Total Hip Replacement
If your hip has been damaged by arthritis, a fracture, or other conditions, common activities such as walking or getting in and out of a chair may be painful and difficult. Total hip replacement is an effective procedure that can help you get back to enjoying everyday activities.
The most common cause of damage is osteoarthritis. Osteoarthritis causes pain, swelling, and reduced motion in your joints. It can interfere with your daily activities. If other treatments such as physical therapy, pain medicines, and exercise haven’t helped, hip replacement surgery might be an option for you.
During a hip replacement operation, the surgeon removes damaged cartilage and bone from your hip joint and replaces them with new, man-made parts. A hip replacement can relieve pain, help you hip joint work better, and improve walking and other movements.
Preparing for Hip Replacement Surgery at OSM
To prepare for surgery, you can:
- Learn what to expect before, during, and after surgery.
- Ask the doctor for booklets about the surgery.
- Ask someone to drive you to and from the hospital.
- Arrange for someone to help you for a week or two after coming home from the hospital.
- Put things you need in one place at home. For instance, put the remote control, telephone, medicine, tissues, and wastebasket next to your chair or bed.
- Place items you use every day at arm level to avoid reaching up or bending down.
- Stock up on food.
- Make and freeze meals.
Points To Remember About Hip Replacement Surgery
- Hip replacement surgery removes damaged or diseased parts of a hip joint and replaces them with new, man-made parts.
- The goals of hip replacement surgery are to relieve pain, help the hip joint work better, and improve walking and other movements.
- Risks of problems after hip replacement surgery are much lower than they used to be.
- People usually spend 1 to 4 days in the hospital after hip replacement surgery. It takes about three to six months to be completely well.
- An exercise program can reduce joint pain and stiffness.
- Wearing away of the joint surface may become a problem after 15 to 20 years, and may require replacement of the joint.
After an injury or surgery, an exercise conditioning program will help you return to daily activities and enjoy a more active, healthy lifestyle. Following a well-structured conditioning program will also help you return to sports and other recreational activities.
Total Hip Replacement: Day of Surgery
After admission, you will be evaluated by a member of the anesthesia team. The most common types of anesthesia are general anesthesia (you are put to sleep) or spinal, epidural, or regional nerve block anesthesia (you are awake but your body is numb from the waist down). The anesthesia team, with your input, will determine which type of anesthesia will be best for you.
Many different types of designs and materials are currently used in artificial hip joints. All of them consist of two basic components: the ball component (made of highly polished strong metal or ceramic material) and the socket component (a durable cup of plastic, ceramic or metal, which may have an outer metal shell).
The prosthetic components may be “press fit” into the bone to allow your bone to grow onto the components or they may be cemented into place. The decision to press fit or to cement the components is based on a number of factors, such as the quality and strength of your bone. A combination of a cemented stem and a non-cemented socket may also be used.
Your orthopaedic surgeon will choose the type of prosthesis that best meets your needs.
The surgical procedure takes a few hours. Your orthopaedic surgeon will remove the damaged cartilage and bone and then position new metal, plastic, or ceramic implants to restore the alignment and function of your hip.
After surgery, you will be moved to the recovery room where you will remain for several hours while your recovery from anesthesia is monitored. After you wake up, you will be taken to your hospital room.
(Left) The individual components of a total hip replacement. (Center) The components merged into an implant. (Right) The implant as it fits into the hip. Image courtesy of AAOS
What can you expect after total hip replacement surgery?
Right away. Usually people do not spend more than one to four days in the hospital after hip replacement surgery.
The following will happen while at the hospital:
- Soon after surgery, you will:
- Breathe deeply, cough, or blow into a device to check your lungs. Deep breathing helps to keep fluid out of your lungs after surgery.
- Work with a physical therapist, who will teach you how to sit up, bend over, and walk with your new hip. The therapist will also teach you simple exercises to help you get better.
- Within one to two days after surgery, you may be able to sit on the edge of the bed, stand, and even walk with help.
After you go home, be sure to follow the doctor’s instructions. Tips for getting better quickly are:
- Work with a physical therapist.
- Wear an apron to carry things around the house. This leaves your hands and arms free for balance or to use crutches.
- Use a long-handled “reacher” to turn on lights or grab things you need. Your nurse at the hospital may give you one or tell you where to buy one.
Long term. You should talk to your doctor or physical therapist about an exercise program to reduce joint pain and stiffness.
To be completely well takes about three to six months, based on:
- The type of surgery.
- Your health.
- How quickly exercises help.
Revision surgery (replacement of an artificial joint) is becoming more common as more people are having hip replacements at a younger age. This is because new joints generally last at least 10 to 15 years. Your doctor may consider revision surgery when:
- Treatments do not relieve pain and help you move better.
- X-rays show changes in the bone or artificial parts of the joint that require surgery.
How Your New Hip Is Different
You may feel some numbness in the skin around your incision. You also may feel some stiffness, particularly with excessive bending. These differences often diminish with time, and most patients find these are minor compared with the pain and limited function they experienced prior to surgery.