Total hip replacement, which is also known simply as hip replacement or hip arthroplasty, is a long-term surgical treatment for reducing your hip joint pain and increasing your hip’s range of motion. Hip replacements are performed by orthopedic surgeons, physicians who specialize in treating diseases and conditions relating to the bones.
During total hip replacement surgery, you will be sedated. Your surgeon will make an incision, remove the hip joint, and replace it with an artificial one. Total hip replacements consist of man-made ball-and-socket joints that are typically composed of hard plastic, metal, or ceramic. Your joint may be any combination of those materials and should extend your quality of life for as long as 10 to 15 years.
It should be noted that there is a relatively new, less invasive alternative to total hip replacement called metal-on-metal hip resurfacing, which involves lining the head of the thigh bone and and socket portion of the joint with a layer of metal. Talk to your doctor to determine whether you should choose total hip replacement or metal-on-metal hip resurfacing.
Eligibility
Patients who are candidates for hip replacement surgery are most commonly those who suffer from osteoarthritis, a degenerative joint disease. Osteoarthritis causes cartilage, the smooth tissue that cushions the ends of your bones, to wear down. When this happens, friction is created as your bones rub against one another when you move. The friction, over time, causes further injury. Other candidates for a hip replacement are patients with damage to the hip joint resulting from trauma or rheumatoid arthritis, an autoimmune disease that causes destructive inflammation and destroys your bone tissue over time. Some patients born with hip deformities may also be candidates for hip replacement surgery.
Alternatives
Typically, physicians will first try less invasive forms of treatment before considering hip replacement surgery. The American Academy of Orthopaedic Surgeons suggests exploring the following nonsurgical treatments before considering hip replacement surgery:
- Physical therapy
- Weight management to reduce or maintain a healthy body mass index
- Mobility assistive devices such as canes, walkers, or crutches
- Analgesics, or pain-relieving medications
- Localized steroid injections
Risks
When these milder forms of treatment fall short of relieving your pain or fail to enable you to accomplish daily activities, it may be time for a hip replacement. Your doctor will discuss the following risks with you prior to surgery:
Complications that may occur during surgery:
- bone fractures
- nerve damage
- blood vessel damage
Complications resulting from and following surgery:
- blood clots
- infections
- prosthetic joint dislocation
- change in leg length
Complications that occur as the prosthetic ages:
- loosening of the prosthetic joint, increased propensity for dislocation
- joint stiffening, decreased range of motion
- implant breakage or wearing down of the prosthetic
Most unwanted effects rarely occur, are treatable, or can even be prevented with medication and compliance with discharge instructions. In-surgery complications are often treated during the course of the procedure. Your physician will carefully measure your leg lengths prior to surgery and do everything to preserve an equilibrium. If surgery does result in a change in one leg’s length after hip replacement, wearing a lift in one shoe can help make up the difference.
Post-Op Care
After surgery, you will be prescribed medications to prevent blood clotting and infection. In the hospital, your nurses and physical therapists will educate and train you to perform everyday movements in modified ways so that your risk of joint dislocation is reduced. According to the Mayo Clinic, less than 2% of patients who undergo total hip replacement surgery experience dislocation of their new hip joint. However, if the bone pops out of its socket, your surgeon may reposition the joint without having to perform another surgery. As your prosthetic ages, the wearing down of the implant is natural and may result in the loosening of the joint. This loosening may increase the likelihood of hip dislocation. Furthermore, at the end of its projected lifespan, the implant is more likely to break.
