Overview
During a hip replacement, the surgeon removes the damaged parts of the hip joint and replaces them with parts that are usually made of metal, ceramic and very hard plastic. This artificial joint (prosthesis) helps reduce pain and improve function.
Hip replacement surgery, also called total hip arthroplasty, may be an option if hip pain interferes with daily activities and nonsurgical treatments haven''t helped or are no longer effective. Arthritis damage is the most common reason for the need for a hip replacement.
Why is this done
Conditions that can destroy the hip joint and require hip replacement surgery include
Osteoarthritis. Known as wear-and-tear arthritis, osteoarthritis destroys the slippery cartilage that covers the ends of bones and helps joints move smoothly.
Rheumatoid arthritis. Caused by an overactive immune system, rheumatoid arthritis results in a type of inflammation that can erode the cartilage and sometimes the bone underneath, which can damage and disfigure joints.
Osteonecrosis. If, as a result of a dislocation or fracture, not enough blood reaches the ball part of the hip joint, the bone may collapse or deform.
You may consider hip replacement surgery if you have hip pain that is
It persists, despite taking pain relievers
It gets worse when you walk, even with a walking stick or walker
affect your sleep
It''s hard to get dressed
Affects your ability to go up or down stairs
Makes it difficult for you to get up from a sitting position
Risks
Risks related to hip replacement surgery can include
blood clots Blood clots can form in the leg veins after surgery. This can be dangerous Because a piece of the blood clot can break off and travel to the lung, heart, or rarely to the brain. Your doctor may prescribe blood-thinning medications to reduce this risk.
infection. Infection can occur at the site of the incision and in the deeper tissues near the new hip. Most infections are treated with antibiotics, but major infections near the prosthesis may require surgery to remove and replace the prosthesis.
fracture. Healthy parts of the hip joint may break during surgery. Sometimes, fractures are small enough to heal on their own, but larger fractures may need to be fixed with wire, screws, and possibly metal plate or bone grafts.
dislocation. Certain positions can cause the ball of the new joint to come out of the socket, especially in the first few months after surgery. If a hip dislocation occurs, your doctor may provide you with a brace to keep your hip in the correct position. If the hip continues to dislocate, surgery is often required to stabilize it.
Change in leg length. Your surgeon takes steps to avoid the problem, but sometimes a new hip makes one leg longer or shorter than the other. Sometimes this is caused by a contraction of the muscles around the hip. In this case, gradually stretching and strengthening these muscles may help. You are not likely to notice slight differences in leg length after a few months.
f ness Although this complication is rare with newer implants, the new joint may not become firmly fixed to your bone or may come loose over time, causing hip pain. Surgery may be required to resolve this problem.
nerve damage In rare cases, nerves in the area where the implant is placed can be affected. Nerve damage can cause numbness, weakness, and pain.
The need for a second hip replacement
A hip replacement can wear down over time, especially if you had hip replacement surgery when you were relatively young and active. Then you may need a second hip replacement. However, the new materials make the implants last longer.
How to prepare
Before surgery, you''ll meet with an orthopedic surgeon for an examination. The surgeon will follow these procedures:
Asking about your medical history and current medications
Examine the hip with attention to the range of motion in the joint and the strength of the surrounding muscles
Ordering blood tests and x-rays. MRI is rarely needed
This pre-operative evaluation allows you a good time to ask any questions you have about the procedure. Make sure you know which medications to avoid or continue to take during the week before surgery.
Because tobacco use can hinder your recovery, stop using tobacco products for at least a month before surgery and for at least two months after surgery. If you need help quitting, talk to your doctor.
Do not undergo dental treatment, including dental cleaning, two weeks before surgery.
During the operation
The surgery takes a few hours. To perform a hip replacement, your surgeon will
Make incisions over the front or side of the hip through the layers of tissue
Removing diseased or damaged bones as well as cartilage, leaving healthy bones untouched
Implanting a prosthetic socket in the pelvic bones, to replace the damaged socket
He replaces the round ball at the top of the thigh with a prosthetic ball that is installed in the appropriate stem in the thigh bone
Hip replacement techniques are constantly evolving. Surgeons are still developing minimally invasive surgical techniques that can reduce recovery time and pain.
After the operation
After surgery, you''ll be moved to a recovery area for a few hours while the anesthesia wears off. Medical staff will monitor your blood pressure, pulse, level of alertness, level of pain or discomfort, and your need for medication.
The length of stay in the hospital after the operation depends on your condition. Many people can go home the same day. You will be asked to breathe deeply, cough or blow into a device to help remove fluid from your lungs.
