(Total Hip Arthroplasty, Hip Arthroplasty, Total Hip Replacement, Hip Replacement)
Hip replacement, also called total hip arthroplasty, is a surgical procedure to replace a worn out or damaged hip with a prosthesis (an artificial joint). This surgery may be considered following a hip fracture (breaking of the bone) or for someone who has severe pain due to arthritis.
Various types of arthritis may affect the hip joint. Osteoarthritis, a degenerative joint disease that affects mostly middle-aged and older adults, may cause the breakdown of joint cartilage and adjacent bone in the hips. Rheumatoid arthritis, which causes inflammation of the synovial lining of the joint and results in excessive synovial fluid, may lead to severe pain and stiffness. Traumatic arthritis, arthritis due to injury, may also cause damage to the articular cartilage of the hip.
The goal of hip replacement surgery is to replace the parts of the hip joint that have been damaged and to relieve hip pain that cannot be controlled by other treatments.
A traditional hip replacement involves an incision several inches long over the hip joint. A newer approach that uses one or two smaller incisions to perform the procedure is called minimally invasive hip replacement. However, the minimally invasive procedure is not suited for all candidates for hip replacement. The doctor will determine the best procedure for a person, based on that individual's situation.
Joints are formed where bones meet. Most joints are mobile, allowing the bones to move without friction or discomfort. The hip joint is a ball-and-socket joint, which allows backward, forward, sideways, and rotating movements. The ball part of the hip joint is the head of the femur (thigh bone), and the acetabulum is the socket, a cup-like structure in the pelvis.
A hip joint consists of the following:
Hip replacement surgery is a treatment for pain and disability in the hip. The most common condition that results in the need for hip replacement surgery is osteoarthritis.
Osteoarthritis is characterized by the loss of joint cartilage in the hip. Damage to the cartilage and bones limits movement and may cause pain. People with severe pain due to degenerative joint disease may be unable to do normal activities that involve bending at the hip, such as walking or sitting, because they are painful.
Other forms of arthritis, such as rheumatoid arthritis and arthritis that results from a hip injury, can also lead to degeneration of the hip joint.
Hip replacement may also be used as a method of treating certain hip fractures. A fracture is a traumatic event that may result from a fall. Pain from a fracture is severe and walking or even moving the leg is difficult.
If medical treatments are not satisfactory at controlling pain due to arthritis, hip replacement surgery may be an effective treatment. Some medical treatments for degenerative joint disease may include, but are not limited to, the following:
There may be other reasons for your doctor to recommend a hip replacement surgery.
As with any surgical procedure, complications can occur. Some possible complications may include, but are not limited to, the following:
There may be other risks depending on your specific medical condition. Be sure to discuss any concerns with your doctor prior to the procedure.
Hip replacement requires a stay in a hospital. Procedures may vary depending on your condition and your doctor's practices.
Hip replacement surgery is performed while you are asleep under general anesthesia or sedated under spinal anesthesia. Your anesthesiologist will discuss this with you in advance.
Generally, hip replacement surgery follows this process:
After the surgery you will be taken to the recovery room for observation. Once your blood pressure, pulse, and breathing are stable and you are alert, you will be taken to your hospital room. Hip replacement surgery usually requires an in-hospital stay of several days.
It is important to begin moving the new joint after surgery. A physical therapist will meet with you soon after your surgery and plan an exercise program for you. Your pain will be controlled with medication so that you can participate in the exercise. You will be given an exercise plan to follow both in the hospital and after discharge.
You will be discharged home or to a rehabilitation center. In either case, your doctor will arrange for continuation of physical therapy until you regain muscle strength and good range of motion.
Once you are home, it is important to keep the surgical area clean and dry. Your doctor will give you specific bathing instructions. The stitches or surgical staples will be removed during a follow-up office visit.
Take a pain reliever for soreness as recommended by your doctor. Aspirin or certain other pain medications may increase the chance of bleeding. Be sure to take only recommended medications.
Notify your doctor to report any of the following:
You may resume your normal diet unless your health care provider advises you differently.
You should not drive until your doctor tells you to. Other activity restrictions may apply. Full recovery from the surgery may take several months.
It is important that you avoid falls after your hip replacement surgery because a fall can result in damage to the new joint. Your therapist may recommend an assistive device (cane or walker) to help you walk until your strength and balance improve.
Making certain modifications to your home may help you during your recovery. These modifications include, but are not limited to, the following:
Your doctor may give you additional or alternate instructions after the procedure, depending on your particular situation.
The content provided here is for informational purposes only, and was not designed to diagnose or treat a health problem or disease, or replace the professional medical advice you receive from your health care provider. Please consult your doctor with any questions or concerns you may have regarding your condition.
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