This surgical procedure creates new joint surfaces through replacing both ends of bones in joints that are damaged. The damaged joint will be removed and replaced by a metal ball, stem, and artificial plastic cup socket.
Why is this Surgery Done?
This procedure is done to replace the femur with a metal ball and the hip socket within the pelvic bone is resurfaced with a plastic liner and a metal shell. It is used to replace all damaged cartilage with new material. Progressively severe arthritis affecting the hip joint is the most common reason this surgical procedure is performed, followed by osteoarthritis affecting the hip joint, hip joint fractures, hip joint trauma, aseptic necrosis of hip bone and rheumatoid arthritis.
Total Hip Replacement Surgery Procedure
Patients will be put under general anesthesia. In few cases, regional anesthesia is used. Antibiotics may also be administered during surgery to help prevent infection.
This surgery can be done with minimally invasive measures, though this is not common, or through large incisions, which is very common. Once the necessary incisions are made, the damaged joint, and all other required bone and tissues, are removed. The artificial joint, stem and plastic cup socket are then inserted. Once everything is in place, methylmethacrylate, a bony cement, is used to fix the stem into the femur. In some cases, a cementless prosthesis is used. The cementless hip is more durable and better for younger patients.
Total Hip Replacement Surgery Recovery
For about the first 24 hours after surgery, the patient will receive intravenous antibiotics. They will receive pain medication to help keep them comfortable, as well, and this can be administered intravenously or orally. Some patients will receive anticoagulants to help prevent blood clots, anti-nausea medications to help alleviate nausea, and medications to help relieve constipation if it occurs.
When the patients awakes from surgery, she will have a catheter connected to the bladder so that she does not have to get out of bed when she has to urinate. A compression stocking or compression pump may be on the leg to help prevent blood clots and keep the blood circulating. There may be a cushion between the legs that help to keep the new hip in correct alignment.
Through the first few days, the patient will most likely still be taking medicine, such as anticoagulants and pain medications. Pain medication will be gradually reduced as the pain improves. Anticoagulants may be taken for several weeks.
The type of rehabilitation used will depend on whether a cementless or cement method was used for joint replacement surface attachment. An uncemented hip will generally have to avoid having weight put on it for approximately six weeks, while a hip that was cemented can often have weight put on it right away. A cane, crutches or walker, is often used for several weeks, regardless of the type surgery done. It usually takes at least six months for total rehabilitation.
Possible Risks and Complications
This is a major surgery, therefore, there are risks and complications that patients can experience. The risks associated with the surgery itself and the recovery period include:
- Blood clots
- Nerve injury
- Bone deposits in the hip joints soft tissues
- Difference in leg length
- Anesthesia complications
- Infection in the joint or around the surgical wound
- Problems with wound healing
- Hip dislocation after surgery
The long-term risks include:
- The artificial hip joints parts loosening
How Well Does this Surgery Work?
Most patients notice that their level of pain is drastically reduced once they recover from this surgery. They are often able to resume their normal activities without pain or a limited range of motion. Most artificial hip joints will be good for at least ten to twenty years or longer. The younger the patient, the more likely it is they will need a second replacement because younger people tend to perform activities that put more stress on their joints. Those who are at least sixty years of age when they have the operation will most likely not need to have a second replacement.
MedicineNet. (2010). Total Hip Replacement. Retrieved on June 19, 2010 from MedicineNet: https://www.medicinenet.com/total_hip_replacement/article.htm
WedMD. (2009). Hip Replacement Surgery. Retrieved on June 19, 2010 from WebMD: https://arthritis.webmd.com/hip-replacement-surgery
Hip Replacement X-Ray: National Institutes of Health – Wikimedia Commons