A hip replacement is a procedure where a surgeon replaces damaged and worn-out surfaces in your hip with new artificial surfaces. Surgeons
Total hip replacement is the most extensive version of this surgery. In a total hip replacement, your surgeon will replace the head of your femur and the socket of your hip joint. Experts expect that the number of people in the United States with total hip replacements will nearly triple by 2040.
If only part of your hip is damaged, a doctor or healthcare professional may recommend less extensive procedures such as partial replacement or resurfacing. Partial hip replacement involves replacing the head of your femur. Hip resurfacing involves covering the head of your femur with an artificial covering.
Keep reading to learn everything you need to know about total hip replacements.
According to the American Academy of Orthopaedic Surgeons, people who benefit from hip replacement surgery include people with:
- hip pain that limits everyday activities such as walking
- hip pain that persists while resting
- hip stiffness that limits leg mobility
- insufficient pain relief from physical therapy, walking aids, and anti-inflammatory drugs
Parts of a hip replacement
A total hip replacement replaces your entire hip joint. The replacement is made up of four parts:
- Cup or socket: A cup-shaped artificial piece replaces the socket of your hip (acetabulum).
- Cup lining: A liner reduces the friction between the ball and socket of your hip.
- Femoral head: A ball replaces the round head at the top of your femur.
- Femoral stem: A stem connects the ball to your thighbone.
Hip replacement implants are available in different materials. Factors such as your age, the cost, and your activity level determine which option is best for you. Opinions on the best material vary between surgeons.
The following types are or were
The ball of the implant is made of metal, and the socket is made of or lined with a type of plastic called polyethylene. These implants were most common up to the
They’re still quite common and work for all types of people. But
The ball of the implant is ceramic, and the socket is made of plastic or lined with polyethylene. It remains the
The ball of the implant is ceramic, and the socket is lined with ceramic. A
One of the main concerns is persistent squeaking, which various studies report occur in
The ball of the implant is ceramic, and the socket is lined with metal. In a
Metal-on-metal implants were common until 2016 in the United States. They stopped being FDA-approved in 2016 due to unsatisfactory results and the production of small metal particles. In the early to mid-2000s, they made up about
A total hip replacement usually takes about 1 to 2 hours. You’ll receive a general anesthetic through an intravenous (IV) line and will be asleep during your procedure.
Surgeons use various surgical techniques to insert the implant. Each approach has its benefits and risks. Research hasn’t shown one approach to be better than the others.
The posterior approach was traditionally the most common technique. During this procedure, the surgeon makes an incision on the back of your leg close to your buttocks and cuts through your gluteus maximus muscle.
During the direct anterior method, a surgeon makes an incision at the front of your hip. The surgeon pushes aside the muscle and tendons to access your joint.
According to a 2015 study, about
Before your total hip replacement surgery
The following steps can help you prepare for your procedure:
- Find a driver for after your procedure.
- Quit smoking if you do.
- Maintain a moderate weight.
- If you have diabetes, ensure that it’s under control.
- Tell the surgeon about any medications and supplements you’re taking.
- Follow the surgeon’s advice about when you need to stop eating and drinking.
- Add grab bars or railings to your bathroom and make other changes to your home to make getting around easier while you’re recovering.
Like with every surgical procedure, a total hip replacement comes with some risk. Serious complications such as infection occur in less than 2% of people.
Other potential risks include:
- blood clots
- uneven legs
- hip dislocation
- nerve and blood vessel injury
Following the surgeon’s recovery instructions can give you the best chance of a smooth recovery. Most people can resume light activity about 3 to 6 weeks after surgery. The surgeon may recommend:
- pain relievers such as opioids, nonsteroidal anti-inflammatory drugs, or acetaminophen (Tylenol)
- having your stitches removed after about 2 weeks
- eating a balanced diet with an iron supplement to promote healing
- drinking plenty of fluids
Regular exercise after your procedure is crucial for increasing strength and mobility. Your surgeon and physical therapist may recommend 20 to 30 minutes of exercise daily during the early recovery. They may recommend exercises such as:
While sitting on a chair or lying on a bed, move your ankle up (toes toward you) and down (toes pointing away from you) slowly. You can do this with one or both ankles.
Bed-supported knee bends
While lying down on your back, slide your foot toward your buttocks while keeping your heel on your bed. Just make sure to hold the bent knee for 5 seconds before straightening.
Straight leg raises
While lying down on your back, use your thigh muscles to lift your leg off your bed with your knee fully straight. Just make sure to hold your leg in the air for a couple of seconds before lowering it.
Standing knee raises
Raise your leg until your thigh is parallel to the ground while holding a chair for balance. Just make sure to hold your raised knee for 2 to 3 counts before lowering. Do not lift your knee higher than your waist.
Standing hip extensions
Extend your leg back as far as you can while holding a chair for balance. Just make sure to hold your extended leg for 2 to 3 counts before lowering it again.
The American Academy of Orthopaedic Surgeons recommends asking a doctor if you should avoid the following while you’re still recovering:
- crossing your legs at the knee for 6 to 8 weeks
- bringing your knee higher than your hip
- leaning forward while sitting
- picking something off the floor from a seated position
- turning your feet inward or outward when bending down
- reaching down to pull up blankets in bed
- bending at the waist beyond 90 degrees
Talk with your dentist
It’s important to tell a dentist about your hip replacement before undergoing any dental procedures. Some dental procedures can cause bacteria to travel through your blood and settle in your artificial joint, which may increase your risk of infection. The dentist may recommend taking antibiotics before your procedure to lower this risk.
Hemiarthroplasty, or a partial hip replacement, is a simpler surgery with a shorter surgery time. In a
Resurfacing is an even less invasive procedure. It involves replacing only the surface of your femur.
But resurfacing comes with its own risks. Most resurfacing procedures involve metal-on-metal surfaces. Surgeons rarely pursue this option because of the risk of metal corrosion and debris.
Here are some frequently asked questions people have about total hip replacements:
What is the success rate for total hip replacement surgery?
Many studies have found that more than
Can I have both hips replaced at the same time?
You can have hip replacement surgery on both hips at the same time or one at a time. Both hips at the same time is called a bilateral procedure.
How long do hip replacements last?
In a 2019 review, researchers found that about
A total hip replacement is a procedure where a surgeon replaces the ball and socket of your hip with implants. It’s a common treatment for late stage osteoarthritis and other conditions that cause hip pain.
A doctor can help you figure out if you’re a good candidate for a hip replacement. Some people can benefit from less invasive procedures such as a partial hip replacement or resurfacing.
There are several different approaches to total hip replacement surgery. They each have their benefits and risks, and no one is better than the other. What’s most important is to find a surgeon you’re confident in.