Hip Replacement Surgery – What You Need To Know

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lady sitting down with her hand on her hip

A hip replacement surgery (Hip Arthroplasty) involves removing the hip joint and replacing it with a ‘ball’ implant or new hip socket. The implants may be plastic, metal, or ceramic ball.

The surgery is performed by hip and knee surgeons to reduce pain and improve mobility for individuals suffering from hip osteoarthritis – a degenerative joint disease – and those unable to tolerate conservative treatment.

This type of operation can generally involve total amputation of the femur and acetabulum, replacing the hips with both the femur and hip sockets.

This article describes hip replacement surgeries in general, their preparation, and the expected outcome.

What Are The Hips Exactly?

The hip is the biggest joint in the body. The hip joint is a ball and socket joint that facilitates mobility while providing the stability required to bear body weight.

The socket region (acetabulum) is located within the pelvis. It forms the hip joint with the acetabulum. The top of the thighbone is the ball component of this joint (femur).

The ball-and-socketed surface features articular cartilage, which provides cushioning and allows easy movement of bones. A thin membrane of synovial membrane surrounds hip joints. In a healthy hip, the membrane is filled with tiny particles of fluid that lubricate cartilage and reduce most friction.

What is Hip Replacement Surgery?

Hip replacement surgery – is an orthopedic surgery that involves removing and replacing parts of the femur (thigh bone) and pelvis that make up the hip joint. It is generally used to treat hip pain and stiffness caused by hip arthritis.

This treatment also addresses injuries such as a fractured or incorrectly developing hip and other disorders.

Also called hip arthroplasty, hip replacement is basically to address hip pain. Hip replacement surgery involves the replacement of one or both parts of the hips.
Artificial implants are used to replace components of the hip joint during surgery. The procedure’s purpose is to allow you to continue everyday activities and exercise with minimal pain.

How Do I Know I Need A Hip Replacement Surgery?

You require a hip replacement if you have pain, inflammation, and damage to your hip joints. It is best to follow your doctor’s recommendations. But your doctor will most likely recommend this surgical procedure if you have any of the following conditions:

  • Osteoarthritis (most common condition)
  • Rheumatoid arthritis
  • Osteonecrosis (avascular necrosis)
  • An injury such as a hip fracture
  • Tumor in the hip joint
  • Low quality of life due to the pain.

Here’s how to tell if the quality of your life is suffering due to hip pain

  • You cannot get sound sleep because of the pain
  • You find it difficult to do simple everyday tasks such as climbing the stairs or getting dressed
  • You cannot fully partake in the activities you enjoy

Usually, hip replacement surgery is the last resort. So, your doctor may recommend other forms of treatments, like taking medicine for pain or inflammation, joint injections, walking aids, and physical therapy.

If these treatments do not work, your doctor will likely recommend hip replacement surgery to restore function and improve quality of life.

person with painful hip

Types of Hip Replacement Surgery

There are different types of hip replacement surgeries. Several factors help determine what type of hip replacement your doctor may recommend. Here are the types of hip replacement surgery:

Total Hip Replacement vs. Partial Hip Replacement

Sometimes, the surgical procedure is determined by what parts of the hips need to be replaced. Are you going for a total hip replacement (total hip arthroplasty) or partial hip replacement?

Total hip replacement, sometimes called total hip arthroplasty, involves replacing the ball and socket.
In a total hip replacement procedure, the surgeon removes the hip joint and replaces it with a hip implant.

For more context, the hip joint comprises a ball-and-socket synovial joint, with the femoral head as the ball and the acetabulum as the socket. The hip joint connects the axial skeleton to the lower extremities by articulating the pelvis with the femur.

So, the whole hip joint is removed in total hip replacement surgery. As complicated as it may appear, hip replacement surgery is one of the most common orthopedic operations.

Partial hip replacements occur when the orthopedic surgeon only replaces the ball.
Unlike a total hip replacement, this treatment does not replace the hip joint’s socket. Instead, the surgeon removes and replaces only the ball of the joint. This is a common surgery for the elderly, especially after a hip fracture caused by a fall.

