Steps before Total Hip Replacement surgery

Reviewed by Greg Jaroszynski MD, FRCSC | Last updated May 2026

The process has several steps. The most important things are to make sure the referral is complete, bring access to your actual x-ray images, and keep our office updated if your health changes before surgery.

1. Discuss surgery with your family doctor

First, discuss your hip arthritis with your Family Doctor or Nurse Practitioner. Non-surgical treatments are usually tried first. If those treatments are no longer controlling your symptoms well enough, ask whether surgical options should be considered.

2. Referral through central intake

If you may be a candidate for hip replacement, your Family Doctor or Nurse Practitioner will usually send the referral through the regional hip and knee central intake clinic. Self-referrals are not practiced in the Canadian health care system.

Central intake reviews the referral, checks that the required hip x-rays are available, and may arrange an assessment with an Advanced Practice Provider before a surgical consultation is booked. If surgery appears appropriate, you may be offered a consultation with the first available surgeon, or with a surgeon or hospital of your choice.

3. Bring access to your x-ray images

It is very important that I am able to see the actual x-ray images, not just the written report. The decision about hip replacement depends on the pattern and severity of arthritis visible on the images. A report alone is not enough.

• Your hip x-rays should be up to date, usually within the last 6 months.
• An MRI is usually not required for routine hip arthritis assessment.
• If your x-rays were done at a community imaging clinic, ask how my office can view the actual images.
• Most clinics now provide online image access. Ask for the access code, sharing code, or portal instructions and bring those details with you.
• Some clinics still provide images on a CD or DVD. If so, bring the disc with you.
• Clinics generally no longer print x-ray films.
• If your x-rays were done at a hospital, please make sure our office knows where and when they were taken.

If the images cannot be viewed at the appointment, the assessment may need to be delayed or rescheduled.

4. Surgical consultation

During the consultation, you will be interviewed, examined, and your imaging studies will be reviewed. The surgeon will tell you whether you are a candidate for total hip replacement.

The decision to have surgery is yours. The surgeon is there to help you understand the options, risks, benefits, and timing.

5. Waiting list and surgical date

If you decide to proceed with hip replacement, you are placed on the waiting list. Waiting lists are an unfortunate reality of our Canadian health care system and are due to limited access to operating rooms and other hospital resources.

Once you have moved up on the waiting list, our office will contact you to confirm your surgical date and complete the required paperwork.

6. Tell us if anything changes

Before surgery, please tell us about any important change in your health or circumstances, including:

• new medical diagnoses
• hospital or emergency room visits
• infections, wounds, or dental problems
• new medications, especially blood thinners
• changes in allergies
• changes in home support
• anything else that could affect the safety or timing of surgery

Sometimes the date or time of surgery may change because of hospital scheduling, operating room availability, emergencies, or medical reasons. If that happens, we will inform you as soon as we are aware of the change.

7. Review Joseph Brant Hospital education

If your surgery is being done at Joseph Brant Hospital, please review the hospital's Joint Replacement education page before your pre-operative appointments. Joseph Brant Hospital states that patients having hip or knee replacement surgery are required to view the class video or slide deck before their pre-operative appointments.

The same page also links patient education material for your new hip, equipment information, forms, and discharge planning resources. Write down any questions and bring them to your appointments.

8. Pre-admission clinic

Within a few weeks of surgery, the hospital and/or the surgeon's office will contact you for a pre-admission clinic appointment. During that appointment, you may meet with a nurse, physiotherapist, pharmacist, or other team members. You will receive instructions about preparing for surgery and what to expect in hospital.