♪ Bob and Brad ♪
♪ The two most famous ♪
♪ Physical therapists ♪
♪ On the internet ♪
- Hi folks, I'm Bob Schrupp, physical therapist,
- Brad Heineck, physical therapist.
- and we are the most famous physical therapist
on the internet.
- In our opinion, of course, Bob.
- Today, our title that we're gonna discuss
is the seven most important questions
to ask your hip surgeons.
So, obviously, you're going in for hip surgery
for some reason.
It might be a hip replacement, might be a pinning,
but this is pretty comprehensive,
and Brad and I were talking about this.
They don't all necessarily have to be of your surgeon.
It might be his assistant,
it might be your nurse. - Nurse.
- It might even be your physical therapist
for some of these later on. - Right.
Yeah, this is a really important video
because, you ever go to the doctor
and you walk out and you say,
"Oh, I wanted to ask him that,"
and you completely forgot about it, and things are rushed,
the doctor doesn't have a lot of time to spend with you,
or whatever, and so, you can look at this-
- I want just to say real quickly, Brad,
that, yeah, you can get the printout of these questions.
If you go to our website, bobandbrad.com,
go to the program section, we have free programs there,
and this one, just find the title.
It would be under hip problems or hip...
- Hip replacement.
- I don't know what it's under,
but it's under hip something.
(Brad laughing)
And under there you'll find this particular video.
The seven most important questions
to ask your hip surgeon,
and then there'll be a printout.
- Yep. PDF printout.
Click it and out it comes and you've got it.
- Then you've got the question.
Let's get started Brad. Okay.
Number one, can you try physical therapy first?
Imagine that, two physical therapists saying
that you should try physical therapy first, Brad.
(Brad laughing)
We've seen many times.
People think they're gonna need surgery,
and they have some therapy, and it goes really well,
and they end up not even needing the surgery
or delaying it.
- I've got a patient right now, extremely tight hips,
who's limping around for quite a while-
- A friend of yours, right?
- Yeah. He just had a stroke too.
But it is coming along, - Oh, right.
- so we're working at this as well
and we're stretching it out, things are getting better.
He's probably gonna need a hip replacement,
but at least he's has got some relief
and it's going to delay it, make things more comfortable
until it's absolutely needed. - Right.
And at the very least, you're preparing the hip for surgery.
- Right. Absolutely.
- If you still have the surgery, it's in better shape.
- Yep.
- Number two, what is the risk to performing surgery now?
So, you wanna ask, "Can I avoid surgery?
Can I wait six months or a year?
Is it gonna compromise your outcome?
Is it gonna affect your outcome?"
- Sure.
- Now, I don't think that's as important on hips
as it is on shoulders.
Like, rotator cuff injuries can actually get worse.
- Sure.
- But it's still a good question to have.
And, you know, to me, I always ask the patient,
"Is your health gonna be okay
in a year or a year and a half?"
- Right.
- 'Cause sometimes you're not able to tolerate a surgery
as you get older.
- Yeah, if you have a heart problem,
and, you know, that's- - Lung problems.
- Yep, and the doctor will go over that
with those precautions
about what limits you from having the surgery.
- Okay. Number three.
Again, this is kind of all tied together.
What are the alternatives to surgery?
Physical therapy, there's anti-inflammatories,
there's injections, and just education,
on how to run your life and keep from hurting your hip.
- Right. Yep.
- Number four, what is the expected length of recovery?
How many days will you be in the hospital?
And then we have lots of sub-questions for that, too.
- Right. Are we gonna-
- Yeah let's go ahead and let's go ahead and start,
and it looks like I'm number one.
How long will you need to follow the hip precautions?
If you don't know what hip precautions are,
they are guidelines given to the patient after surgery,
and they include such things as,
"Don't cross your legs,
and don't bend your hip greater than 90 degrees
and all that. - Yep. Yep.
