The doctor will first examine your pelvis, both hips, spine and legs and, when doing so, will palpate various muscles and bone structures. He will then perform a few movement tests in order to gain an impression of the mobility of the hip joint. He further examines the pain caused when the hip joint is moved in different directions, for example adduction, abduction, rotating, bending and stretching. At the same time, the doctor also examines to see if there is a difference between the length of the legs.
Your doctor will first ask you to give details of your complaints. He will want to know where it hurts and where the pain radiates to. He will also ask about the intensity of the pain, its duration and any factors which intensify or ease the discomfort.
Using the X-ray image, the doctor is able to recognise the changes caused by coxarthrosis: the intra-articular space between the acetabulum and the femoral head is either no longer uniform, is narrower or indeed is no longer visible. The bone structure of the femoral head and acetabulum appears irregular and altered whilst in very advanced stages the sections of the joint are deformed.
On the day before the surgery, the surgeon will usually talk to you in detail about the planned procedure. He will explain the surgical method and the type of prosthesis to be used. The prosthesis model selected depends on the nature of your bones, your body weight and your level of physical activity. The surgeon will have normally decided beforehand which prosthesis model and type of fixation to use on the basis of your X-ray and data.
In the majority of cases, the surgeon will also ask you about your state of health on the day before the surgery. Do not hesitate to inform your doctor of any complaints which you consider minor, such as colds and skin infections, even if you are not asked. Although harmless, these illnesses need to be cured before a surgical intervention.
The anaesthetist will also talk to you on the day before the surgery to explain the potential risks involved with the anaesthesia. He will perform a few minor examinations; he is particularly interested in your heart and lung functions and any possible allergies. He will then talk to you about the type of anaesthesia to be used.
Under certain circumstances, large amounts of blood may be lost when performing a hip prosthesis surgery. A blood transfusion then becomes necessary. An autologous blood transfusion using the patient's own blood which was donated at an earlier date, essentially rules out the risk of infections such as Hepatitis C and HIV.
As a rule, there is sufficient time between the diagnosis and the hip prosthesis surgery (around two to six weeks) to discuss this issue with your attending doctor. Use this opportunity to ask about the option of an autologous blood donation.