A hip replacement is a common surgical procedure that a surgeon will perform to treat a damaged hip joint. The operation involves replacing the joint with an implant, or a prosthesis.
Hip replacement surgery, also called hip arthroplasty, aims to improve the function of the hip joint and relieve pain. Having a new hip typically allows a person to return to their normal activities. Most hip replacements last for many years.
Most people who undergo hip replacement surgery experience less pain, increased mobility, and a better quality of life.
This article discusses why a person may need a hip replacement, the procedure itself, and what to expect from the recovery process.
The hip joint is where the top of the thighbone, or femur, connects to the pelvis. It provides stability and supports body weight. Having a well-functioning hip is essential for lower body movements, including walking and standing.
Some conditions or injuries cause damage to parts of the hip joint that can affect its functioning. Hip replacement surgery involves replacing damaged parts of the hip with artificial materials, such as plastic and metal.
Common conditions that might cause a person to need a hip replacement include:
The most common condition that results in someone needing hip replacement surgery is osteoarthritis. Osteoarthritis causes the breakdown of the cartilage in a joint.
A hip replacement removes the damaged cartilage surfaces and replaces them with an artificial joint, or a prosthesis. The operation can greatly relieve pain and improve the function of the hip joint.
Someone with advanced damage to their hip joint that results in significant pain and limited mobility may benefit from a hip replacement.
Before surgery, doctors will often attempt non-surgical treatments, such as medications, physical therapy, and injections. However, they will usually offer hip replacement surgery to those who have persistent symptoms.
Older adults are more likely to develop conditions that damage the hip joints, such as osteoarthritis. Bone health also decreases with age, increasing the risk of hip fracture.
There are many types of implants for replacing parts of the hips, as well as different surgical techniques for the operation. Most involve replacing the ball on the top of the femur and placing a cup, or socket, in the pelvis.
Surgeons usually use metal for the stem that they insert into the top of the femur. The head, or ball, of the implant is usually made of metal or ceramic, and the cup that they place in the pelvis is usually also made of metal.
They will place a plastic liner that matches the head into the cup, allowing the new hip to move freely and painlessly.
To attach the implants to the bone, surgeons may use a special type of bone cement. However, in younger people, the implants are often “press-fit.” This refers to using implants with a special coating that allows bone to grow onto it.
A hybrid hip replacement uses a combination of both of these techniques.
Hip replacement surgery typically reduces pain and increases mobility. However, a hip replacement operation does have some associated risks.
- blood clots
- pulmonary embolus
- nerve damage
- the implant loosening
Before undergoing surgery, a person will need to visit their doctor and undergo some screening blood work. People with certain medical conditions may also require additional testing, including an electrocardiogram (to assess heart function) and a chest X-ray.
The doctor will also review the person’s complete medical history and current medication list and perform a physical examination. In some cases, before surgery, they may also recommend performing strengthening exercises, losing weight, and quitting smoking (if applicable).
Other considerations include organizing transport to and from the hospital and planning for time off work after the operation.
Most surgeons perform hip replacement surgeries using a combination of anesthetic techniques, including general anesthetics, spinal or epidural anesthetics, peripheral nerve blocks, and local anesthetics. They will inject these into the tissues surrounding the hip joint.
The operation involves a skin incision, the separation of the muscles, and then the exposure of the hip joint. The surgeon will then remove the damaged part of the joint and fix the implants to the bone.
They will then close the skin incision using either surgical staples or suture. Finally, they will place a sterile bandage over the incision site.
Following hip replacement surgery, a doctor will provide intravenous fluids and medications to aid in the recovery process.
The recovery time will vary from person to person. Most people spend 2–3 days in the hospital, but some centers are now performing outpatient, or same-day, total hip replacement surgeries.
Upon discharge from the hospital, a person will receive prescriptions for any necessary medications. These may include pain medications and blood thinners, which can help prevent blood clots in the legs.
Recovery at home usually involves performing exercises to strengthen the hip and improve mobility. These exercises can include simple activities around the house, such as learning to walk or climb stairs with the new hip.
A physical therapist may also attend a person’s home until it is safe and comfortable for the person to attend therapy outside of the home.
Doctors may also recommend making some changes to the home environment, such as installing handrails in the shower or using a raised toilet seat.
Most people will require the use of a walker, crutches, or a cane following their operation. However, many can walk independently 2–3 weeks after their operation, and most will have fully recovered in 3–4 months.
Undergoing physical therapy and performing home exercises are very important following hip replacement surgery. People should carry these out as the doctor prescribed in order to achieve the best possible result following their operation.
Hip problems can have a major impact on a person’s mobility and quality of life. A person should seek medical attention for persistent pain in the hip or difficulty with the movement of the hip joint.
A doctor will often recommend non-surgical treatments before offering a hip replacement.
Those who have had a hip replacement should contact their surgeon’s office if they experience any of the following:
- worsening hip pain
- swelling in the legs
- calf pain or tenderness
- fever over 100.4ºF (38ºC)
- drainage from the incision
- flushing around the incision
After the operation, a person should always contact their surgeon’s office if they have any concerns.
Hip replacement surgery is a very common operation, especially in older adults. It is most commonly necessary when a person has osteoarthritis of the hip. It can greatly reduce the person’s pain and improve their mobility and quality of life.
An orthopedic surgeon will usually recommend a hip replacement after first trying other treatments, including medications, injections, and physical therapy.
It takes time to fully recover from a hip replacement, and most people will require physical therapy to help restore their normal walking ability, mobility, and strength.