Hip Replacement

Overview

Hip replacement is considered to be a highly successful surgery. An Orthopedic surgeon removes the damaged parts of the hip joint. These parts are replaced by artificial joints (implants) constructed of metal, ceramic and hard plastic. Also referred to as prostheses, the artificially constructed joints reduce pain and improve function.

Hip replacement is usually an option when all other treatment procedures fail to help patients relieve symptoms interfering with their daily activities. The surgery is a treatment course for damage caused by Arthritis.

What is a Hip Replacement?

Hip replacement is a surgical procedure involving removing and replacing damaged portions of the pelvis and femur (thigh bone) that form the hip joint. This surgery is recommended to help relieve hip pain and stiffness experienced by patients due to hip Arthritis.

Hip replacement surgery may be an option for treating other conditions and injuries, such as an abnormal growth of the hip, a broken hip, etc.

Types

Hip replacements are performed by using a posterior approach or an anterior approach. A posterior hip replacement involves an incision at the hip's side or back. An Anterior hip replacement is performed by making an incision at the front of the hip.

Here are the different types of Hip Replacement Surgery:

• Total Hip Replacement: This is the most common hip surgery involving artificial components to replace the entire hip structure. The procedure involves the surgeon inserting a stem into the patient's femur to achieve stability. The head of the femur is then replaced with a ball, and an artificial cup is used to replace the natural socket in the hip joint.
• Partial Hip Replacement: This surgery aims at repairing hip fractures. It involves removing and replacing the femoral head (the ball located at the top of the thigh bone). The surgeon will attach a ball made of metal or ceramic to the top of a stem inserted into the center of the femur. Surgeons typically perform this surgery to repair certain types of hip fractures.
• Hip Resurfacing: This surgery aims to relieve pain from cartilage loss. The surgeon will trim the damaged portion of the natural bone ball located at the top of the thigh bone. It is resurfaced using a smooth metal covering. Towards the last step, the surgeon will use a shell or metal to line the natural bone socket of the hip.

Am I a candidate for Hip Replacement?

This surgery is commonly recommended in patients with Arthritis to relieve pain. Severe hip arthritis is painful and limits one's daily activities. Hip joint replacement is usually suggested for ages 60 and above. The surgery works by relieving the following issues among patients with Arthritis:

• Inability to sleep through the night due to hip pain.
• Hip pain persists despite treatment with other methods such as medications.
• Hip pain restricts you from engaging in day-to-day activities, such as walking, bathing, household chores, preparing meals, etc.
• Inability to walk even with a cane or walker.

Symptoms

Here are some signs that you should consider if hip replacement surgery is right for you:

• Chronic and Significant Pain: Consult an orthopedic surgeon as soon as possible if you experience chronic and significant pain between your hip and knee. If the pain is constant and drives you to take painkillers regularly. If it keeps you awake at night, causes trouble walking or bending over, limping, using a walking aid, and/or does not go away with ample rest, It may be time to speak to a specialist and decide if you need surgery.
• Inability to accomplish Routine Tasks: The disability of the hip joint makes it difficult or even impossible to accomplish most routine tasks such as putting on your socks and shoes, bearing weight on the affected leg, walking typical distances, etc.
• Hip Stiffness: Most patients need hip replacement surgery if stiffness of the hip restricts their normal range of motion in the joint. Joint stiffness can make walking feel strenuous and bending the hip joint difficult. Many patients are unable to even lift their legs.
• No Relief from Pain: Suppose the pain does not respond to physical therapy, steroid injections, and anti-inflammatory medications. In that event, it is time to speak to your doctor about hip replacement surgery.
• Advanced Stage Arthritis/Joint Damage: Advanced stages of Arthritis do not respond to any alternative therapies. Therefore, it is essential to have a discussion with an Orthopedic specialist about surgery.
• Emotional and Mental Issues: Apart from physical pain, Hip Arthritis and damage can also take a toll on one's emotional and mental health. Chronic pain has been linked to severe issues and complications, which may increase the effects of preexisting mental illness, such as depression and anxiety.
• Side Effects from Pain Medications: Pain medications, if taken under the guidance of a medical expert, are usually safe and effective. However, these medications also have side effects if used for a long time, such as ulcers, dependence, stomach irritation, blood clots, increased tolerance for dosage, increased risk of stroke and heart attack, and a weakened immune system.
• Simple Surgical Procedures Failed to Help: Alternative surgeries to hip replacement surgery may work if there is minor damage. However, an orthopedic specialist may suggest hip replacement surgery if these simple procedures fail to offer relief. For example, severe hip fractures cannot be treated with replacement surgery, especially for older adults.

Success Rate and Results

Total hip replacement has been announced and reported as the best treatment option for dramatically reducing pain and improving function among individuals with the following conditions:

• Severe joint damage resulting from osteoarthritis
• Rheumatoid Arthritis

A recent study demonstrated that 6,168 patients who received their first (or major) total hip replacement and 2,063 with revision surgery between the years 1993 and 2005 were known to have experienced significant relief from symptoms. The surgery was found substantially helpful for patients.

