Hip replacement is one of the most frequently performed joint replacement surgeries in the United States. The American Academy of Orthopaedic Surgeons reports that more than 193,000 Americans undergo total hip replacement surgery each year. Surgeons and biomedical researchers have developed many innovations since the first hip replacements of the 1960s. Hip surgery options help surgeons better meet the individual needs of their patients.
Cemented Total Hip Arthroplasty
Hip replacement surgery, also known as hip arthroplasty, involves removal of the damaged head of the thighbone and replacement with a metal stem topped with a ball-like head. The stem fits into a cavity in the core of the thighbone created by the surgeon. The surgeon can use different techniques to fix the stem in place. Bone cement glues the stem within the thighbone and sets almost immediately, which enables the patient to bear weight on the leg within the first day after surgery.
The other component of a hip arthroplasty is replacement of the hip socket. The surgeon removes the damaged bony socket of the hip and replaces it with a metal cup fitted with a hard plastic liner, explains the AAOS. In a cemented hip arthroplasty, bone cement holds the metal cup in place. The round head of the replacement rod fits into the metal socket, creating an artificial ball-and-socket hip joint.
A cemented hip arthroplasty offers the advantage of beginning rehabilitation almost immediately after surgery, which speeds recovery time. A potential disadvantage of cemented fixation is a risk for implant loosening over time due to cracking in the bone cement, points out the American Arthritis Foundation. People with an active lifestyle and those who are overweight have an increased risk of early implant loosening. Cemented hip arthroplasty remains a popular hip surgery option, especially for older patients and those who do not participate in strenuous physical activities.
Noncemented Total Hip Arthroplasty
The procedures for a noncemented hip arthroplasty mirror those of a cemented procedure, with the exception of the replacement implant fixation. As the name implies, a noncemented hip arthroplasty does not utilize bone cement. Rather, the implant parts have surface pores that enable the patient's bone to grow into the implant and hold it in place, explains the AAOS. Screws and plates hold the implants in place while bone grows into the surfaces in the months following surgery.
Recovery time is typically slower with a noncemented procedure compared to a cemented arthroplasty because full weight bearing cannot take place until the bone has firmly grown into the implant. The advantage of a noncemented hip arthroplasty is a sturdier fixation that can withstand an active physical lifestyle.
Partial Hip Arthroplasty
Although most people who require hip replacement surgery have severe damage necessitating replacement of both parts of the hip joint, some patients do not. Surgeons can perform a partial hip arthroplasty for this group of patients, replacing only that part of the hip joint with significant damage, explains Dr. Harpal Khanuja of Johns Hopkins Arthritis Center.