Anterior, Posterior, Or Lateral Hip Replacement

Orthopedic surgeons can access the hip from different angles. Some of these include:

  1. Anterior approach to hip replacement (Through the front)
  2. A lateral approach to hip replacement (Through the side)
  3. Posterior approach to hip replacement (Through the back)

Methods of Hip Replacement Surgery

Minimally Invasive Hip Replacement

Minimally invasive surgery is done to minimize the effect of surgery on tissues, muscles, and blood vessels.

A minimally invasive hip replacement surgery means your surgeon will access the hip joint through one or two minor incisions by moving the muscles aside.

Most orthopedic surgeons prescribe this for hip replacement because:

  • This surgery has a quick and easier recovery than other hip surgical procedures
  • It provides a lower risk of muscle damage
  • It brings less pain and less limping.
  • Since the recovery time is fast, your stay in the hospital is short
  • With this surgery, you have a lower chance of hip dislocation.

Traditional Hip Replacement

In a traditional hip replacement surgery, the surgeon has to make a big opening to gain access to the hip bone. The surgeon performs the hip replacement using the lateral approach (from the side) or using the posterior system (from the back)

Because the surgeon must cut through or detach several muscles and tendons to reach the joint, recovery following a typical hip replacement can be extended. (When the hip implants are in place, the muscles and tendons are healed.) You may be at risk of dislocation until all of the supporting components in your new hip have healed.

Consult your orthopedic hip surgeon to determine which surgical procedure is best for you.

What To Do Before Hip Replacement Surgery.

Besides trying to stay in shape as well as possible there are some exercises you can do before the surgery.

Just make sure to consult your doctor or physical therapist before starting these exercises to make sure they are the right ones for you and use the right exercise equipment if you need them.

Components of a Hip Replacement Implant (Hip Prosthesis)

The hip replacement implant, commonly known as the hip prosthesis, is made up of two parts: a ceramic ball and a metal cup.

The ceramic ball linked to a metal stem is implanted into the thigh bone (femur) for stability. A while ago, the ball was made of metal, but nowadays, it is made of ceramic.

The metal cup has an inner plastic layer fitted to the hip joint’s socket portion (acetabulum) to allow the prosthetic joint to spin smoothly.

Is a Hip Replacement a Major Operation?

Yes, it is. Because a hip replacement is a major surgery, it is typically advised only when other treatments, such as physiotherapy or steroid injections, have failed to relieve pain or improve mobility.

What are Some Benefits of a Hip Replacement?

Pain relief is the most significant benefit and the primary purpose of hip replacement surgery. Other advantages of the technique include the following:

  • Improved mobility.
  • Improved strength.
  • Improved torso and leg coordination.
  • The capacity to walk, climb stairs, and live an active lifestyle more comfortably.
  • The survival rate is excellent. Less than 1% of patients who have had a hip replacement die within 90 days after the procedure.

What are The Risks Associated With Hip Replacement Surgery?

Every surgery has risks, but as far as surgeries go, hip replacement surgery is very safe. However, complications of hip replacement surgery can include the following:

Hip dislocation:

Certain positions can make the ball of the new joint pop out of the socket, especially during the first few months of surgery.

If the hip dislocates, your doctor may recommend a brace to keep the hip in the proper position. However, if the hip keeps dislocating, you may require another surgery to stabilize it.

Infection:

Infections can occur at the surgery site and in the tissue near the new hip.
Mild infections can be treated with antibiotics, but a significant infection may require surgery to replace the artificial joint or artificial hip.

Nerve Damage:

This occurs rarely, but in the occasion that it does, nerves in the area where the implant is, are injured. This causes numbness, weakness, and pain.

Change in Leg Length:

A new, artificial hip may cause one leg to be shorter or longer than the other. A constriction of the muscles around the hip can sometimes cause this.

In some circumstances, gradually strengthening and extending specific muscles may be beneficial. Slight variations in leg length are generally undetectable after a few months.

Loosening of the Joint

This occurs in up to 5 out of every 100 hip replacements. It can produce discomfort and give the impression that the joint is unstable.

Joint loosening can occur when the artificial joint becomes loose in the hollow of the thigh bone (femur) or bone thinning around the implant.
It can occur at any moment. However, it commonly occurs 10 to 15 years after the first operation.
Another procedure (revision surgery) may be required if your orthopedic surgeon advises it. Though, this is not always the case.

