Why it’s done
Various conditions can cause damage to the hip joint, requiring this procedure sometimes:
- Osteoarthritis is a common condition. The wearing down of the cartilage that helps joints move smoothly can result in osteoarthritis, also known as wear-and-tear arthritis.
- Arthritis of the hands and feet. This form of arthritis develops when the immune system overreacts, inflaming cartilage and occasionally undermining bone, causing damage and deformity to joints.
- The condition of osteonecrosis. When a dislocation or fracture results in an insufficient supply of blood to the ball of the hip joint, the bone can collapse and deform.
Hip replacement may be beneficial if your hip pain:
- Worsens with walking, even with a cane or walker
- Makes it difficult to rise from a seated position
- Interferes with your sleep
- Makes it difficult to get dressed
- Persists, despite pain medication
- Affects your ability to go up or down stairs
There are several risks that come with hip replacement surgery, including:
- In rare cases, blood clots may occur. After surgery, you may develop clots in your leg veins. It can be dangerous because a fragment of a blood clot can break off and travel to the lungs, heart, or even the brain. Medications that reduce this risk may be prescribed by your doctor.
- It is possible to contract an infection. Your incision site, as well as the deeper tissue surrounding your new hip, can be infected. Antibiotics are usually able to treat minor infections, but if the infection spreads near the prosthesis, it may require surgery.
- Fractures can occur. It’s possible that healthy portions of the hip joint could be fractured during surgery. A fracture that is small enough to heal on its own may not require any stabilization at all, but if it is larger, a metal plate or bone graft may be required.
- There are several types of dislocations. In the first few months following surgery, certain positions can result in the ball of the new joint coming out of the socket. A brace might be fitted to you if the hip dislocates. Often, surgery is required to stabilize a hip that keeps dislocating.
- The length of the legs has changed. Although your surgeon does everything possible to prevent this from happening, sometimes the new hip may cause one leg to be longer than the other. Sometimes this is due to muscle contractions around the hips. The muscles might be able to be strengthened and stretched progressively in this case. In a few months, you won’t notice any differences in leg length.
- In this case, loosening is important. It is possible for your hip joint to loosen over time or to not be solidly fixed to your bone, leading to hip pain. The problem might need to be fixed through surgery.
- Injuries to the nervous system. An implant can rarely cause nerve damage near where it is placed. Numbness, weakness, and pain can be caused by nerve damage.
How you prepare
Your orthopedic surgeon will examine you before surgery. During the operation:
- Get a history of your current medications and medical history.
- Make sure your hip is mobile and your muscles are strong around it when you examine it.
- X-rays and blood tests should be ordered. It is rare to need an MRI.
Asking questions about the procedure during your preoperative evaluation is a good idea. If you plan to take any medications the week before surgery, be sure to check with your doctor about whether you should stop or continue taking them.
Avoid using tobacco products during the month before surgery and for two months after the surgery, since tobacco use can interfere with healing. See your doctor for assistance if you want to quit.
You shouldn’t have any dental work done two weeks before surgery, including teeth cleaning.
What you can expect
Your hospital gown will be waiting for you when you check in for surgery. Your lower half of the body will be numbed either with a spinal block or through a general anesthetic.
Additionally, your surgeon may inject you with an anesthetic around nerves or in and around joints to help block pain after surgery.
How does a hip replacement surgery work?
Hospitals or surgery centers perform hip replacements. In most cases, outpatient procedures are considered the most appropriate even when complications require observation or care.
A typical, uncomplicated total hip replacement surgery has the following steps.
- An intravenous (IV) line will be attached to your hand or arm once you arrive in the operating room. As well as a catheter, a urinary tube may be placed.
- Depending on your orthopedic surgeon and anesthesiologist’s recommendation, you will receive general (whole body) or epidural (below the waist) anesthesia.
- You will be placed in an appropriate position for the surgeon to make an incision at the hip joint. An incision will be placed depending on how the surgeon approaches the problem (from the front, the back, or the side).
- As part of the procedure, the surgeon will remove the head (ball) of the femur and make an incision in its top. After that, the ball prosthesis stem is inserted, either with or without cement. After that, the ceramic replacement head will be attached to the top of the femur implant.
- An acetabulum (the socket part of the joint) will be removed and a new cup attached.
- You will have your leg bent and moved by your surgeon to make sure it works properly.
- Embroidery stitches that dissolve will be used to close tissue layers. Closing the skin’s outermost layer with surgical glue is essential. After your surgery, you will not need to remove any stitches.
- We will transfer you to a hospital room after you are discharged from the recovery room. When you can go home, which may be the same day, the surgeon will notify you.
After hip replacement surgery, you can expect less pain and a greater range of motion in your joints. Be realistic about the amount of activity you’ll be able to do once your hip becomes painful. Your artificial joint might be damaged if you participate in high-impact activities, such as running or playing basketball. Nonetheless, you will eventually be able to swim, play golf, hike, or drive a bike.