And again, make sure that's clear,
'cause there's more than one type of hip procedure
and precautions are different. - Yes.
Yes. For each doctor, they're different.
- Next one, will you need a full-time or part-time care?
If so, how long?
So, let's talk about when you return home,
are you gonna be able to be independent
or you need to have a spouse or family member
or maybe home care come in to help you out?
- And that requires pre-planning,
obviously. - Yep. Yep.
- Will you need a hospital bed at home?
Good question.
- How soon will you be able to walk after surgery?
Weight-bearing status.
Typically, as 100% weight-bearing, or as tolerated,
but not always.
Sometimes you may have complications
and there are some restrictions for-
- Well, especially if you fractured your hip,
- Right. Mm-hmm.
- and in that case, you might be non-weightbearing.
You may not even be able to...
So, that's gonna greatly affect your ability to get around.
- Yep. (Bob chuckling)
- If you are not full weight-bearing.
I'm next. (laughing)
Will you need crutches or a walker?
And if so, how long?
So, you wanna again, prepare ahead,
'cause you aren't gonna go out
to the store and get crutches,
or, I guess you can order online too,
when you're at home.
- Sometimes they're given to you here,
or they issue it to you at the hospital,
but make sure that you don't wanna be stuck
to be waiting for a walker at home for two days.
That's very uncomfortable.
It's not safe. - Exactly. Exactly.
- When can you lie on the operative side?
So, sleeping in bed or you're on the couch,
can you roll over on the side that's been operated on?
Very important to know.
- It's funny.
It's usually sooner than I think.
They allow it pretty quick usually.
A lot of times on the recheck they'll say that it's okay.
- Yeah, and that's with that hip.
I think with a fracture or something like that,
- It might be different.
- that's when you really need to pay attention more.
- How soon will you be able to climb stairs after surgery?
So, if you have a lot of stairs,
in therapy,
a lot of times we work on that before you go home.
- Right
- If you're staying in the hospital.
- There's a specific pattern on how to go up
and downstairs to take the pressure off you're involved
or operated hip. - Right.
There's a right way and a wrong way.
- Mm-hmm.
When can you shower after surgery?
That's a really good one.
You don't wanna have an infection in that incision,
'cause that will really raise havoc in your life,
so get that very clear.
- When can you drive?
It's an important one, 'cause, you know,
when are you gonna be able to start getting around?
- Independence, you know?
- Right.
- How soon will I be able
to resume normal lifestyle activities besides walking?
Gardening-
- Well, going back to work.
- Yeah, going back to work.
Yep. Exactly.
- The people at work are gonna be asking you,
"When can you come back?"
So, that's a good question to ask.
Again, does it always have to be the surgeon?
I don't know if I'd load up the surgeon
with all these questions.
But I would ask someone that is in the know.
Yeah. - Yeah.
If it's a typical hip replacement surgery,
they can oftentimes say it's probably gonna be this,
but if it's a fracture or something like that,
there's too many other variables
that may intervene with that.
- What are your lifting limits? That's a good one.
- Yeah, and you gotta pay attention
and listen to 'em. (chuckles)
- I left this next ones for Brad.
- Oh, yes. (Bob chuckles)
When is sexual intercourse feasible after surgery?
It's a good one to know,
'cause you don't wanna have a dislocation
or mishap there. - Right. Exactly.
That could be a problem.
- Again, this is probably a later question.
Which sports can you participate in?
- Yeah. Well, plan on none for a little while.
- Yeah, yeah, yeah. (Brad laughs)
And there's some that you may never be able to do again.
- Yeah. I knew someone, I know him.
I haven't seen him for a while,
but he had a total hip replacement in his early 50s,
and he plays adult, they call it masters hockey.
- Oh, my God. - Yeah,
and he wants to get back into it.
I'm saying, "Forget it, buddy." (laughs)
- Well, at least it's not pounding.
- Yeah, well, when you fall,
- Yeah, yeah, yeah. - and you're gonna fall.
