Hip Replacement Overview

    The hip joint is made up of a ball-and-socket. The socket is made of bone and cartilage, and the ball is the top of the thigh bone, also known as the femoral head.

    Sometimes, either the socket of the hip and/or the thigh bone is injured or becomes diseased. This can result in pain, trouble with walking, and taking care of everyday tasks.

    If the pain isn’t helped by other methods, such as medications, change in activities, physical therapy, or supports or braces, your doctor may recommend hip replacement surgery. Hip replacement surgery is an operation to replace the damaged ball-and-socket with new and durable artificial synthetic parts that mimic the ball-and-socket.

    Who Needs a Hip Replacement?

    Hip replacements are usually performed for arthritis of the hip. Arthritis is a disease that causes the cartilage to break down. Cartilage acts as a cushion between bones. Without cartilage, the bones rub against each other, which can cause severe pain.

    Doctors usually try to control this discomfort with the use of walkers or canes, a low-impact exercise program, and non-steroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen. If these measures fail, however, hip joint replacement is the best solution.

    Doctors generally recommend hip joint replacement if you can’t sleep or sit comfortably because of the pain and if your arthritis limits your activities.

    Sometimes doctors perform a hip replacement if a tumor grows in the hip joint.

    Hip replacement may also be done on an emergency basis to fix a fracture in the hip joint or the thigh bone.

    According to the American Academy of Orthopaedic Surgeons, most people who have hip joint replacements are between the ages of 50 and 80 (AAOS).

    How Is the New Hip Constructed?

    The replacement hip is made up of four components:

    • a metal socket
    • a liner to help the ball move easily within the socket
    • a metal ball to replace the femoral head
    • a metal rod used to stabilize the thigh bone

    How Is Hip Replacement Surgery Performed?

    Unless you are having emergency hip replacement due to an accident, your surgery will probably be scheduled several weeks in advance. Your doctor will urge you to use the time to get into the best physical condition possible. He or she may suggest that you lose some weight. You will also need to stop taking any medications, including NSAIDs that make it difficult for your blood to clot. During this time, you may also want to rearrange your living space to minimize having to walk long distances or up and down stairs.

    You will not be able to eat or drink anything after midnight on the day of the surgery. Hip surgery is done in a hospital operating room. After you check in at the surgery desk, a nurse will take you into a room to be prepared for surgery. You will take off your street clothes and put on a hospital gown, and the nurse will start an IV in your hand, wrist, or arm. The IV allows you to receive fluids and medications during the procedure.

    When it is time for your operation to begin, you will be taken into the operating room on a wheeled bed called a gurney. There, you may be given a general anesthetic or a medicine that makes you sleep through the surgery without pain.

    If your surgeon believes that you have other health considerations that might make general anesthesia difficult or risky (such as heart or lung conditions), he or she might recommend a localized or regional anesthetic. This is a small amount of medication injected into your spine that makes everything below your waist numb. Some people who receive a localized or regional anesthetic are also given sedatives to help them remain calm during the surgery.

    When the anesthesia has taken effect, your surgeon will make an incision, or cut, over your hip bone. The surgeon will then cut off and remove the femoral head. Next, he or she will remove damaged tissue and bone from the hip socket. Next, the new socket is put into place and a metal rod is inserted into the thigh bone to stabilize it. Finally, the surgeon places the human-made ball into your new joint and secures all the parts in place with a substance much like cement. Finally, he or she repairs the muscles and tendons that were cut to reach the hip joint and closes the surgical wound.

    The procedure takes anywhere from one to three hours.

    Aftercare

    You will wake up in a recovery room. The staff there will monitor your vital signs and give you medicine for pain. When they are sure that you are stable, you will be transferred to a room in the hospital.

    Your hospital stay will last three to five days. The day after the surgery, a physical therapist will help you get up and take a few steps.

    Some people go home immediately after discharge from the hospital, although they continue to work with a physical therapist on an outpatient business. Other people choose to go to a rehabilitation facility or a skilled nursing facility to receive additional care and inpatient therapy services.

    Full recovery from a hip joint replacement takes about three to six months.

    Final Outcomes

    The American Academy of Orthopaedic Surgeons has called the hip replacement “one of the most successful operations in all of medicine.” Most people who undergo the procedure report significantly less hip pain and a greater ability to perform the activities of daily living (AAOS).

    Hip joints are built to last for 15 to 20 years, but putting too much wear and tear on them through high-impact activity or obesity may shorten their lifespan. Some people have to get a second hip replacement if the first one begins to deteriorate.