Total Hip Replacement
A total hip replacement — or hip arthroplasty — involves removing broken down or deteriorated hip joints with functioning artificial joints through a surgical procedure. This procedure can restore full function to your hip and relieve any pain you may have been experiencing.
If you're experiencing severe hip joint pain or have dealt with hip fractures in the past, a total hip replacement may be right for you. Talk with your orthopedic hip surgeon to discuss the right surgical approach for you and your needs.
Hip Replacement Surgery FAQs
What Is a Total Hip Replacement?
A total hip replacement is a surgical procedure that involves replacing parts of the hip joint, the ball and socket, with artificial prosthesis to alleviate hip pain.
During a total hip replacement, a surgeon will remove the damaged portions of the patient's pelvis and demus from their hip joint and substitute it with artificial joints made of metal, ceramic, or rigid plastic. Patients may require a hip replacement because of traumatic hip fractures or to alleviate severe pain due to the original joints' deterioration caused by conditions like osteoarthritis.
This procedure helps patients regain hip mobility, relieve pain, and improve functionality to better their overall quality of life.
Hip Replacement Surgical Methods
Your orthopedic surgeon may use one of three different methods to perform total hip replacement surgery. This will depend on the surgeon and on the patient's age, health, and anatomy.
Hip replacement surgery can provide life changing pain relief and improvement of both day-to-day and recreational function. Surgery naturally carries certain risks and a lengthy recovery, but these can be minimized with careful preparation and selection of the procedure. It is important for patients to be as educated as they can be before going into surgery. The stronger and healthier one is before, the easier the recovery will be. Learn more about the three hip replacement surgery methods below:
Anterior Hip Replacement Approach
Direct Anterior Approach — or DAA — is a minimally invasive technique. The surgeon will make their incision from the front of the hip, and the patient is asked to lie on their back. The removal of any damaged joint bone or cartilage is thus done through the front of the hip. The surgeon will replace the damaged areas with artificial joint pieces and anchor them in place. This approach avoids unnecessarily cutting or damaging any surrounding muscle, which may help make recovery faster.
Posterior Hip Replacement Approach
A posterior hip replacement is the most common approach in the United States for this procedure. It involves the surgeon making their incision close to the back of the hip, near the buttocks, and the patient is asked to lie on their stomach. Similar to the anterior approach, no surrounding muscles are disturbed.
Lateral Hip Replacement Approach
A lateral hip replacement approach is done with the surgeon making their incision from the side of the patient's hip. The patient is placed on their side and likely stabilized so they do not shift during the procedure. This procedure is only done when completely necessary, because it involves cutting and moving the abductor muscles that help you walk, which lengthens the recovery time significantly. After the damaged bone and cartilage is removed and replaced, the muscles are sutured back in place.
Why Is Hip Replacement Performed?
Physicians recommend total hip replacements if a patient experiences:
- Chronic hip pain Hip pain that restricts everyday activities, such as walking, exercising, or bending
- Hip pain that affects your sleep quality and length
- Hip stiffness that constricts flexibility and mobility
- Arthritic damage that severely diminishes joint cushion between hip bones
- No symptom alleviation from physical therapy and medications
- Disorders that may result in unusual bone growth
How To Prepare For a Hip Replacement
Before hip surgery, patients should consult with their orthopedic surgeon. They will document your medical history and current medications, order blood tests, and compile x-rays or MRIs, if needed. The physician will examine your hips and test your range of motion and strength. Be sure to ask your physician any and all questions you may have about the procedure.
For total hip replacement, the patient should adhere to the following recommendations when getting ready for this surgery:
- Arrange for transportation to and from your procedure, including any follow-up visits.
- Modify the home to accommodate their needs during patient during recovery, including:
- Placing handrails for showers and baths.
- Purchasing a stable and cushioned chair for recovery.
- Buying a raised toilet seat.
- Removing potential tripping hazards, such as loose carpet and electric cords.
- Obtain a walking cane and a tool to grab objects without having to bend over.
- Refrain from smoking tobacco for at least a month before surgery.
- Do not have any dental work at least two weeks before surgery.
What Happens During a Hip Replacement?
To begin the procedure, the physician will administer anesthesia to the patient and make an incision from the front, side, or back of the hip to expose the hip joint. The surgeon removes the damaged cartilage and bone from the hip socket and inserts the new metal, plastic, or ceramic implant.
The doctor will then place a prosthetic socket into the pelvic bone and replace the round ball at the femur with a prosthetic ball. The prosthetic socket in the pelvic bone will help the patient regain hip mobility and functionality. After the physician tests the new prosthetics, the surgeon will close the incision and bandage the patient.
The entire procedure takes around one to two hours. The patient will need to stay in the hospital for a couple of days during recovery. Once the physician examines and approves of the patient's recovery status, they may leave the hospital.
For an anterior approach, you are asked to lie on your back for the procedure. An orthopedic surgeon will make an incision near the front of your hip and remove any damaged cartilage or bone first. Then, they will replace that with artificial joint pieces and anchor them in place.
For a posterior approach, you are asked to lie on your stomach. An orthopedic surgeon will make an incision near the back of your hip, close to your buttocks. They will remove any damaged cartilage or bone first, and then replace it with artificial joints and anchor them in place.
For a lateral approach, you will be placed on your side and likely stabilized so you do not shift during the procedure. An orthopedic surgeon will make an incision on the side of your hip. This approach involves the cutting of abductor muscles in order to properly reach the hip joint. The surgeon will remove any damaged cartilage or bone and replace it with artificial joints, then anchor them in place. After this, they will move your muscles and suture them back in place.
Are There Risks Associated With a Total Hip Replacement?
Like most surgical procedures, there are some risks associated with a total hip replacement no matter which approach your surgeon uses. Those include:
- Blood clot formation in the legs, which may travel to your lungs, heart, or brain in rare cases. Consult with your physician to learn about blood-thinning medications to reduce risk.
- Infections near the site of the incision. Physicians can treat small infections with antibiotics, but major infections may require an additional surgical procedure.
- Dislocation caused by the ball of the new joint coming out of the socket. A physician may correct the issue with a hip brace or perform an additional surgery to stabilize it.
- Nerve damage at the point of the implant, which may cause numbness, weakness, or pain.
- Newer implants may not solidify at the bone and loosen over time, causing pain. A new hip may make one leg longer than the other one. Stretching and strengthening exercises can correct the length discrepancy.
- Parts of the hip joint may fracture during surgery, and may be able to heal on their own.
Post-Hip Replacement Surgery and Recovery Time
After surgery, the hospital staff will monitor the patient's blood pressure, pulse, and breathing rate. The patient will need to stay in the hospital for several days after surgery. A physical therapist will begin helping the patient move the new joint and perform rehabilitation exercises. The patient will continue to practice recovery exercises at home once they are discharged from the hospital.
A physician will prescribe suitable pain medication during at-home recovery, along with specific instructions to follow. During a follow-up visit, a doctor will remove the stitches and staples. If all of the physical therapy exercises are followed appropriately and you take care of your health, recovery can take between one and two months depending on your age and activity levels.