Total Hip Replacement (Arthroplasty)

During a Hip Replacement, a surgeon removes the damaged sections of your hip joint and replaces them with parts usually constructed of metal and very hard plastic. This artificial joint (prosthesis) helps reduce pain and improve function. Also called total Hip Arthroplasty, Hip Replacement Surgery may be an option for you if your hip pain interferes with daily activities and more-conservative treatments haven’t helped. Arthritis damage is the most common reason to need a Hip Replacement.

How to Prepare for Surgery    

People can do many things before there Hip Replacement Surgery to make everyday tasks easier and help speed up their recovery:

• Blood work, medical evaluation, chest x-ray, and an EKG depending on your age and medical condition.
• Since there can be some blood loss during Hip Replacement surgery, you may need a blood transfusion, so you may want to consider donating your own blood before the procedure.
• Learn what to expect. Request information written for patients from the doctor.
• Arrange for someone to help you around the house for a week or two after coming home from the hospital.
• Arrange for transportation to and from the hospital. Set up a “recovery station” at home. Place the television remote control, radio, telephone, medicine, tissues, wastebasket, and water pitcher and glass next to the spot where you will spend the most time while you recover
• Place items you use every day at arm’s level to avoid reaching up bending down.
• Stock up on kitchen supplies and prepare food in advance, such as frozen casseroles or soups that can be reheated and served easily.

Hip Replacement Surgical Procedure

Hip Replacement Surgery can be performed traditionally or by using what is considered a minimally-invasive technique. The main difference between the two procedures is the size of the incision. During standard Hip Replacement Surgery, you are given general anesthesia to relax your muscles and put you into a temporary deep sleep. This will prevent you from feeling any pain during the surgery or have any awareness of the procedure. A spinal anesthetic may be given to help prevent pain as an alternative.                                                                                                              The doctor will then make a cut along the side of the hip and move the muscles connected to the top of the thighbone to expose the hip joint. Next, the ball portion of the joint is removed by cutting the thighbone with a saw. Then an artificial joint is attached to the thighbone using either cement or a special material that allows the remaining bone to attach to the new joint. The doctor then prepares the surface of the hipbone — removing any damaged cartilage — and attaches the replacement socket part to the hipbone. The new ball part of the thighbone is then inserted into the socket part of the hip. A drain may be put in to help drain any fluid. The doctor then reattaches the muscles and closes the incision.

Hip Replacement Recovery

You will be allowed only limited movement immediately after Hip Replacement Surgery.

• When you are in bed, pillows or a special device are usually used to brace the hip in the correct position.
• You may receive fluids through an intravenous tube to replace fluids lost during surgery.
• There also may be a tube located near the incision to drain fluid, and a type of tube called a catheter may be used to drain urine until you are able to use the bathroom.
• The doctor will prescribe medicine for pain or discomfort.

On the day after surgery or sometimes on the day of surgery, therapists will teach you exercises to improve recovery. A respiratory therapist may ask you to breathe deeply, cough, or blow into a simple device that measures lung capacity. These exercises reduce the collection of fluid in the lungs after surgery.                                              As early as 1 to 2 days after surgery, you may be able to sit on the edge of the bed, stand, and even walk with assistance.

While you are still in the hospital, a physical therapist may teach you exercise such as contracting and relaxing certain muscles, which can strengthen the hip. Because the new, artificial hip has a more limited range of movement than a natural, healthy hip, the physical therapist also will teach you the proper techniques for simple activities of daily living, such as bending and sitting, to prevent injury to your new hip.

Helpful Tips Following Hip Replacement Surgery

• Follow the doctor’s instructions.
• Work with a physical therapist or other health care professional to rehabilitate your hip.
• Wear an apron for carrying things around the house. This leaves hands and arms free for balance or to use crutches.
• Use a long-handled “reacher” to turn on lights or grab things that are beyond arm’s length.

Hip Replacement Surgery Risks

Hip Replacements Surgery has been performed for years and surgical techniques are being improved all the time. As with any surgery, however there are risks.

• Since you will not be able to move around much at first, blood clots are a particular concern. Your doctor will give you blood thinners to help prevent blood clots from occurring.
• Infection and bleeding are also possible, as are risks associated with using general anesthesia.

Other less common concerns that you and your doctor must watch out for are:

• Your legs may not be of equal length after the surgery
• You must be careful not to cross your legs or not to sit too low because the joint may be dislocated
• Pieces of fat in the bone marrow may become loose, enter the bloodstream and get into the lungs, which can cause very serious breathing problems
• Nerves in the hip area may be injured from swelling or pressure and can cause some numbness
• Infection