Reports have revealed the following:

1. About 90% of patients experiencing moderate pain reported mild or no pain after five years of their first surgery.
2. About 89% of patients observing severe pain prior to their first surgery reported mild or no pain after five years.
3. About 80% of patients experiencing moderate pain before revision hip surgery reported mild or no pain after five years.
4. About 78% of patients experiencing severe pain before revision hip surgery reported mild or no pain even after 5 years.

Patients undergoing total hip surgery have reduced long-term self-reported physical quality of life and hip functionality. However, these individuals still perform physically better than patients who did not receive any treatment for advanced hip osteoarthritis. Overall, the level of post-surgical satisfaction is very high.

A clinically significant improvement occurred in about 90% of patients with hip replacement and 70% of those with a knee replacement. Patients with severe disease at the time of surgery were more likely to substantially improve pain and functional ability.

Long Term Results

Generally, it takes around one year for patients to see full results from a total hip replacement surgery. One can expect the following benefits from a hip replacement surgery:

• Relief from Pain
• Improved Quality of Life
• Improved Mobility
• Freedom from Dependence on Caregivers and Family Members
• Long-term Health Benefits such as reduced mortality, reduced risk of heart failure, reduced risk of diabetes, and depression.
• Peace of Mind

Risks and Complications of Hip Replacement Surgery

Hip replacement complications are generally minor. However, in some cases, the surgery may lead to complications such as a dislocation, blood clots, infection, change in leg length, fractures, and loosening of the implant.

Common Hip Replacement Complications and Risks:

• Stiffness
• Pain (subsides over time)
• Swelling
• Changes in leg length
• Muscle weakness
• Tingling sensation
• Swelling
• Bladder infection

Rare Complications

• Nerve injury
• Bleeding
• Infection
• Blood clots
• Blood vessel injury
• Dislocation
• Fractures
• Loosening of implant

Before, During, and After Hip Replacement Surgery

How to Prepare for Hip Replacement Surgery?

Patients are advised to learn about the procedure and prepare a list of questions/concerns for their initial meeting with an orthopedic specialist.

Make sure you know the impact of this surgery on your professional and personal life and make the appropriate arrangements.

Reducing your weight under medical guidance and getting in shape before surgery will help you recover faster and more effectively.

Make arrangements at home and get family and friends to help. You may also require making living changes in your home, such as shifting your bedroom to the first floor and freeing up space to move around with a walker or crutches.

Consider investing in helpful aids such as stairway railings, reachers, long-handled shoe horns, etc.

What to expect on the day of Hip Replacement Surgery?

On the day of surgery, you will be admitted to the hospital early to review and sign all documentation, including a consent form, giving the surgeon permission to carry out the procedure. You may be issued a sedative if you feel worried or anxious.

You will be guided to the operating room and placed on a bed. An anesthetic will be administered before the start of the procedure.

What can I expect during Hip Replacement Surgery?

This surgery is performed under general anesthesia (while you are asleep) or sedated under spinal anesthesia.

You will be asked to remove your clothing and wear a hospital gown. The nurse may start an intravenous (IV) line in your arm or hand and then position you on the operating table until you fall asleep; then, a urinary catheter may be inserted. The anesthesiologist will monitor the following during the surgery:

• Heart rate
• Blood pressure
• Breathing
• Blood oxygen level

An antiseptic solution will be used to ensure the surgical site is clean. The surgeon will start the surgery with an incision in the hip area, where they will extract the damaged parts of the hip joint and replace them with the prosthesis. Once the procedure is completed, the incision will be closed with stitches or surgical staples. Lastly, the surgeon will apply a sterile bandage or dressing to the surgical site for protection.

What can I expect after Hip Replacement Surgery?

Once the procedure is completed, you will be taken to the recovery room and put under observation. After the nurse reports stable blood pressure, pulse, and breathing, you will be shifted to your hospital room. You should expect a hospital stay for a few days until doctors declare you are healthy and have made a complete post-operative recovery.

A physical therapist will assess you and plan an exercise program for you. Depending on your recovery, you will be discharged home or to a rehabilitation center.

Recovery

Once at home, you should follow your doctor's and physical therapist's advice. It is advised to report any side effects or abnormal effects to your doctor, such as fever, swelling, redness, bleeding from the incision site, numbness, pain, etc.

How long will it take to recover?

Generally, it takes around one year for patients to recover entirely from hip replacement surgery.

Why Choose Larkin?

Larkin Community Hospital has board-certified orthopedic specialists with many years of experience in helping thousands of people with healthy, pain-free joints. Our technologically advanced facility is known for innovation, excellence in service, and the highest quality of patient care. We hold expertise in Pain Management Techniques to help patients reduce post-operative discomfort and pain.

Our team of professionals is specialized in offering Minimal Invasive Techniques and can handle complex surgeries to enhance the quality of life for patients.

Frequently Asked Questions