Total Hip Replacement
What is total hip replacement?
Total hip replacement surgery has become a common orthopaedic procedure in the United States. It is estimated that more than 100,000 such operations are performed each year. Hip replacements are done to alleviate conditions caused by osteoarthritis, rheumatoid arthritis, fractures, dislocations, congenital deformities, and other hip related problems. The surgery involves replacing the damaged surfaces of the hip with artificial surfaces. The head and neck of the femur are removed and replaced with a metal ball. The damaged socket is also lined with a metal socket.
Are there different types of hip replacement surgeries?
There are two main types of hip replacements currently in use. They are commonly referred to as “cemented” and “cementless.” Cemented hip replacements have been performed since the early 1960’s. “Cemented” refers to the acrylic material used to anchor the implant to the bone. This “acrylic cement” functions to provide a mechanical interlock between the bone and the implant.
What are the benefits?
The benefits of total hip replacement are profound. The operation usually takes one to three hours. The hospitalization is relatively short (usually about 3-4 days) with pain relief occurring within the first week. After six months, most patients can expect to be relatively pain-free, have full mobility of his or her hip, walk with minimal or no limp, and lead a normal life.
How long does hip replacement last?
Most individuals want to know how long their hip replacement will last. The answer is complex. The metal and plastic parts can be subject to wear and loosening just like any other mechanical device. A person’s activity level and age are significant factors that may contribute to wear and loosening of the implant. Based on many studies we know that the vast majority of implants are functioning well 10-15 years after surgery. A small percentage (5-10%) may require another operation to exchange some or all of the parts. Thus over 90% of replacements never need revision.
How do I know if I am a candidate for hip replacement surgery?
Hip replacement surgery is typically indicated for individuals who no longer benefit from non-surgical treatments such as medications, therapy, walking aids, injections and activity modification. When the pain is significant and quality of life is diminished, surgery should be considered. However, if you are relatively young, hip replacement may not be the best choice and other surgical options may be considered.
What are the risks?
There are some risks common to all types of surgery (ie, anesthetic risks or medical problems) as well as risks unique to hip replacement surgery. Complications related to hip surgery include infection, bleeding, nerve injury, blood clot formation, leg length inequality, fracture and hip dislocation. The risks of the problems are small (approximately 5%) and are usually correctable.
Total hip replacement procedure
How long does the surgery last?
Approximately 1 to 3 hours, depending on the condition of your hip at the time of surgery.
Why and how long do I have to keep my legs apart?
To prevent the hip from dislocating. When the muscles around the hip joint mend and strength returns, they will hold the hip in its socket (this takes approximately 6-12 weeks).
Can I sleep on both sides?
Avoid sleeping on the operated side for 4 weeks.
Can I sleep on my stomach?
We do not recommend it for the first 3 months because it is difficult to turn on your stomach without twisting and risking possible dislocation.
How far can I bend forward when I have a new hip?
You must limit hip flexion for three months. You may bend forward until your fingertips are able to touch your knees (90 degrees of flexion), but no further. Remember to keep your knees apart.
Will the implant set off metal detectors at airports?
Usually not, but if you desire, the clinic can provide you with a card that documents your hip replacement.
Do I need an x-ray at 12 months if my hip feels fine?
Yes, X-rays are an important part of each follow-up visit and essential in determining the amount of bone ingrowth, implant positioning and the condition of your bone around the implant. X-rays assure us that there are no problems developing.