You're in your fifties, - Yeah, you're gonna fall.
- you're playing hockey, - Right.
and even though they don't go after people aggressively,
but they're guys.
- Yup. Yup. - Things are gonna happen.
- And you get caught up in the emotion.
All right, let's go to number five.
This is the main questions now.
And this one, I hope you can maybe find out
without asking the surgeon,
but how many hip surgeries do you do a year,
and how many surgeries of this type?
And this is a really important question
because they have found through studies
that the surgeons
that do more hip surgeries obviously have better results.
It just makes sense.
- Right.
- You know, if you're doing one a year,
(Brad laughing)
I don't think I'd go along with that guy.
I don't even know if I'd go along
with the guy that does shoulders, hips,
you know, he's doing everything.
- Yeah.
- I would like the guy that's doing a lot of hip surgeries.
- Right.
- Yeah, you gotta do the homework on that.
- Right
Number six, what are the risks of complication,
and what is your complication rate?
So, you can find that out,
how often does this doctor have people have problems,
and how often do they have people die?
And, yeah. (chuckles)
- A big one is infection rate.
- Yeah. - If you can look
at the percentage of infection rate, their history,
that's probably one of the biggest things.
- Yeah.
Number seven, final question,
but then there's some sub-questions on that too.
If you're going to undergo hip replacement surgery,
you may wanna ask these specific questions then.
These are just for hips
- Yep.
- replacement.
So, number one, what is the implant made of?
You want to know if you're gonna set off metal detectors
on the airport.
- Right. Yep.
And if so, then you do have to carry a piece of paper
or something in your wallet that helps you get through,
'cause that happens.
This has been going on for years.
- Yep, yep. Actually.
- How long will your joint replacement last?
That's a good one.
- Yeah.
- Is it going to be 10 years? 20 years?
If you're gonna be playing hockey, well...
- Yeah, it's gonna be less than that.
And this is going to be a good one
for your physical therapists.
What can you do to keep your joint replacement working
as long as possible?
Again, your therapist can guide you on that.
- Right. Yep.
What activities or factors
could make your joint replacement wear out more quickly?
Again, a physical therapist- - Falling in hockey.
- Yeah, yeah, yeah.
Obviously, any falls is not gonna be good,
but can you go back to running?
- Right.
- I'm quite certain that's a negative.
- Probably no. Sorry. (Brad laughing)
- But biking, that may be a different situation.
You're gonna have to make sure your seat
to your bike's adjusted properly.
Things like that.
- Yep. Good.
Good one for your therapists again.
And this one's gonna have to be the surgeon
or maybe his assistant.
Will you need antibiotics for dental care?
- Oh, right. Yeah.
I know I've had knee and hip patients.
When they go to the doctor, they've gotta take-
- They gotta let them know.
- Yep, they gotta let them know,
and sometimes they have to take a round of antibiotics
before they go in.
It's something about, you can get infection...
- In your mouth and then it travels to your hip, really.
- Right.
For some reason, these replaced joints
- Really suck it up, don't they?
- attract these, and you can get infection
without even opening the skin,
and it's amazing how that happens,
but that's definitely a concern,
and they should make you very aware of that.
- Yeah, it happened a mother-in-law.
It was her knee, but she didn't have any cuts down here,
but she had some nosebleeds and stuff,
and I don't know if she got it through her nose.
- Sure.
- Picked up a bug. - Yep.
It gets into your system, and goes-
- It seems to go right towards that joint.
- Right.
The metal in there, it's not a normal thing
to have that in your body, so it reacts different.
It's a good question to ask the surgeons.
- I'd like to hear a surgeon espouse
his few thoughts on that. - Maybe we can do a video
on that or podcast. - Yeah, yeah.
That would be good.
All right. Thanks, everybody, for watching.
- Oh, we're already done.
- Yeah, we're done. - Wow. Thank you.
(upbeat music)