Ceramic Hip Replacement

There are no age or weight restrictions for total hip replacements. Most people who’ve had hip replacement surgery are between 50 and 80 years of age.

Several reasons a doctor may recommend hip replacement surgery include:

• arthritis of the hip, such as osteoarthritis or rheumatoid arthritis
• pain or stiffness in the hip that restricts normal activities, such as walking
• pain that continues while resting
• insufficient relief from anti-inflammatory medications, physical therapy, or walking supports

If you’re overweight, a doctor may ask you to lose weight before surgery to minimize stress on your new hip and help decrease the risks of surgery. If you smoke, you may be asked to quit before the surgery.

A doctor may recommend ceramic hip replacement for:

• younger people due to the material’s durability and longevity
• people sensitive to nickel used in metal hip replacements

Surgeons began using ceramics for hip replacement surgery due to the problems of friction and wear often reported with metal or metal and plastic.

Artificial hips were once typically made of a metal ball and a polyethylene (plastic) socket. Over time, hard metal can wear away soft plastic. But ceramic is very hard and provides more longevity for an artificial hip.

Ceramic may be used for both the ball and the lining of the socket (ceramic on ceramic) or just the ball. Other parts may be made of either metal or plastic, ceramic on metal, or ceramic on plastic (polyethylene).

Research shows that ceramic-on-ceramic bearings decrease wear, bone, and muscle loss, and lower the risk of dislocation. The human body also tolerates ceramic well, with low reactivity and no toxicity. Research shows that ceramic hip replacements may be preferable to metal or plastics, as ceramic is more durable and may last longer.

There are some limitations for ceramic materials, including a risk of fracture during implant. Improvements in modern materials have made fractures less of a concern today. But it is still difficult to revise a fractured ceramic implant, as there may be many tiny fragments.

A small percent of people who get a ceramic-on-ceramic hip replacement report squeaking sounds similar in sound to the creaking of a door hinge coming from their hip.

Experts do not universally agree as to the best material for hip replacement. A surgeon will assess the advantages and disadvantages of each material for your case before making a decision.

Here are some common steps you’ll need to take as you prepare for a ceramic hip replacement:

• If a surgeon requests, complete a physical examination with a primary care doctor before surgery to make sure you’re healthy enough to have the surgery.
• Tell your doctor about any medications you’re taking.
• Take good care of your skin before the surgery to avoid any infections or irritation.
• If you live alone, ask a friend or family member to support you during your recovery. You can also meet with a social worker at the hospital to make arrangements to have someone assist you at your home.
• Install safety bars or handrails in your shower or bath and along all stairways.
• Purchase a raised toilet seat and a bench or chair for the shower.
• Acquire a dressing stick and tools to help dress yourself, including putting on socks and shoes, without having to bend the hip.
• Remove loose carpet and rugs from your home that you could easily slip on.

Hip surgery is typically done in an operating room at the hospital and takes from 1 to 3 hours.

Once you’re checked in at the hospital, a nurse will take you into a room to prep for surgery, where you’ll put on a hospital gown.

The nurse will then start an IV in your hand, wrist, or arm for you to receive fluids and medications during the surgery.

Then, an orthopedic surgeon will do the following:

1. Clean and sterilize the area around the front of your hip.
2. Cover the area with sterile drapes.
3. Make an incision in front of your hip joint.
4. Move the muscle and other tissue out of the way until the bones in your joint are visible.
5. Remove the ball of your hip joint and any damaged parts of the socket.
6. Attach the artificial ceramic ball to your thigh bone and socket to your pelvic bone.
7. Close the incision.

Recovery usually takes 3 to 6 weeks before you can get around and perform light daily tasks on your own.

Your surgeon may schedule a follow-up appointment 2 to 3 months after surgery to make sure your hip is healing properly. Full recovery may take a year or more.

Here’s a general overview of what may happen in the days and weeks after surgery:

• You may need to stay in the hospital for 1 to 4 days after surgery.
• Your surgeon will give you instructions on how soon you can start using a cane, walker, or crutches. They will also tell you when it’s safe to put weight on your new hip. This can vary from immediately to several weeks after the procedure, depending on the type of hip replacement you’ve received.
• Right after surgery, follow your surgeon’s instructions for reducing the risk of blood clots, including taking any prescribed blood thinners and wearing compression socks.
• Once you’re home, you’ll need help from a caretaker or an occupational therapist for daily activities, such as getting dressed.
• You’ll need to have physical therapy for several months to help build up muscle strength and improve the range of motion of the hip. A physical therapist will provide exercises for you to do at home.
• Take regular walks to help with recovery.

Like other surgeries, ceramic hip surgery has some risks, including:

• reaction to anesthesia
• infections
• excessive bleeding
• blood clots

After surgery, it’s also possible to experience:

• hip dislocation
• bone fractures
• nerve damage
• bone loss
• infection of the joint
• reactions to the particles or ions generated from the implant, especially if metal was used
• pain in the hip or leg
• one leg that is longer or shorter than the other
• swelling
• limping
• clicking, grinding, or squeaking sounds from the hip joint

On average, hip replacements last 20 to 25 years before repair or replacement.

In one study, only 4.4 percent of people who received a hip replacement required revision surgery in the first 10 years after surgery. About 15 percent required revision by the 20-year mark.

Limited data is available regarding how long ceramic-on-ceramic hip replacements last, but ceramic implants are believed to have a longer durability than other implant materials because of their low wear rate.