Total Hip Replacement Surgery

Total hip replacement is a surgical procedure in which the damaged cartilage and bone are removed from the hip joint and replaced with artificial components. The hip joint is one of the body's largest weight-bearing joints, located between the thigh bone (femur) and the pelvis (acetabulum). It is a ball and socket joint in which the head of the femur is the ball and the pelvic acetabulum forms the socket. The joint surface is covered by smooth articular cartilage which acts as a cushion and enables smooth movements of the joint.

Symptoms

The most common symptom of hip arthritis is joint pain and stiffness resulting in limited range of motion. Vigorous activity can increase the pain and stiffness which may cause limping while walking.

hip joint

Why a total hip replacement?

Several diseases and conditions can cause damage to the articular cartilage. Total hip replacement surgery is an option to relieve severe arthritis pain that limits your daily activities.

Arthritis is inflammation of the joints resulting in pain, swelling, stiffness, and limited movement. Hip arthritis is a common cause of chronic hip pain and disability. The three most common types of arthritis that affect the hip are:

  • Osteoarthritis: It is characterized by progressive wearing away of the cartilage of the joint. As the protective cartilage wears down, the bone ends rub against each other and cause pain in the hip.
  • Rheumatoid arthritis: This is an autoimmune disease in which the tissue lining the joint (synovium) becomes inflamed, resulting in the production of excessive joint fluid (synovial fluid). This leads to loss of cartilage causing pain and stiffness.
  • Traumatic arthritis: This is a type of arthritis resulting from a hip injury or fracture. Such injuries can damage the cartilage and cause hip pain and stiffness over a period.

Surgical Procedure

Surgery may be recommended if conservative treatment options such as anti-inflammatory medications and physical therapy do not relieve the symptoms.

The surgery is performed under general anesthesia. During the procedure, a surgical cut is made over the hip to expose the hip joint and the femur is dislocated from the acetabulum. The surface of the socket is cleaned and the damaged or arthritic bone is removed using a reamer. The acetabular component is inserted into the socket using screws or occasionally bone cement. A liner made of plastic, ceramic, or metal is placed inside the acetabular component. The femur or thigh bone is then prepared by removing the arthritic bone using special instruments, to exactly fit the new metal femoral component. The femoral component is then inserted into the femur either by a press fit or using bone cement. Then the femoral head component made of metal or ceramic is placed on the femoral stem. All the new parts are secured in place using special cement. The muscles and tendons around the new joint are repaired and the incision is closed.

Post-operative care

After undergoing total hip replacement, you must take special care to prevent the new joint from dislocating and to ensure proper healing. Some of the common precautions to be taken include:

  • Avoid combined movement of bending your hip and turning your foot inwards
  • Keep a pillow between your legs while sleeping for 6 weeks
  • Never cross your legs and bend your hips past a right angle (90)
  • Avoid sitting on low chairs
  • Avoid bending down to pick up things, instead, a grabber can be used to do so
  • Use an elevated toilet seat

AFTER SURGERY

After surgery, you will feel pain. This is completely normal and part of the healing process. Your doctor and nurses will work together to reduce your pain, this will help you recover faster.

Prior to you leaving the hospital your doctor will send a prescription to your pharmacy for some short-term pain relief after surgery. Your doctor may suggest multiple medications to help manage your pain, such as opioids, non-steroidal anti-inflammatory drugs (NSAIDs), and local anesthetics. Your doctor will discuss which options or combinations would be best for you.

OPIOIDS

At MD West One, your health is always a top priority, which is why we are very passionate about getting you back to full activity in a safe and timely manner. We understand every patient is unique when it comes to pain management. A key component of a successful pain treatment plan includes weighing all risks and benefits to find the pain treatment plan that best fits you.

A high risk of dependence and overdose is associated with the use of opioids. To avoid this from accruing our agreement with you:

  1. You should take all medications as ordered by your provider. If you take the medication in excess of what is prescribed and run out of the medication prior to the refill date, the refill will not be authorized early.
  2. If you are requiring a refill of your prescription please call during regular business hours. Our providers will not refill any pain medications over the weekend, holidays, or after clinic hours.
  3. Make sure to tell your physician or nurse which medications you are taking, including herbal remedies, since narcotic medications can interact with over-the-counter medications and other prescribed medications, especially cough syrups that contain alcohol, codeine, or hydrocodone.
  4. Alteration of any written prescription, sharing, trading, or selling your medication is a federal offense and will be reported.
  5. You are responsible for keeping your pain medication in a safe and secure place, such as a locked cabinet or safe. Stolen medications should be reported to the police and to your physician immediately.
  6. If your medications are lost, misplaced, or stolen, your physician may choose not to replace the medications or to taper and discontinue the medications.

Risk Factors

As with any major surgical procedure, there are certain potential risks and complications involved with total hip replacement surgery. The possible complications after total hip replacement include:

  • Infection
  • Dislocation
  • Fracture of the femur or pelvis
  • Injury to nerves or blood vessels
  • Formation of blood clots in the leg veins
  • Leg length inequality
  • Hip prosthesis may wear out
  • Failure to relieve pain
  • Scar formation
  • Pressure sores

Total hip replacement is one of the most successful orthopedic procedures performed for patients with hip arthritis. This procedure can relieve pain, restore function, improve your movements at work and play, and provide you with a better quality of life.

Are you interested in seeing if you're a candidate for total hip replacement surgery? Don't wait any longer to get relief. Make an appointment to see one of our total joint specialists. 

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AMERICAN ASSOCIATION OF HIP AND KNEE SURGEONS

This article has been written and peer-reviewed by the AAHKS Patient and Public Relations Committee and the AAHKS Evidence-Based Medicine Committee.