Hip Replacement Surgery 101

hip replacementThe hip is one of the body’s largest and most important joints. It allows us to walk, run and jump, and bears our body’s weight and the force of the muscles of the hip and leg. If your hip has been severely damaged—by a fracture, arthritis, osteonecrosis or other conditions–common activities such as walking or getting in and out of a chair may be painful and difficult. You may even feel uncomfortable while resting.

If other alternatives such as medications, the use of walking supports, or changes to daily activities do not effectively help your symptoms, hip replacement may be a viable solution and you should consult with your physician to learn more. Generally, hip replacement surgery is a safe and effective procedure that can help you get back to enjoying everyday activities.

So what occurs during a hip replacement surgery?
In a total hip replacement surgery, the damaged bone and cartilage is removed and replaced with prosthetic components. Here’s the basic flow of the operation:

  • The damaged femoral head is removed from the upper end of the femur bone- this allows the surgeon to access the socket.
  • The socket is prepared to accept a titanium metal shell. The shell is implanted into the bony socket. The surface of the shell is designed to allow the bone to grow to the shell- a process called “osseointegration.”
  • A polyethylene liner or “insert” in placed inside the shell. Inserts are available in various shapes and sizes to allow the surgeon the ability to best reproduce the anatomy of the hip.
  • The hollow canal of the femur bone is prepared to accept a titanium stem. The stem is coated with the same material that allows “osseointegration.”
  • A “head ball,” usually made of ceramic, is attached to the top of the stem.
  • The joint is the “reduced,” allowing the new head ball to articulate with the new socket surface.

Who needs hip surgery?
There are no absolute age or weight restrictions for total hip replacements. Those who maintain aerobic conditioning and an ideal body weight have lower risk of complications with the surgery. You should consult your physician if you’ve experienced hip pain that persists, despite pain medication, worsens with walking, interferes with sleep or makes it difficult to rise from a seated position.

Conditions that can damage the hip joint sometimes necessitate surgery. For example, the following conditions can, if serious enough, be cause for surgery:

  • Osteoarthritis: Osteoarthritis damages the slick cartilage that covers the ends of bones and helps joints move smoothly.
  • Rheumatoid arthritis: Caused by an overactive immune system, this infliction produces inflammation that can erode bone and cartilage and deform joints.
  • Osteonecrosis: This can lead to inadequate blood supply to the ball portion of the hip joint, causing bone to collapse and deform.

Next steps:
The decision to have hip replacement surgery should be well thought out and you should consult your family, your primary care doctor, and your orthopaedic surgeon. Typically your doctor will provide a referral to an orthopaedic surgeon for an initial evaluation. If you do elect for hip surgery, you should know that some planning is required, such as medical evaluations and tests prior to, and making sure your home is modified so it is easier to navigate during your recovery. You should also plan to take time after your surgery for wound care, recovery and physical therapy.

Complications:
Just like all invasive surgeries, there is the possibility of complications. Blood clots, infection, bone fracture during surgery, hip dislocation, change in leg length and the need for a second hip replacement are all possibilities you should be aware of while considering hip replacement surgery.

About Dr. Bradbury

Thomas Bradbury, MDThomas Bradbury, MD, enjoys hip and knee arthroplasty because of the consistency of success in the properly selected patient. Dr. Bradbury’s professional goal is the improvement in quality of life for patients with pain secondary to hip and knee problems.
His research interests center around infections involving hip and knee replacements which are rare, but difficult problems. Dr. Bradbury is researching the success rate of current treatment methods for hip and knee replacement infections caused by resistant bacteria (MRSA). Through his research, he hopes to find better way to both prevent and treat periprosthetic hip and knee infections.

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