What is a Hip Replacement?
The hip is a ball-and-socket joint that connects the femur, or thigh bone, to the pelvis. The femoral head fits into a socket in the pelvis called the acetabulum. Both the femoral head and the acetabulum are covered in articular cartilage to prevent bone-on-bone contact.
Hip replacement surgery, also known as hip arthroplasty, aims to remove damaged bone and cartilage and replace them with metal and plastic parts. About 300,000 hip arthroplasties are performed in the U.S. each year.
Common Reasons for a Hip Replacement
Most chronic hip pain is a result of one of three types of arthritis. They are:
- Osteoarthritis—This is the most common type of arthritis, and causes articular cartilage to wear down. The result is bone-on-bone grinding, which is painful and can lead to bone spurs.
- Post-traumatic arthritis—This form of arthritis is damage to cartilage after a hip injury.
- Rheumatoid arthritis—This is an autoimmune disease that causes the body’s immune system to attack the synovium, a thin membrane that surrounds the hip joint. The synovium becomes inflamed, which can cause pain and stiffness.
Other conditions that can make hip replacement necessary include:
- Avascular necrosis—occurs when the blood supply to the femoral head is cut off, causing the bone tissue to die; also known as osteonecrosis
- Childhood hip disorders—can lead to the hip growing incorrectly, causing osteoarthritis
Candidates for Hip Replacement Surgery
Hip arthroplasty is not the right choice for everyone with one of these conditions. People who are good candidates for hip replacement surgery may:
- Be between the ages of 50 and 80, usually
- Have already tried anti-inflammatory medication, physical therapy or walking supports without relief
- Have moderate hip pain even at rest
- Have severe hip pain that limits everyday activities
- Have stiffness in the hip that limits mobility
How the Procedure Is Performed
A total hip replacement is broken into multiple steps. First, the femoral head is removed and replaced with a ball attached to a metal stem, which is then pressed or cemented into the femur. Next, damaged articular cartilage in the acetabulum is replaced with a metal socket. Finally a plastic spacer is inserted into the acetabulum.
The surgery usually done with spinal anesthesia. Some people may be able to leave the hospital the same day as the surgery, while others may need a brief (one or two night) hospital stay.
Possible post-surgical complications include:
- Blood clots
- Hip dislocation
- Hip fracture
- Implant loosening
- Leg length inequality
- Nerve injury
Exercise and activity are crucial to recovery, for both getting back to normal activity and preventing complications. Following a walking program that gradually increases distance, resuming everyday household activities as soon as possible, and doing specific exercises as recommended by a surgeon or a physical therapist are all critical components to recovering from the surgery.
If you have hip pain that hasn’t responded to other treatment and think you’re ready for hip replacement surgery, schedule an appointment with one of our specialists today.