Hip Replacement: Procedure, Preparation, and Recovery
An interview with Priv.-Doz. DDr. Maximilian Kasparek, MSc
Many people are apprehensive about the prospect of needing an artificial joint – or they simply lack a clear understanding of how the surgery proceeds. Therefore, this article aims to provide patients with a realistic, reassuring picture: What can I expect? What can I do myself? And what does the journey after surgery truly feel like?
Preparation and Preliminary Consultations
How do you specifically prepare your patients for hip surgery – both medically and emotionally?
It is very important to me that my patients feel well cared for – not only medically, but also personally. A hip surgery is a major step for many, and I understand that. That is why I take the time to explain everything clearly and address all questions. This builds trust, and potential fears can be alleviated.
I always tell my patients: You are not alone. I personally accompany you on this journey – from preparation through surgery to aftercare. It is important to me that there is always a dedicated contact person who provides information about the process and explains all steps. When you know what to expect, many things lose their apprehension.
What happens in the weeks before?
Before a hip surgery, there are several steps to optimally prepare our patients. These include medical preliminary examinations and, of course, the detailed consultation with the surgeon and the anesthesiologist. Everything is explained in detail, and any open questions can be discussed at leisure.
Even small preparations at home are helpful, for example, having aids ready or starting with light physiotherapy. This strengthens the muscles and facilitates recovery. And those who are well-informed usually approach the procedure much more calmly.
What are pre-operative washes and what is their purpose?
Pre-operative washes are special disinfectant washing solutions that are used in the days leading up to a surgery. They reduce the natural bacterial count on the skin and thus lower the risk of infections during and after the procedure. Especially for procedures like a hip replacement, this is an important contribution to avoiding complications and supporting wound healing.
What are the most common questions you are asked during the initial consultation? Are there certain myths or misconceptions that you frequently have to clarify?
During the initial consultation, many patients first ask the question: “How long will it take until I can walk again?” or “How painful will it be?” – these are completely understandable concerns. I then explain that most patients can get up with assistance on the day after the surgery, and thanks to modern procedures, pain is very well controllable today.
A common myth is that after a hip replacement, one ‘is no longer allowed to do anything’ – meaning no sports or no normal movement. That is not true. On the contrary: The goal of the surgery is to become pain-free and active again. Of course, it requires some time and patience during rehabilitation, but most patients can enjoy their lives independently again afterward and continue to pursue many of the sports they engaged in before the procedure.
What role does physical preparation play – such as muscle building, exercise, nutrition, or pain therapy before the surgery?
Physical preparation plays a significant role. Those who are already somewhat active and strengthen their muscles before the surgery generally recover significantly faster. A balanced diet and a well-coordinated pain therapy also optimally support the body. In short: The better prepared one is, the easier the recovery afterward.
Many wonder: Is there an ideal time of year for hip surgery – or does the season not matter?
Essentially, the season does not play a major role. What is crucial is the patient’s health status and when the pain becomes so severe that it limits their quality of life. Some prefer spring or autumn because the weather is milder and movement is easier – but medically, hip surgery can be safely performed throughout the year.
In which cases do you advise bilateral surgery – i.e., the implantation of two hip or knee prostheses simultaneously or in quick succession?
Bilateral surgery is only considered if both hip joints are severely affected and the general health condition is stable. In such cases, it may be advisable to treat both sides in one procedure – which saves a second surgery and shortens the overall recovery time. However, it is always important to individually assess whether this is the right approach for the respective patient.
What are the advantages, what are the risks, and how do preparation, surgery, and rehabilitation differ from a unilateral procedure?
The advantage of bilateral surgery is that one only needs anesthesia once and can complete the entire rehabilitation in one step. This saves time and also means less strain from multiple procedures. However, the surgery itself is somewhat more demanding, as both joints must heal simultaneously. Therefore, preparation and aftercare are particularly important.
Surgical Procedure
What does the surgery day itself involve? What do patients experience from admission until their return to the room?
On the day of surgery, everything proceeds in a very structured manner. Patients usually arrive at the hospital the day before, are prepared, and undergo the final examinations as well as the anesthesia consultation. The next day, they proceed to the operating room, where the entire team is already ready. The surgery itself usually lasts about one to two hours.
After the procedure, patients are first taken to the recovery room, where we monitor them closely. Once everything is stable, they return to their room. Many are surprised at how quickly they are awake and responsive again. Most patients can get up for the first time with assistance on the very first day.
Which technique do you use – and why do you particularly rely on the AMIS approach? What is the advantage for patients?
