. It provides specialized orthopaedic care to joint patients, physical therapy facilities and houses a number of ongoing research projects. Dr. Waldman is director of the joint replacement program at the Rubin Institute.

What if I live alone?
Most patients who live alone will qualify for inpatient rehabilitation. When patients leave rehab, they should be able to care for themselves independently.

Will I need a second opinion prior to the surgery?
The office secretary will contact your insurance company to pre-authorize your surgery. It is exceedingly rare that a second opinion is required by an insurance company. If a second opinion is required, you will be notified.

How long does the surgery take?
We reserve approximately 2½ - 3 hours for surgery. Some of this time is taken by the operating room staff to prepare for the surgery and to prepare the room for the next operation. The actual surgery takes about one hour.

Do I need to be put to sleep for this surgery?
You may have a general anesthetic, which most people call “being put to sleep.” In most patients we recommend a spinal anesthetic, which numbs only your legs and does not require you to be asleep. In general, spinals are more pleasant and provide better pain relief, however, choice is made individually for each patient after discussion with the anesthesiologist.

Will the surgery be painful?
You will have discomfort following the surgery, but we will try to keep you as comfortable as possible with the appropriate medication. Most patients control their own medicine with a special pump that delivers the drug directly into their IV for the first day. Generally most patients are able to stop very strong medication within a few days.

Who will be performing the surgery?
Dr. Waldman will perform the surgery. Jonas Griffin, PA-C assists on most of the procedures. We often have a resident physician there to assist and to help take care of you after the surgery. They are there to learn and not to perform your surgery.

How long, and where, will my scar be?
The scar will be approximately three to four inches long in most patients. The length of the scar is somewhat proportional to the size of the patient. It will be along the side of your hip.

Will I need a walker, crutches or cane?
Yes, for about three weeks we do recommend that you use a walker or crutches. The hospital will help provide these items if necessary. Most patients can use a cane for three to four weeks after the walker or crutches are discontinued. Your physical therapist will help to determine when you will advance from walker to cane to no assistance.

Where will I go after discharge from the hospital?
Most patients are able to go home directly after discharge. Some patients may transfer to an acute or sub-acute rehabilitation facility and stay there for 3–14 days. Many patients are transferred to Sinai Rehabilitation on the 5th floor of the main hospital, so no travel is needed. The social worker will help you with this decision and make the necessary arrangements.

Will I need physical therapy when I go home?
Yes, the hospital social worker arrange for a physical therapist to provide therapy at your home. Following this, you may go to an outpatient facility two to three times a week to assist in your rehabilitation. The length of time required for this type of therapy varies with each patient.

How long until I can drive and get back to normal?
If the surgery was on your left hip and you have an automatic transmission, you could be driving at two weeks. If the surgery was on your right hip, your driving could be restricted as long as four weeks. Getting “back to normal” will depend somewhat on your progress.

When will I be able to get back to work?
We recommend that most people take at least one month off from work, unless their jobs are quite sedentary and they can return to work with crutches. An occupational therapist can make recommendations for joint protection and energy conservation on the job.

How often will I need to be seen following the surgery?
You will be seen for your first postoperative office 6 weeks after the surgery. The frequency of follow-up visits after that will depend on your progress. Many patients are seen at six weeks, four months and then yearly.

Do you recommend any restrictions following this surgery?
Hip patients will be restricted from crossing their legs, twisting operated leg, bending 90 degrees at hip or twisting side-to-side for the first six weeks to three months after the surgery. Depending on the type of prosthesis, there may be some permanent restrictions on high impact sports. Metal-on-metal hips often have no restrictions after the healing is completed.

What physical/recreational activities may I participate in after my surgery?
You are encouraged to participate in low-impact activities such as walking, dancing, golf, hiking, swimming, bowling and gardening. More aggressive sports are often possible, so please ask us about any specific activities you would like to pursue.

Will I notice anything different about my hip?
In many cases, patients with hip replacements think that the new joint feels completely natural. The leg with the new hip may be slightly longer than it was before, either because of previous shortening due to the hip disease or because of a need to lengthen the hip to avoid dislocation. Most patients get used to this feeling in time or can use a small lift in the other shoe. Some patients have aching in the thigh on weight bearing for a few months after surgery.