Total Hip Replacement

What is a hip replacement?

Hip replacement, also called hip arthroplasty, is a surgical procedure to address hip pain. The surgery replaces parts of the hip joint with artificial implants. The hip joint consists of a ball (at the top of the femur, also known as the thigh bone) and a socket (in the pelvis, also known as the hip bone). Hip replacement surgery includes replacement of one or both parts. The goal of the procedure is to allow you to resume daily activities and exercise with less pain.

What are the types of hip replacements?

There are two major types of hip replacements:

  • Total hip replacement (the most common type): A total hip replacement switches both the femoral head and the acetabulum with a prosthesis.
  • Partial hip replacement: A partial replacement substitutes the femoral head only. This is typically done for patients with certain types of hip fractures.

Symptoms

Some of the following symptoms may be related to conditions that hip replacements address. They include:

  • Pain in the anterior hip or groin.
  • Pain in the buttock and trochanteric region.
  • Pain with activity and at rest.
  • Pain that gets worse when you put weight on the leg.
  • Stiffness/tightness of the hip.
  • Loss of motion.
  • Difficulty sleeping.
  • Difficulty walking.
  • Difficulty putting on shoes and socks.

What happens during a hip replacement surgery?

Hip replacements are performed in a hospital or surgery center. They are often considered outpatient procedures, even though you might need to stay a night or two for observation or to resolve complications.

A typical, uncomplicated total hip replacement surgery has the following steps.

  • Once in the operating room, you will get an intravenous (IV) line in your hand or arm. A urinary catheter may be inserted as well.
  • You will receive anesthesia, either general (whole body) or below-the-waist (epidural), depending on the recommendation of your anesthesiologist and orthopaedic surgeon.
  • The surgeon will place you in an appropriate position to access the hip joint and make an incision. The incision's location depends on which approach (front, back or side) the surgeon uses.
  • The surgeon will remove the head of the femur (the ball part of the joint) and make an opening in the top of the femur. He or she will then insert the stem of the ball prosthesis, with or without cement. The ceramic replacement head will then be attached to the top of the femur implant.
  • The surgeon will then remove the damaged cartilage from the acetabulum (the socket part of the joint) and attach the new cup.
  • Your surgeon will bend and move your leg to ensure that it functions properly.
  • Layers of tissue will be closed with stitches that dissolve. The outermost layer of skin is closed with surgical glue. No stitches will need to be removed after your surgery.
  • You will be taken to the recovery room for a couple hours and then transferred to a hospital room. The surgeon will let you know when it is safe to go home, which could be the same day, depending on your condition.

Risks involved

Most patients do well with hip replacement. As with any surgical procedure, there are some risks during and after a hip replacement:

  • Bleeding
  • Infection
  • Blood clots in the legs or lungs
  • Leg length discrepancy
  • Injury to nearby nerves
  • Fracture
  • Continued pain or stiffness
  • Dislocation
  • Loosening or wearing out of the prosthesis
  • Unrelieved joint pain (this may be temporary)
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