The two bones that comprise the hip joint are the thigh bone, or femur, and the acetabulum, a concave depression in the pelvic bone. The head of the femur is dome-shaped and fits into the pocket made by the acetabulum. The hip is a ball-and-socket joint that allows adequate motion for sitting, standing, walking, squatting and climbing stairs. Over time, the hip joint can wear out, causing pain and loss of motion that may necessitate surgery.
Indications
Osteoarthritis and rheumatoid arthritis lead to inflammation within the hip joint. The cartilage covering the femoral head can wear away with osteoarthritis or become swollen with rheumatoid arthritis, causing joint pain. According to the American Academy of Orthopaedic Surgeons, hip-joint pain is a dull, aching pain in the groin, thigh and buttocks. Pain is worse on rising and decreases with activity throughout the day. Your doctor may suggest total hip replacement surgery when the pain becomes debilitating and conservative measures are no longer effective. It is also a treatment option when the head of the femur fractures or loses its blood supply from avascular necrosis.
Tests
First, your doctor will examine you thoroughly. According to MayoClinic.com, the physical examination includes evaluating range of motion of the affected hip joint to determine muscle strength and which motions generate pain. Give your physician a complete list of your medications and supplements. Pre-operative tests include an X-ray of the affected hip, a chest X-ray of the lungs, blood tests and an MRI. Consult with your doctor to discuss any questions or concerns.
Total Hip Replacement Surgery
The goal of hip surgery is to relieve the pain and improve range of motion. During surgery, the painful, damaged parts of the hip joint are removed. According to DePuy Orthopaedics, the surgeon reshapes the acetabulum and fits it with a metal cup lined with polyethylene or metal. The surgeon then removes the head of the femur, drills a channel for the femoral stem implant and fits the stem with a ball implant. Once the entire implant is in place, the new joint is checked for stability, position and range of motion.
Risks
Total hip replacement is major surgery that is generally safe, but there are some risks. According to MayoClinic.com, blood clots can form in the legs. A fracture can occur in healthy bone during surgery, which is usually fixed right then. There is risk of infection because the joint is completely open during the procedure. The implant can loosen, dislocate or break afterward. The position of the implant can make leg length longer or shorter. The joint can stiffen up or wear out over time.
Recovery
After surgery, follow your surgeon's instructions exactly. The usual hospital stay is three to five days. According to the American Academy of Orthopaedic Surgeons, physical therapy is started during recovery in the hospital, teaching you safe ways to move and bend. Pain medications are prescribed, along with antibiotic and anticoagulant medication to prevent infection and blood clots. A respiratory therapist may prescribe breathing exercises.
