Hip Replacement Surgery

X-rays of Total Hip Replacement

X-rays of Total Hip Replacement

Hip replacement is surgery for patients with severe hip damage. The most common cause of damage is osteoarthritis. Osteoarthritis causes pain, swelling, and reduced motion in the joints. It can interfere with daily activities. If other treatments such as physical therapy, pain medicines, and exercise haven’t helped, hip replacement surgery might be an option.

During a hip replacement surgery, the surgeon removes damaged cartilage and bone from the hip joint and replaces them with new, artificial parts. The surgery will replace all or part of the hip joint with a man-made joint. The artificial joint is called a prosthesis.

The hip joint is made up of 2 major parts. One or both parts may be replaced during surgery:

  • The hip socket (a part of the pelvic bone called the acetabulum)
  • The upper end of the thighbone (called the femoral head)

The new hip that replaces the old one is made up of these parts:

  • A socket, which is usually made of strong metal.
  • A liner, which fits inside the socket. It is usually plastic. Newer materials are available now, like ceramic or metal. The liner allows the hip to move smoothly.
  • A metal or ceramic ball that will replace the round head (top) of the thigh bone.
  • A metal stem that is attached to the thigh bone to anchor the joint.

A doctor may recommend a hip replacement for these problems:

  • Patient can’t sleep through the night because of hip pain.
  • Hip pain has not gotten better with other treatments.
  • Hip pain limits or prevents patient from doing normal activities, such as bathing, preparing meals, doing household chores, and walking.
  • Patient has problems walking that require to use a cane or walker.

Other reasons for replacing the hip joint are:

  • Fractures in the thigh bone. Older adults often have a hip replacement for this reason.
  • Hip joint tumors.

A hip replacement can:

  • Relieve pain
  • Help the hip joint work better
  • Improve walking and other movements

Surgical Procedure

The patient will have one of 2 types of anesthesia:

  • General anesthesia – patient will be asleep and unable to feel pain.
  • Regional (spinal or epidural) anesthesia – anesthetic is put into the back to make the patient numb below the waist. Patient will also get medication to make him/her sleepy.

After administering anesthesia, the surgeon will make a surgical cut to open up the hip joint. This cut is often over the buttocks. Then the surgeon will:

  • Cut and remove the head of the thigh bone.
  • Clean out the hip socket and remove the rest of the cartilage and damaged or arthritic bone.
  • Put the new hip socket in place, a liner is then placed in the new socket.
  • The metal stem is then inserted into the thigh bone.
  • Place the correct-sized ball for the new joint.
  • Secure all of the new parts in place, sometimes with a special cement.
  • Repair the muscles and tendons around the new joint.
  • Close the surgical wound.

This surgery takes about 1 to 3 hours.

Minimally Invasive Hip Replacement

In a minimally invasive hip replacement, a smaller surgical cut is used. Also, fewer muscles around the hip are cut or detached.

To perform this surgery:

  • A cut will be made in one of three places — on the back of the hip (over the buttock), on the front of the hip (near the groin), or on the side of the hip.
  • In most cases, the cut will be 3 to 6 inches long. In a regular hip replacement surgery, the cut is 10 to 12 inches long.
  • The surgeon will use special instruments to work through the small cut.
  • Surgery involves cutting and removing bone. The surgeon will remove some muscles and other tissues. Less tissue is removed than in regular surgery. Most of the time, muscles are not cut or detached.

This procedure uses the same type of hip replacement implants as regular surgery.

Post-Surgery

Hospital stay will be for 1 to 3 days. The patient will be asked to start moving and walking as soon as the first day after surgery.
Patients who had minimally invasive hip replacement can have a shorter stay in the hospital and faster recovery.

Hip replacement surgery results are often excellent. Most or all of the pain and stiffness should go away. The patient is expected to walk without walking aids at about 1 to 2 weeks after the surgery.

Some people may have problems with infection, loosening, or even dislocation of the new hip joint.

Over time, the artificial hip joint can loosen. This can happen after as long as 15 to 20 years. A second replacement may be needed.

Younger, more active people may wear out parts of their new hip. It may need to be replaced before the artificial hip loosens.

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