Blood Clots in your Lungs

Although it is implausible, it is possible that there may be blood clots in your lung (pulmonary embolism), which requires immediate treatment.
You will be given blood-thinning medications and compression stockings to lower your risk of blood clots.
Moving your legs as soon as possible after hip replacements is an excellent strategy to avoid this. Consult your doctor to determine what you should be doing.

What is the Average Recovery Time for Hip Replacements Surgery?

Recovery starts within 24hrs after surgery.

As days pass, your doctor will recommend increasing the distance and frequency of walking. Depending on your type of surgery, you can progress to using a walker, cane, or crutches to walk around within a day or two after surgery.

Full recovery can take anywhere from 2-8 weeks, depending on several factors.

What Happens After Surgery?

You will be given pain medicine and an antibiotic after surgery. Your surgeon may recommend medications or physical therapy to avoid blood clots.

You may be given medicine, special socks, and ankle pumps for 2-3 days following surgery to reduce your risks of developing a Deep Vein Thrombosis (DVT).

Depending on how your orthopedic surgeon closed the surgery site, you may be scheduled for an appointment to have the staples or external sutures removed (if present).

If you have any of the subsequent symptoms, you should contact your orthopedic surgeon:

  • Your skin has turned very red.
  • New or increased swelling or pain
  • Drainage around the incision
  • Bumpy or pimpled skin.
  • Any additional developments you are unsure about?

If there are no new developments, you will meet with your physical therapist within 24 hours.

One product that might be advised to use after hip replacement is toilet height extenders to make it less painful on your hips to use the bathroom.

Another one is a step stool for the bed to make it easier to get in and out of the bed for the period you need to recover.

How Long Will You be in The Hospital?

Consult your healthcare practitioner about the optimal recovery strategy. You might remain in the hospital or surgery center for up to two days following surgery.
If it is risky for you to return home from the hospital or surgery center, you may need to go to a rehabilitation facility before being discharged.

Three factors determine the length of time spent in the hospital:

  1. If your pain is under control: You will not be allowed to go home if your pain is severe.
  2. How well you move about safely: You will not return home if you appear in danger.
  3. How medically stable you are: You won’t be allowed to leave if your blood pressure is too high, for example.

How Painful Is a Hip replacement?

Following hip replacement, some swelling and discomfort at the joint are usual. To alleviate pain:

  • Take a break between therapy sessions.
  • Ice the leg and the location of the incision.
  • After checking with your doctor, use anti-inflammatory drugs to alleviate these symptoms.

It is critical to monitor your pain levels. Mention it to your doctor if you constantly feel at a six or above on a 1-10 pain scale since this might indicate infection or another issue. If you continue physical therapy, your pain levels should gradually reduce to approximately 1 or 2 in 12 weeks following the hip replacement.

What You Cannot do After a Hip Replacement

Before starting any exercise it is important to talk to your doctor or physical therapist first. Here are a few recommended exercises to do after hip replacement surgery.

Following hip surgery, you should avoid twisting your hip joint more than 90 degrees in any physical activity (including intimacy) and turning your legs in the following direction. This will keep your hip joint safe as it heals.

Exercises You Can Do After Hip Surgery

Stick to the essentials and resist the urge to attempt anything new. If you have any queries or suffer further discomfort, contact your doctor.

If you feel well enough to travel, you’re probably OK. Call your doctor if you have any queries. They can always steer you on the proper path! Remember to listen to your body.

people doing exercises to benefit their hip mobility

Will You Need Revision Hip Replacement Surgery?

Over time, your hip implant may wear out or loosen. Your hip implant can also be dislocated if you suffer an injury or dislocation. 

Most hip prostheses have a lifespan of 20 years or more. You may extend the life of your implant by engaging in frequent low-impact activity, avoiding high-impact exercise (such as running), and taking safety precautions.
To repair the damaged elements of the prosthesis, you may require revision surgery.

 Infection is a rare complication of hip replacement, which can occur if bacteria in the bloodstream become trapped in the prosthetic components.

A diseased hip joint caused by an infection may require revision surgery to remove affected tissues and medications to eradicate the germs. When the infection clears, your surgeon can insert a new prosthesis.

If you undergo a partial hip replacement (just the ball component of the joint), you may need to have the socket replaced later.

Eddie Vandam

Eddie Vandam realized when he was getting older that it was hard to find information about products for seniors and decided to share his experiences here on the website to help others. Read more.

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