I work with the so-called AMIS technique – a minimally invasive anterior approach. The great advantage of this is that no muscles are cut, but merely pushed aside. This makes the procedure particularly gentle. Pain is usually less, and patients can often get up and move again significantly faster.
Many are surprised at how well this works even in the first few days. Thanks to the muscle-sparing approach, most patients recover much faster, mobility quickly returns, and many can take their first steps with assistance on the very day of surgery – that is always a very motivating moment.
After the operation
What does it feel like to wake up after surgery – what can patients expect immediately afterwards?
Waking up after the operation is usually very calm. Our patients are carefully monitored in the recovery room and are often surprised that the operation is already over. Mild pain may occur, but thanks to modern pain therapy, it can be controlled very well. Many feel relief above all – the new joint is in place, and the old, deep-seated pain is often noticeably less noticeable in the first few hours.
How severe is the pain typically after hip surgery – and how long does it last? What do you say to people who are very afraid of it?
The pain after hip surgery is much less today than many fear. Immediately after the procedure, most people feel more of a wound pain – but the typical, deep-seated joint pain is usually gone immediately. Thanks to modern pain therapy, the symptoms can be controlled very well, so that patients can become mobile again early on.
To people who are very afraid of pain, I always say: You are not alone – and we will not leave you alone with it either. We actively take care of pain management, adapt it individually and discuss everything openly. This quickly takes away the biggest worry for most people.
When does mobilization begin – i.e. when are you allowed to stand, walk, move again?
Mobilization begins very early – usually on the first day after the operation. Together with physiotherapy, patients carefully stand up and take their first steps with support. This quickly provides security, promotes healing and strengthens confidence in the new joint. Many are surprised at how well this works even immediately after the operation.
What can patients themselves do to ensure that recovery is as quick and successful as possible?
Your own cooperation is crucial for success. Those who do the exercises regularly, move around and follow the instructions of the physiotherapy usually get back on their feet very quickly. Of course, the body also needs time to heal – so patience is important. A positive attitude, a healthy diet and some discipline support the healing process enormously. It is often seen that those who actively participate regain their quality of life much faster.
Which sports or movements are allowed in the weeks afterwards – and when can you be “normally” active again?
In the first few weeks after the operation, gentle movements are the focus – i.e. walking, light cycling on the ergometer and the exercises from physiotherapy. After about six to eight weeks, many patients are allowed to become a little more active again. Joint-friendly sports such as swimming, cycling or hiking are particularly suitable. On the other hand, you should avoid contact sports or heavy jumping loads. The goal is to be active again in a mobile and pain-free way – without overloading the new joint.
Are there differences in the healing process – depending on age, weight or pre-existing conditions?
Yes, of course the individual state of health plays a role. Younger and fitter patients often recover a little faster, but older people also make surprisingly good progress. What is crucial is not so much age as the general physical condition and motivation. Those who actively participate and adhere to the recommendations can achieve very good results at any age.
Personal & Motivation
Was there a special moment or patient in your career that showed you why you do this job?
In my career, I have been able to accompany many patients who can live pain-free again and enjoy their favorite activities thanks to hip surgery – be it skiing, tennis or traveling. Seeing them move freely again without having to constantly think about their hip is always something special for me.
As a passionate skier, I am particularly happy when I receive photos of happy faces on the slopes. Such moments show me time and again why I do this job – because I am allowed to help people regain their joy of life.
Which movements or everyday activities of your patients are you particularly pleased about when they are possible again after the operation?
What pleases me most is when my patients can return to their everyday lives and their hobbies. I often get photos – from ski slopes, tennis courts, golf tournaments or even hunting trips – and that touches me every time.
Seeing someone active again, enjoying exercise and enjoying their life is the best thing about this job for me. Then I know: The operation has not only changed the hip, but has brought back a piece of quality of life – and that makes me personally very happy.
If you could give someone something who is still hesitant – what would it be?
I understand very well that many hesitate at first – that is quite normal. After all, hip surgery is not a small step. But I see again and again how great the relief is afterwards. Many say with a smile: “Why didn’t I do that sooner?”
I always say to my patients: I can advise you, but you make the decision yourself. My advice would be: Trust that it is a way back into life – to movement, freedom and joy of life. And you are not alone – we will accompany you from the first conversation to complete recovery.
Final question
What do you wish patients knew or asked before the initial consultation?
I hope that patients come to the initial consultation without any hesitation – with all their questions, worries and expectations. No one needs to know everything or be perfectly prepared. It is only important to say openly what you feel and what is particularly difficult in everyday life. This way we can find the best solution together.
I am also always happy when someone wants to know how they can contribute to recovery themselves. This interest and active participation are often the first step towards a really good result.
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