Answers to the most common questions patients ask before total hip replacement surgery via the direct anterior approach, including anaesthetic, recovery, activity restrictions, and follow-up.
01
Surgery and Anaesthetic
How long will the surgery take?
In general, surgery (minus anaesthetic) takes between 45–55 minutes. This depends on your anatomy, muscle, and adipose tissue around the hip joint. Every care is taken to ensure perfect alignment with minimal soft tissue damage.
What is a spinal anaesthetic?
A spinal anaesthetic is a regional technique where agents are placed next to the spinal cord to anaesthetise the legs. Depending on your wishes, you can be fully awake, sedated, or put to sleep. Spinal anaesthetics decrease your risk of blood clots and bleeding, and improve post-operative pain relief.
Why is the direct anterior approach used?
The best approach is the one your surgeon is most familiar with. Dr Liew is fellowship trained in the direct anterior approach, as well as posterior and lateral approaches. He uses the DAA for all total hip replacement surgery as he believes the benefits are significant. There are no limitations to who can have the direct anterior approach.
02
Early Post-Operative Recovery
When can I walk after the operation?
Once you have regained quadriceps control, you can get up with the help of nurses or physiotherapists. This can be within hours after your operation. Most patients stand and take a few steps a few hours after surgery is complete.
Do I need a drain?
Dr Liew sometimes uses a wound drain to decrease bruising around the hip joint, reducing haematoma under the skin and improving pain control and leg swelling. The drain is only in place for approximately 24 hours post-operatively.
What is a good tip for the post-operative period?
Using ice improves post-operative swelling considerably. Often ice is as effective as analgesia. Using ice on and off the thigh and wound area will help with comfort levels greatly.
When can I go home after surgery?
Normally patients stay 3–4 days. Some patients are on a “fast stream” and return home the next day or day 2. There is no rush for discharge — once you are safe mobilising and pain is under control, you can go home.
Will I require rehabilitation at a rehab centre?
In general no. Most patients go directly home after their total hip replacement surgery.
03
Wound Care and Activities
When can I wet the wound?
A waterproof dressing is placed over your wound, but keep it mostly dry until your 2–3 week review. At that point a small hypafix dressing is placed which you can get wet, remaining until it falls off (usually 5–7 days).
When can I drive?
You are restricted from driving for 2 weeks until your first review with Dr Liew. At that appointment, if deemed suitable, you will be cleared to drive. Around 80% of patients achieve the ability to drive at the 2–3 week mark.
When can I fly?
For interstate patients, once discharged and walking well with a stick you are allowed to fly home — generally 5–7 days post-operatively. For international flights, we recommend waiting until 4 weeks post-operatively when blood clot risk is minimal.
What activities can I perform long term?
There are no real restrictions after a DAA total hip replacement, except impact activities such as running, jumping, skydiving, and water skiing. You are allowed to snow ski, swim, cycle, go to the gym, skip, and hike.
What are my long-term movement restrictions?
There are no long-term movement restrictions. You can move and sleep as you like, and perform almost all activities except impact activities. The rate of dislocation is very low — you will not require a toilet seat raise or other seat raise, even immediately after your operation.
04
Blood Clot Prevention
The main benefit of quicker recovery is early walking, which minimises blood clot risks. Additional measures include:
- White compression socks worn for 2 weeks
- Foot pumps simulating walking used immediately after surgery
- Twice daily Aspirin for 4 weeks (or alternatives such as Clexane if Aspirin is contraindicated)
The plan is modified based on each patient's individual risk factors.
05
Long-Term Follow-Up
Dr Liew follows up hip replacement surgery at 2 weeks and 3 months post op. In general, most patients are 90% through the recovery by 3 months, with a forgotten hip by 6–9 months post op. Xrays are often performed along the way to reassess the bony ingrowth and check everything has stayed perfectly positioned. After your review at 3 months, if recovery has been as expected, then further reviews and Xrays are not required. Routine Xrays at later stages are not beneficial.
Patient Information Summary
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Medical Disclaimer: This content is for educational purposes only. Individual outcomes vary. AHPRA Registered Specialist.