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All you need to know about hip replacement surgery

What is hip replacement surgery?

Also called total hip arthroplasty, a hip replacement surgery is an option for people that have tried other types of treatments for arthritis on the hip joint.

Basically, there are three sources of arthritis that affect the hip joint:

  • Osteoarthritis. A degenerative joint disease that affects mostly middle-aged and older adults, causing joint cartilage and surrounding bone in the hips breakdown. Osteoarthritis is the most common cause of damage and causes pain, swelling, and reduced motion in your joints.

About 90% of patients who undergo hip replacement have hip osteoarthritis.

  • Rheumatoid arthritis. It causes inflammation of the synovial lining of the joint and extra synovial fluid.

  • Traumatic arthritis. This type of arthritis is caused by an injury and damages the hip cartilage.

A hip replacement replaces a worn out or damaged hip joint with an artificial joint (prosthesis), usually made of metal, ceramic, or hard plastic.

What are the benefits of hip replacement surgery?

According to the National Institute of Arthritis and Musculoskeletal and Skin Diseases, a hip replacement surgery can:

 

  • Relieve pain

  • Help your hip joint functionality

  • Improve body movements like walking and others

Who is an ideal candidate for hip replacement surgery?

More than 327,000 people have total hip replacement surgery in the United States each year.

 

You may want to consider a hip replacement surgery if your hip joint causes severe pain and interferes with your daily activities such as walking, going upstairs, and bending to get in and out of chairs.

 

Doctors recommend this surgery when the hip joint damage is caused by a medical condition, such as osteoarthritis, rheumatoid arthritis, osteonecrosis, or bone tumors.

 

Other criteria for hip replacement surgery involves:

 

  • When you experience pain even while resting or sleeping

  • When the joint degeneration has caused stiffness and improper range of motion during normal activities

  • When symptoms are not adequately alleviated by non-surgical treatments, such as non-steroidal anti-inflammatory drugs (NSAIDs), physical therapy, steroid injections, or the use of a cane or walker.

 

If you feel identified with these parameters, ask your doctor if you are a candidate for minimally invasive surgery, because of its faster recovery and reduced pain when compared to open surgery.

Who may not be an ideal candidate for hip replacement surgery?

Even if you meet the aforementioned criteria, there is still a chance of not being a good candidate for hip replacement surgery, mainly because of a greater than average risk of post-surgical complications.

 

These reasons include:

 

  • Patients who are prone or have an existing infection.

  • Patients who use tobacco are ten times more likely to have medical complications. Candidates for total hip replacement are encouraged to quit or cut back on tobacco use.

  • Patients who have severe osteoporosis are not suitable as the bones may be too brittle to properly support and adhere to the new joint prostheses.

  • Patients who are unable to follow with pre- and post-surgical instructions., like those who suffer from dementia or alcoholism.

Which types of hip replacement surgery are available?

The three major types of hip replacement are:

 

  • Total hip replacement (most common)

  • Partial hip replacement. Involves replacing only one side of the hip joint. This procedure is most commonly performed in older patients who have fractured their hip.

  • Hip resurfacing. Most commonly done in younger, active patients.

What are the risks of hip replacement surgery?

The vast majority of total hip replacement surgeries are successful. However, like any major surgery, there are some possible risks:

 

  • Dislocation of the ball of your new joint, particularly in the first few months after surgery. An estimated 3 to 4% of hip replacement patients have at least one episode of hip dislocation, making it the single most common complication.

 

  • Infection. Occurs at the site of incision has an incidence of about 1% of patients.

 

  • Blood clots can form in your leg veins after surgery. Your doctor will prompt you to follow physical therapy and prescribe blood-thinning medications to reduce this risk.

 

  • Inflammation and swelling.

 

  • Change in leg length. Occasionally, a new hip makes one leg longer or shorter than the other, caused by a contracture of muscles surrounding the hip. Small differences in leg length can be countered with special shoe inserts.

 

  • Need for revision or additional hip surgery.

 

  • Nerve injury that causes weakness, numbness, or both.

  • An allergic reaction to the bone cement used.

You may have other risks depending on your specific health condition.

What is hip replacement surgery like?

A hip replacement surgery takes about two hours and is performed under general anesthesia. You can expect to stay at the hospital for two to three days.

 

During hip replacement surgery, the surgeon resurfaces the bones that form the ball-and-socket of the hip joint.

 

The femoral head is then removed and replaced with a prosthetic ball.

 

This ball is connected to a stem that is inserted into the marrow space of the upper thigh bone (femur).

 

The rounded socket of the pelvis is resurfaced and lined with a prosthetic cup.

 

After, the prosthetic femoral ball fits into the prosthetic hip socket to form a new hip joint.

 

A positioning splint, such as a foam pillow placed between your legs, may be used to protect your hip during early recovery.

What is the success rate of hip replacement surgery?

Hip replacement surgery has a 96% success rate.

 

According to the American Academy of Orthopaedic Surgeons, hip replacements have an 80% chance of lasting at least 20 years, and some can last even longer.

How is the hip replacement surgery recovery like?

Your recovery starts 24 hours after surgery. Your therapist will help you sit up, get in and out of bed, and practice walking and climbing stairs using a walker, cane or sometimes crutches.

 

As the days progress, you will increase the distance and frequency of walking.

 

Patients are prompted to wear special compression stockings and take blood thinners for several days to weeks to reduce the chances of developing blood clots in the legs.

 

Physical therapy extends outside of your medical facility for six to eight weeks to improve and restore strength and mobility on your new joint. You are able to use warm or cold compresses for 10 to 20 minutes to help warm up the joint and to control swelling after therapy.

 

After this period, you may return to everyday activities under your therapist guidelines and precautions.

 

These precautions include: special abductor pillows, avoiding crossing the legs, as well as excessive bending or rotating of the hip.

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