At the hip joint, the rounded head of the thigh bone or femur lies in a bowl-like depression of the pelvis called the acetabulum. Hip replacement surgery or total hip arthroplasty replaces a faulty hip joint with an artificial one to relieve hip pain and restore normal strength and range of motion.
Candidates
The gradual damage of arthritis or the lasting damage from an injury can degrade the hip joint beyond the body’s ability to repair it. People whose daily lives are limited by hip pain and stiffness that fail to respond to pain medication and physical therapy could benefit from hip replacement.
The National Institute of Arthritis and Musculoskeletal and Skin Diseases says that while in the past doctors encouraged only people 60 or over to consider hip replacement, the advent of new bio-materials for artificial hip joints expands candidacy to younger people as well, and that general health and activity level are better predictors for success than age.
Procedure
To perform the procedure, the surgeon makes a large incision in the side of the hip, retracts the muscle, removes any damaged bone and cartilage at the joint and replaces the head of the femur and the acetabulum with artificial ones. The surgical procedure lasts about 1 to 2 hours.
Materials
An artificial hip joint consists of a ball to replace the femur head, made of metal or ceramic, and a socket to replace the acetabulum, lined with plastic, ceramic or metal. The artificial materials glide smoothly over one another and are “bio-compatible”--the body will accept it as its own tissue.
Risks
As with any surgery, hip replacement procedure incurs risks of infection or formation of post-surgical blood clots. In addition, during removal of damaged bone, healthy parts of the bone can fracture. Small fractures can heal on their own but more serious fractures might need to be corrected with wires or bone grafts before the replacement surgery continues.
After surgery and healing, there is a risk of hip dislocation, particularly if the patient brings the knees to the chest. Over time, the artificial joint can loosen, wear out or break, which would require another surgery.
Recovery and Rehabilitation
Immediately after the surgery, the patient lies in bed, propped in position that braces the artificial hip. The day after the surgery, the patient is encouraged to sit up in bed or even walk with help.
The normal hospital stay is three to five days. Physical therapy begins in the hospital and continues after discharge until the patient can walk without a walker or cane.
The Mayo Clinic says that most people resume normal activities within 6 to 8 weeks of the surgery, and the National Institute of Arthritis and Musculoskeletal and Skin Diseases says that full recovery takes 3 to 6 months.
