Hip Replacement

Overview:

Hip replacement is surgery to remove damaged sections of the hip joint and replace them. Replacement parts are usually made of metal, ceramic and hard plastic. This artificial joint, called a prosthesis, helps reduce pain and improve function.

Hip replacement also is called total hip arthroplasty. Hip replacement might be an option if hip pain interferes with daily activities and nonsurgical treatments haven't helped or are no longer effective. Arthritis damage is the most common reason to need hip replacement.

Why it's done:

Conditions that can damage the hip joint, sometimes making hip replacement necessary, include:

Osteoarthritis: Commonly known as wear-and-tear arthritis, osteoarthritis damages the slick cartilage that covers the ends of bones and helps joints move smoothly.

Rheumatoid arthritis: Caused by an overactive immune system, rheumatoid arthritis produces a type of inflammation that can erode cartilage and occasionally underlying bone. This can result in a joint that is damaged or changes shape.

Osteonecrosis: If there isn't enough blood supplied to the ball portion of the hip joint, the bone might collapse and change shape. Osteonecrosis might result from a dislocation or fracture that disrupts the blood supply to the bone.

Hip replacement may be an option if hip pain:

Doesn't stop despite taking pain medicines.

Worsens with walking, even with a cane or walker.

Interferes with sleep.

Affects the ability to walk up or down stairs.

Makes it difficult to rise from a seated position.

How you prepare:

Before the operation, you'll likely have an exam with the orthopedic surgeon. The surgeon may:

Ask about your medical history and current medicines.

Examine your hip, paying attention to the range of motion in your joint and the strength of the surrounding muscles.

Order blood tests and an X-ray. An MRI is rarely needed.

During this appointment, ask any questions you have about the procedure. Be sure to find out which medicines you should avoid or continue to take in the week before surgery.

Because smoking can interfere with healing, it's best to stop using nicotine products, including vaping, before surgery. If you need help quitting, talk with your healthcare professional.

What you can expect:

When you check in for your surgery, you're asked to remove your clothes and put on a hospital gown. You're given either a spinal block, which numbs the lower half of your body, or a general anesthetic, which puts you into a sleeplike state.

Your surgeon might also inject a numbing medicine around nerves or in and around the joint to help block pain after your surgery.

During the procedure

The surgical procedure can usually be completed within two hours. To perform a hip replacement, the surgeon:

Makes an incision over the hip, through the layers of tissue.

Removes diseased and damaged bone and cartilage, leaving healthy bone intact.

Puts the replacement socket into the pelvic bone.

Inserts a metal stem into the top of the thighbone, which is then topped with a replacement ball.

After the procedure

After surgery, you are moved to a recovery area for a few hours while the anesthetic wears off. Medical staff monitor your blood pressure, pulse, alertness, pain or comfort level, and need for medicines.

You're asked to breathe deeply, cough or blow into a device to help keep fluid out of your lungs. How long you stay after surgery depends on your individual needs. Many people can go home that same day.

Physical therapy:

Daily activity and exercise can help you regain the use of your joint and muscles. A physical therapist can recommend strengthening and mobility exercises. The therapist also can help you learn how to use a walking aid, such as a walker, a cane or crutches. As therapy goes on, you slowly increase the amount of weight you put on your leg until you're able to walk without assistance.

Home recovery

Before you leave the hospital, you and your caregivers get tips on caring for your new hip. For a smooth transition:

Arrange to have a friend or relative prepare some meals in advance.

Place everyday items at waist level so you won't have to bend down or reach up.

Consider getting a raised toilet seat and a shower chair for your recovery at home.

Put your phone, tissues, TV remote, medicine and books near the area where you'll be spending most of your time during recovery.

Results:

Full recovery from a hip replacement varies from person to person, but most people are doing well three months after the surgery. Improvements typically continue during the first year after surgery.

The new hip joint can reduce pain and increase the hip's range of motion. But don't expect to do everything you could do before the hip became painful.

High-impact activities, such as running or playing basketball, might be too stressful on the artificial joint. But in time, most people can participate in lower impact activities — such as swimming, golfing and bicycle riding.