(at least one month prior to surgery is recommended)

Hip replacement surgery is a major procedure and care must be taken that you are in the best medical condition. You must see your regular medical physician within a few months before your surgery. He or she will perform the necessary tests. We will provide you with a minimum list that we require, but your physician may need to perform additional tests before you are cleared for surgery. Surgical clearance by your medical doctor does not mean that he/she or I guarantee that you won’t have a complication. It is just our attempt to make sure you are in the best shape possible prior to surgery.

If necessary, your physician can “tune you up” prior to surgery. We prefer that you see your physician at least one month prior to surgery. If you have your evaluation too close to surgery this leaves us very little time to do unexpected but necessary follow-up testing (for example a cardiologist consult) or correct abnormalities such as anemia prior to surgery. This may lead to postponement of surgery or it may tempt you to accept suboptimal preparation to keep a surgical date. Some people have problems that put them at higher risk that cannot be fully corrected. This does not mean that they cannot have an operation. They must just weigh the higher risks with the benefits and make their choice if it is worthwhile. Some people have conditions that are correctable and place them at higher risk (obesity), but feel they are not willing or able to change.

Others have conditions like diabetes that has lower risk when tightly controlled, but they are unwilling and unable to comply with optimum treatment. They are accepting a higher risk. This is their decision. Patients older than 80 are known to have a 25% chance of major medical complication after joint replacement surgery. Most of these can be managed with a reasonable outcome. Even older patients who have been told by their doctor that they are very healthy for their age have a higher risk simply because of their age. At age 80 your heart is not as strong as when you were 20, no matter what anyone says.

Surgery is a major stress on your system that can cause any number of medical complications. Each patient in consultation with their regular physician must weigh the risk and benefit. If a patient has had a medical clearance and has accepted the risks, I only decline to perform elective surgery in extreme cases where I still think it is very unreasonable. Please have your regular physician send his/her clearance as well as all test results to us. We need to review them, as does the anesthesiologist who is involved in your operation. If you don’t have a regular physician and you live in the Columbia metro region, we may can assist you in getting an appointment with a local physician.

You need to be seen in our office approximately within a week of your surgery. At this time we will review the proposed surgery with you, make adjustments to your plan of care dictated by your preferences and particular medical problems and to answer any last minute questions you may have. At this time you may purchase crutches and ice machine to use after surgery, at low cost, in our office. We will also give you all prescriptions that you will need after surgery in advance.

You should have them filled at a local pharmacy before the operation. Long’s Drug carries all the medications that I routinely use. Delays may occur if you try to fill them elsewhere. Delays and hassles may also occur because some insurance companies deny paying for certain medication or require additional precertification prior to filling certain prescription. They always try to imply that there is something that the doctor has done wrong that causes the denial. This is a highly irritating practice of some insurance companies. They are not experts in medical care and shouldn’t be making decisions about medications. Their behavior also significantly increases the costs of providing your care. It is their shortsighted attempt at trying to avoid paying for medical costs for which you have paid high insurance premiums all these years.

We provide your prescriptions in advance so that these insurance headaches can be resolved in advance of you leaving the hospital. In an attempt to provide a more seamless service, patients having outpatient surgery at our ambulatory surgery center will receive all medication (already included in surgery center fee) from our center. By law, many narcotics cannot be filled across state lines, so be sure you get them filled here before you return home to another state.

It is imperative that you not eat or drink anything after midnight (12:00 AM) the night before surgery. This helps to prevent potential nausea and vomiting from occurring during surgery that could cause complications.