Total Hip Replacement
What is a Total Hip Replacement?
In a total Hip Replacement (also called total Hip Arthroplasty), the damaged bone and cartilage is removed and replaced with prosthetic components similar to the ones below.
When is hip surgery recommended?
People who benefit from hip replacement surgery often have:
- Hip pain that limits activities such as walking or bending
- Continuous hip pain when resting
- Stiffness in a hip which limits mobility
- Inadequate pain relief from anti-inflammatory drugs, physical therapy, or walking supports
Is hip replacement surgery for you?
The decision to have hip replacement surgery should be a cooperative one made by you, your family and Dr Al-Khateeb.
You can find out more information here and watch an animation of a Total Hip Replacement
Candidates for surgery
Recommendations for surgery are based on a patient’s pain and disability, not age. Most patients who undergo total hip replacement are age 50 to 80, but orthopaedic surgeons evaluate patients individually.
Total hip replacements have been performed successfully at all ages, from the young teenager with juvenile arthritis to the elderly patient with degenerative arthritis.
The Orthopaedic Evaluation
An evaluation consists of several components.
- Medical history. We will gather information about your general health and ask questions about the extent of your hip pain and how it affects your ability to perform everyday activities.
- Physical examination. This will assess hip mobility, strength, and alignment.
- X-rays. These images help to determine the extent of damage or deformity in your hip.
- Other tests. Occasionally other tests, such as a magnetic resonance imaging (MRI) scan, may be needed to determine the condition of the bone and soft tissues of your hip.
Deciding to have hip replacement surgery
Talk with Dr Al-Khateeb
We will review the results of your evaluation with you and discuss whether hip replacement surgery is the best method to relieve your pain and improve your mobility. Other treatment options — such as medications, physical therapy, or other types of surgery — also may be considered.
In addition, we will explain the potential risks and complications of hip replacement surgery, including those related to the surgery itself and those that can occur over time after your surgery.
An important factor in deciding whether to have hip replacement surgery is understanding what the procedure can and cannot do. Most people who undergo hip replacement surgery experience a dramatic reduction of hip pain and a significant improvement in their ability to perform the common activities of daily living.
Most surgeons advise against high-impact activities such as running, jogging, jumping, or other high-impact sports.
Realistic activities following total hip replacement include unlimited walking, swimming, golf, driving, hiking, biking, dancing, and other low-impact sports.
With appropriate activity modification, hip replacements can last for many years.
Preparing for Surgery
If you decide to have hip replacement surgery, we may ask you to have a complete physical examination by your primary care doctor before your surgical procedure. This is needed to make sure you are healthy enough to have the surgery and complete the recovery process. Many patients with chronic medical conditions, like heart disease, may also be evaluated by a specialist, such a cardiologist, before the surgery.
You will either be admitted to the hospital on the day of your surgery, or you will go home the same day.
Upon arrival at the hospital or surgery center, you will be evaluated by a member of the anesthesia team.
The most common types of anesthesia are general anesthesia (you are put to sleep) or spinal, epidural, or regional nerve block anesthesia (you are awake but your body is numb from the waist down).
Many different types of designs and materials are currently used in artificial hip joints. All of them consist of two basic components: the ball component and the socket component.
The prosthetic components may be “press-fit” into the bone to allow your bone to grow onto the components or they may be cemented into place. The decision to press fit or to cement the components is based on several factors, such as the quality and strength of your bone. A combination of a cemented stem and a non-cemented socket may also be used.
We will choose the type of prosthesis that best meets your needs.
This shows the acetabular and femoral components.
The success of your surgery will depend in large measure on how well you follow instructions regarding home care during the first few weeks after surgery.
Medications are often prescribed for short-term pain relief after surgery. Many types of medicines are available to help manage pain, including opioids, nonsteroidal anti-inflammatory drugs (NSAIDs), acetaminophen, and local anesthetics. Dr Al-Khateeb may use a combination of these medications to improve pain relief, as well as minimize the need for opioids.
You may have stitches or staples running along your wound or a suture beneath your skin. The stitches or staples will be removed approximately 2 weeks after surgery.
Avoid getting the wound wet until it has thoroughly sealed and dried. You may continue to bandage the wound to prevent irritation from clothing or support stockings.
Some loss of appetite is common for several weeks after surgery. A balanced diet, often with an iron supplement, is important to promote proper tissue healing and restore muscle strength. Be sure to drink plenty of fluids.
Exercise is a critical component of home care, particularly during the first few weeks after surgery. You should be able to resume most normal light activities of daily living within 3 to 6 weeks following surgery. Some discomfort with activity and at night is common for several weeks.
Your activity program should include:
- A graduated walking program to slowly increase your mobility, initially in your home and later outside
- Resuming other normal household activities, such as sitting, standing, and climbing stairs
- Specific exercises several times a day to restore movement and strengthen your hip. You probably will be able to perform the exercises without help, but you may have a physiotherapist help you at home or in a therapy center the first few weeks after surgery
New hip changes and differences
You may feel some numbness in the skin around your incision. You also may feel some stiffness, particularly with excessive bending. These differences often diminish with time, and most patients find these are minor compared with the pain and limited function they experienced prior to surgery.
Your new hip may activate metal detectors required for security in airports and some buildings. Tell the security agent about your hip replacement if the alarm is activated.
Protecting your new hip replacement
There are many things you can do to protect your hip replacement and extend the life of your hip implant.
- Participate in a regular light exercise program to maintain proper strength and mobility of your new hip
- Take special precautions to avoid falls and injuries. If you break a bone in your leg, you may require more surgery
- Make sure your dentist knows that you have a hip replacement
- Arrange periodically for routine follow-up examinations and x-rays, even if your hip replacement seems to be doing fine