Hip replacement surgery: an overview of what to look for

Hip replacement surgery (hip replacement) involves removing a damaged or diseased hip joint and replacing it with an artificial implant.

This surgery is most often performed to relieve pain and improve mobility in patients with symptoms of hip osteoarthritis that have not gone away with conservative treatment.

The most common type of this surgery is total hip replacement, which replaces the acetabulum (hip) and the head of the femur (the ball of the hip).

What is hip replacement surgery?

Hip replacement surgery is considered very successful with reliable results. A new hip works like a normal hip and significantly improves quality of life.

In a total hip replacement , part of the pelvis and the head of the femur are completely removed. They are replaced with similar implants: a cup that serves as the socket and a ball that serves as the head of the femur. A metal rod is inserted into the femur to secure the new head.

When only the head of the femur is replaced with a prosthesis, the operation is called a partial hip replacement (hemiarthroplasty) .

Hip replacement is performed by an orthopedic surgeon . Although the procedure is traditionally performed in a hospital setting, some patients may be eligible for surgery on an outpatient basis.

What is a same day hip replacement?

Same day hip replacement allows the patient to have a hip replacement installed on an outpatient basis without having to stay overnight. It is also called rapid hip recovery because it promotes faster healing.

Various surgical techniques

There are several options for how the surgeon can perform a hip replacement:

  • Posterior approach: this is the most common method. They operated on him because he is lying on his side; An incision is made on the outside of your thigh, next to your buttock. The muscles are cut to access the hip joint.
  • Lateral approach: This is essentially the same as the posterior approach, except that the incision is made on the outside of the thigh, closer to the front of the body (rather than the buttocks).
  • Direct anterior approach : You lie on your back and the incision is made in the front of the thigh. This is sometimes called a muscle sparing hip replacement because the surgeon works around the muscles (rather than cutting them) to gain access to the hip joint.

Some may be more appropriate for you than others, and it is worth discussing which approach your surgeon wants to use and why.

Implant options

Hip implant options fall into two categories:

  • One-piece implants where the socket and the head are aligned
  • Modular implants in which each of these components is available (and can be selected) separately

These pieces can be made of plastic, metal, ceramic, or a combination of both. A spacer is placed between the two components so that they can be moved easily.

Some implants can be anchored with acrylic cement or screws, while others can be pressed (basically pushed into place so new tissue can grow that can hold them in place).

All of these options have their pros and cons, as well as varying levels of durability.

Contraindications

Certain medical circumstances can make this operation completely contraindicated. Active infection and severe osteoporosis are two examples.

Contrary to the opinion of some, age is not a clear contraindication for hip replacement.

However, since these implants wear out over time, having surgery at a young age means that at some point, you may need to have it redone. Old age can sometimes be an exclusion factor for hip replacement when the risk of surgery is too high.

Your healthcare provider will decide on the safety and need for a hip replacement in your particular case after reviewing your medical history, hip images, lifestyle choices, desire for recovery, and more.

Potential risks

Get Medical Information / Jessica Olah

Hip replacement may present a certain risk or a higher level of risk, depending on your medical condition.

Generally speaking, the possible risks of hip replacement include:

There is also the possibility that the hip implant will loosen , symptoms will persist, or a new operation will be required.

Fortunately, only 4% of adults who undergo hip replacement surgery experience complications.

Purpose of hip replacement surgery

If you have tried other treatments for your symptoms without success and they significantly affect your daily life, your healthcare provider may suggest a hip replacement.

These include pain relievers, activity modification, physical therapy, and the use of walking aids (such as a walker).

A hip replacement may be recommended in cases where the hip joint has deteriorated due to:

The damaged / diseased parts of the hip joint are replaced with:

  • Reduce persistent hip pain
  • Improve joint mobility
  • Regain confidence and ease of movement for a better quality of life

About 85% of hip replacement patients have good results after 20 years. The American Academy of Orthopedic Surgeons calls the operation "one of the most successful operations in all of medicine."

How to prepare

Preparation for a hip replacement begins a few weeks before the procedure and includes both preparing your body for and recovering from surgery, as well as solving practical problems.

Some of the tips your healthcare provider can give you:

  • Try to lose weight and quit smoking, if possible, to reduce the risk of complications.
  • Stay active and do whatever exercises your healthcare provider recommends to build strength.
  • Get help around the house, like shopping, cooking, and cleaning.
  • As you recover, make sure your home is as safe and accessible as possible. For example, move frequently used items to easily accessible areas, clean up clutter, consider lifting the toilet seat, etc.
  • Use the recommended means of transportation, such as a cane or crutches.

What to Expect the Day of Surgery

Hip replacement generally takes one to two hours.

Despite the different surgical approaches, the steps for hip replacement are basically the same.

Regional or general anesthesia is used for this operation.

The surgeon makes an incision using a predetermined surgical approach and then, using precise instruments, removes bone and cartilage from the ball of the hip. They create surfaces that are ideal for placing implants.

In a complete hip replacement, a cup is first placed to serve as the new hip joint. (This is omitted for partial hip replacement).

The surgeon then pierces the end of the femur and places a metal rod to which an artificial femoral head is then attached. Finally, the ball is placed in the cup.

Once all the incisions are closed and the operation is complete, you move on to recovery. Steps will be taken to reduce pain, minimize swelling, and move safely.

You will stay in the hospital for at least one night (unless you have an outpatient procedure, in which case you will be discharged the same day).

Some patients may be discharged to a nursing or rehabilitation facility if the surgeon feels they need more time and help to recover.

Recovery

The success of hip replacement surgery is due in large part to the rehabilitation period that follows the surgery. Most of your progress will occur in the first few months after surgery, but recovery should continue after that.

You will work with a physical therapist to restore normal gait , maintain hip mobility, improve lower extremity strength, and more.

Do nothing until you are allowed to. Walking with a cane, walker, or crutches will help you feel more confident on your feet.

You will be given instructions for proper wound and shower care, which you must follow carefully.

Swelling of the calves and ankles is not uncommon and should decrease every day.

Call your healthcare provider right away if you notice any possible signs of infection (such as fever or redness at the incision site) or blood clots (such as new or increasing leg swelling that does not improve with elevation).

Long term care

You may feel like a new hip is giving you new life.

As you enjoy days with less pain and more ease of movement, be sure to take steps to protect the integrity of the replacement and reduce the risk of injury.

The National Institute of Arthritis, Musculoskeletal, and Skin Diseases offers many tips to help you do this, including:

  • Avoid strenuous activities like jogging and basketball.
  • Doing a doctor-approved exercise that can support muscle strength and general fitness.
  • Wear supportive shoes with non-slip soles.
  • Save your home from tripping hazards
  • Make sure all parts of your home are well lit and have handrails and handrails where needed.

How long does a hip replacement take?

Estimates vary from study to study, but hip replacement can take 15 to 25 years. After this time, your doctor may recommend that you replace the implant.

Get the word of drug information

Hip replacement is a major operation, and the decision to perform it is a major one.

When weighing the possible risks, also think about the possible consequences of postponing the operation . Ask your doctor any questions you need to feel comfortable with your choice to continue (or not).

If you are under 60, hip resurfacing , which removes less bone, may be an alternative to ask about as it is easier to fix when needed.

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