Total Hip Replacement
The hip is a "ball-and-socket" joint where the "ball" at the top of the thigh bone (femur) fits inside the "socket" in the pelvis (acetabulum). A natural substance in the body called cartilage covers the end femoral head and the socket (acetabulum). When the bone and/or cartilage of the hip becomes diseased or damaged from arthritis, hip fractures, bone death or other causes, the joint can stiffen and be very painful. A total hip replacement may be recommended for patients who experience severe hip pain and whose daily lives are affected by the pain.
Initial treatment for advanced hip conditions often includes nonsurgical techniques such as medication, physical therapy and using assistive devices such as orthotics or a cane. If these methods are unsuccessful, patients often turn to surgery to relieve their symptoms and resume a more active and enjoyable lifestyle.
Total hip replacement involves replacing the diseased bone and cartilage with a metal ball and plastic cup to relieve pain and restore movement and function to the joint. After this procedure, patients will be able to once again move without the stiff, debilitating pain of arthritis.
Preparing for Surgery
Patients considering total hip replacement to relieve severe pain and stiffness caused by arthritis, fractures or other conditions will need to undergo a thorough evaluation of their medical history and overall health prior to surgery. The choice to undergo this procedure should be made only after careful consideration of all options and an in-depth discussion with your surgeon about the benefits, risks and details of this procedure.
Total Hip Replacement Procedure
During a total hip replacement, an incision is made in the joint to carefully remove the damaged bone and cartilage ends and replace them with the prosthetic joint. The prosthesis may be cemented in place, may be cementless, or may be a hybrid of both. Your doctor will determine which technique is best for your individual condition during a pre-surgical consultation. The surgery is performed under general anesthesia or regional anesthesia and takes from two to four hours, followed by another few hours spent under observation in a recovery room.
Recovery
After a total hip replacement, patients will stay in the hospital for a few days and will likely experience mild discomfort, swelling and bruising in the area. Your doctor may prescribe pain mediation to manage these symptoms during the recovery process. Hip replacement produces immediate pain relief from arthritis or other degenerative conditions.
Physical therapy starts as soon as the first day after surgery with the goal of strengthening the muscles and preventing scarring (contracture). Therapy begins with the patient sitting in a chair and progresses to stepping, walking and climbing stairs, first with crutches or walkers and then without supportive devices. Patients are encouraged to stand up and walk around as soon as they feel comfortable, often as soon as the next day after surgery. Occupational therapy and at-home exercises help patients learn how to use the prosthesis in everyday activities.
Total hip replacement is successful in over 95% of well-selected patients. On average, replacements last 15-20 years. Some patients enjoy full use of the prosthesis after 25 years or longer and can participate in a wide range of activities that they were previously unable to enjoy while suffering from arthritis.
Risks
Risks associated with total hip replacement are considered rare, but many include infection, blood cots, fracture, loosening of the new joint, stiffness and more. These risks can be further reduced by choosing an experienced surgeon to perform your procedure, and by adhering to your surgeon's instructions before and after surgery.
These risks, along with any concerns you may have, will be discussed during a pre-surgical appointment to ensure that patients understand all aspects of their procedure and maintain realistic results for their total hip replacement.
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