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 Hip replacement, also referred to as hip arthroplasty, total hip replacement; or hip hemi-arthroplasty, is a surgical procedure in which all or part of a diseased hip joint is removed and replaced with an artificial device (prosthesis). The hip is essentially a ball and socket joint, linking the ball at the head of the thigh bone (femur) with the cup-shaped “socket” in the pelvic bone. A total hip prosthesis is surgically implanted to replace the damaged bone within the hip joint. If the surgery is a “hemi-arthroplasty,” the only bone replaced with a prosthetic device is the head of the femur.
Some of the more common reasons for hip joint replacement are:
- The wearing down of the hip joint that results from osteoarthritis,
- Rheumatoid arthritis (a chronic inflammatory disease that causes joint pain, stiffness, and swelling)
- Avascular necrosis (loss of bone caused by insufficient blood supply)
- An injury that did not heal properly
- And bone tumors that lead to deterioration of the hip joint
A total hip prosthesis consists of three parts:
- A cup replaces your hip socket
- a ball that will replace the fractured head of the femur
- And a stem that is attached to the shaft of the bone to add stability to the prosthesis
The prosthesis could be made of ceramic, metal or plastic; or combination thereof. Your doctor will discuss the best choice for you, based on your particular diagnosis.
The hip joint is one of the body’s largest weight-bearing joints, consisting of a ball and socket. A healthy hip joint is formed where the rounded head of the thighbone joins the pelvis. The joint is covered with slippery tissue and powered by large muscles. When all of the parts are healthy a hip should move easily.
Cartilage is a layer of smooth soft tissue. It covers the ball of the thighbone, and lines the socket that the thighbone fits into. Healthy cartilage absorbs stress and allows the ball to glide easily in the socket. Muscles power the hip and leg movements. Tendons attach the muscles to the bones.
A healthy hip joint allows you to walk, squat, and turn without pain. But when a hip joint is damaged, it is likely to hurt when you move. Sometimes just standing still can cause pain. When one or more parts of the hip are damaged, movement becomes stiff. Over time, cartilage starts to crack or wear away. When this happens, the bones making up the joint rub together. Stiffness and pain occur when the ball starts to grind in the socket. During total hip replacement surgery a new socket is implanted, after which a metal stem is inserted into the femur. Then, the artificial components are fixed in place and the muscles and tendons are replaced against the bones.
Hip joint pain can be painful and frustrating; may limit your mobility and keep you from accomplishing simple, daily tasks such as walking or standing up from a chair. Surgery is not without risks and it can’t make you young again, but it does have benefits; such as it:
- Stops or greatly reduces hip pain
- Increases legs’ strength because you are able to use your leg and build up your muscles
- Improves quality of life
After examination and evaluation by your doctor, he or she may determine that you are a candidate for total hip replacement. Hip replacement is a common surgery and each year thousands of people have successful hip replacement surgery.
Based on your doctor’s recommendation, you could start moving and walking within hours after your surgery although you will most likely remain in the hospital for 3 to 5 days. The medical staff and therapist will teach you proper movements and exercises to do so that your new hip is protected.
Whether you’re recovering at home or in a rehabilitation facility, sit and move the way you were taught in the hospital so that you don’t dislocate the prosthesis. The new hip will not have the same range of movement as the original joint; therefore, you will need to take special precautions, including:
- Avoid crossing your legs or ankles even when sitting, standing, or lying
- When sitting, keep you feet about 6 inches apart
- When sitting, keep your knees below the level of your hips. Avoid chairs that are too low. You may sit on a pillow to keep your hips higher than your knees
- When getting up from a chair, slide toward the edge of the chair and then use your walker for support
- Avoid bending over at the waist and/or bending and twisting at the waist. You may consider purchasing a long-handled shoehorn or a sock aid to help you put on and take off your shoes and socks without bending over. Alternatively, an extension “reacher” or “grabber” may be helpful for picking up objects that are too low for you to reach
- Place a pillow between your legs when lying in bed to keep the joint in proper alignment
Return to activity slowly. Practice walking a little every day and soon you’ll be able to walk without the aid of a walker. Don’t be surprised if you feel a little stiff at first, total hip replacement is major surgery and it may take a few months for complete recovery. It is very important to keep all your scheduled follow-up visits with your surgeon.
It’s is always important to stay healthy and active, but consult with your surgeon before beginning any new sport or activity, to find out what type and intensity of sport or activity is appropriate and it’s affects on your new hip.
For information on Chesapeake Orthopaedic & Sports Medicine Center physicians that specialize in the treatment of the hip, click below.
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