Hip replacement is surgery to reconstruct all or part of the hip joint with an implant device. The implant is called prosthesis.
The artificial hip joint has four parts
- A cup shaped socket that lines your bony hip socket. The socket is usually made of metal.
- The liner, which fits inside the socket. It is usually polyethylene plastic. Metal and ceramic materials have also been used. The liner is the bearing surface allows the hip to move smoothly.
- A metal stem that is inside the shaft of the thigh bone to transfer load to the leg.
- A metal or ceramic ball is attached to the top of the stem to form the ball of the ball and socket hip joint.
You will receive an anesthetic chosen for you by your doctors to make your surgery comfortable. This means you will be unaware and unable to feel pain.
After you receive anesthesia, your surgeon will make a surgical incision to expose your hip joint. There are different approaches to the hip and your surgeon will chose the best approach for you. Often this incision is place on the side of your hip with you lying on your side. Then your surgeon will:
- Remove the ball of your hip joint
- Shape your hip socket and remove the remaining damaged cartilage and arthritic bone.
- Put the new hip cup and liner in place, then insert the metal stem and ball into your thigh bone.
- Secure all the new parts in place, sometimes with special cement. .
- Repair the muscles and tendons around the new joint.
- Close the surgical incision.
This surgery usually takes 1 to 3 hours.
The most common reason to have a hip joint replaced is to relieve severe arthritis pain that is limiting your activities.
Your doctor may recommend a hip replacement when these problems are not treatable with medical means:
- You can't sleep through the night because of hip pain
- Your hip pain has not gotten better with other treatments
- Hip pain limits or prevents you from doing your normal activities, such as bathing, preparing meals, doing household chores, and walking
- Fractures in the thigh bone. Older adults often have hip replacement for this reason
- Bone tumors involving the hip joint.
Before the procedure
- Be sure tell your doctor or nurse what drugs you are taking, whether it is prescription medication or drugs, supplements, or herbs you bought without a prescription
- Two weeks before surgery you may be asked to stop taking drugs that make it harder for your blood to clot. These include aspirin, ibuprofen (Advil, Motrin), naproxen (Naprosyn, Aleve), and other drugs or dietary supplements.
- Ask your doctor which drugs you should still take on the day of your surgery.
- If you have diabetes, heart disease, or other medical conditions, your surgeon may ask you to see your medical doctor who treats you for these conditions.
- Attend the pre-op Joint Class.
- You will have a large dressing (bandage) over your surgical incision. A small drainage tube may be placed during surgery to help drain blood that collects in your hip joint after surgery.
- You will have an IV (a tube, that is inserted into a vein, usually in your arm). You will receive fluids through the IV until you are able to drink on your own.
- You may have a urinary catheter inserted into your bladder to drain urine. Usually it is removed the day after surgery.
- You may all wear special inflatable compression stockings on your legs. These stockings improve blood flow and reduce your risk of getting blood clots.
- Most people will also take blood-thinning medicine to reduce the risk of blood clots. This will be continued after you go home.
- Your doctor will prescribe pain medicines to control your pain. Your doctor will give you antibiotics after surgery to prevent infection.
- You will be helped to sit at the edge of the bed by nursing staff the evening of your surgery.
- A physical therapist will work with you the day after surgery to help you get out of bed and to a chair. You will be able to walk a short distance.
- When you are in bed, pump your ankles often. You will also be taught other leg exercises to do while you are in bed to prevent blood clots. It is important to do these exercises every few minutes while awake.
- By the second day, you will be encouraged to do as much as you can for yourself with staff assistance available. This includes getting out of bed with assistance as needed and walking to the bathroom and taking walks in the hallways.
- You will learn the proper positions to protect your new hip during the healing period.
Most patients stay in the hospital three nights. Some may need a short stay in a rehabilitation center or a skilled nursing unit after they leave the hospital and before they go home. Our goal is to return you to your home when you are safe and able.
Hip replacement surgery results are usually excellent. Most or all of your pain and stiffness should go away in the first 6 weeks with your full recovery of function and strength returning in one year.
People who have prosthesis, such as an artificial joint, need to carefully protect themselves against infection. You should carry a medical identification card in your wallet that says you have a prosthesis. You should take antibiotics before any dental work or invasive medical procedures likely to cause bacterial contamination.