Hip Replacement also referred to as total hip arthroplasty, hip replacement surgery can be an alternative for you if your hip pain hinders your daily activities and more-conventional treatments has not helped or are no longer useful. Arthritis damage is the most prevalent cause of a hip replacement.
Why it’s done
Conditions that can denigrate the hip joint, occasionally requiring hip replacement surgery, include:
Osteoarthritis. Ordinarily identified as wear-and-tear arthritis, osteoarthritis damages the smooth cartilage that covers the ends of bones and helps joints move smoothly.
Rheumatoid arthritis. Produced by an immune system that is hyperactive, rheumatoid arthritis generates a type of inflammation that can decay cartilage and sometimes underlying bone, creating damaged and malformed joints.
Osteonecrosis. If there is poor blood circulation to the ball portion of the hip joint, the bone may become deformed or collapse.
You might contemplate hip replacement if you’re undergoing hip pain that:
- Worsens with movement such as walking, even with a cane or walker
- Persists, despite pain medication
- Prevents you from sleeping
- Impacts your ability to go up or down stairs
- Makes it challenging to rise from a seated position
Risks linked with hip replacement surgery may comprise:
- Blood clots. Clots can develop in your leg veins following the surgical procedure. This can be risky because a portion of a clot can tear off and progress to your heart, lung, or in rare instances your brain. Your physician may recommend blood-thinning medications to decrease this risk.
- Infection. Infections can transpire at the surgical site of the incision and in the deep tissue near your new hip implant. The majority of infections are managed with a dose of antibiotics, but a severe infection near your prosthesis may necessitate additional surgery to remove and replace the first prosthesis.
- Fracture. During the surgery, healthy parts of your hip joint may become damaged and fracture. Sometimes the fractures are so minute that they heal on their own. However, more massive fractures may require correction with pins, wires, and potientialy bone graft or metal plates.
- Dislocation. Some positions can force the ball of your new joint replacement to dislodge, especially in the first few months following surgery. If the hip dislocates, your surgeon may place you in a brace to keep the hip in the precise position. If your hip persists to dislocated again, surgery is often needed to stabilize it.
- Change in the length of Your Leg. Your surgeon exercises precautions to avoid the issue, however occasionally a new hip makes one leg longer or shorter than the other. Sometimes this is produced by a contracture of muscles encompassing the hip. In this instance, gradually and continued stretching and strengthening those muscles may help correct this misalignment.
- Loosening. Even though this complication is rare with newer implants, your new joint may not grow solidly attached to your bone or may loosen over time, producing pain in your hip. Surgery may be needed to fix the issue.
- Require a second hip replacement
Your prosthetic hip joint may ultimately wear out, so if you have hip replacement procedure when you’re reasonably young and active, you may eventually need a second hip replacement. Nevertheless, new materials are making implants last longer, so a second prosthetic may not be needed,
Most artificial hip joints have a polished metal or ceramic ball that goes into a cup liner that’s composed of solid plastic. Some older kinds of prostheses utilized principally in the last decade use an alloy cup liner, which may last longer but can induce other problems. Metal-on-metal prostheses are more likely to expose metal ions into your bloodstream, which can produce inflammation and bone erosion. Due to these concerns, metal-on-metal prostheses are now infrequently used.
How you prepare for Surgery
Before surgery, you’ll meet with your orthopedic surgeon for an exam. The surgeon will:
Inquire about your medical history and current medications
Do a brief general physical examination to make sure you’re healthy enough to undergo surgery
Examine your hip, analyzing the range of motion in your joint and the health of the surrounding muscles
Request blood tests, an X-ray and potentially an MRI
This preoperative evaluation is a good time for you to ask questions about the procedure. Be sure to find out which medicines you should avoid or proceed to take in the week before surgery.
What you can expect
When you check in for your operation, you’ll be asked to remove your clothing and put on a hospital robe or gown. You’ll be provided either a general anesthetic or a spinal block, which dulls the lower portion of your body.
During the procedure
To perform a hip replacement, your surgeon:
Makes an incision over the anterior or side of your hip, through the folds of skin, fat, muscle and tendon tissue
Removes damaged and diseased bone and cartilage, leaving healthy bone intact
Implants he prosthetic socket into your pelvic bone, to replace the damaged socket
Replaces the round ball above your femur with the prosthetic ball, which is fastened to a stem that positioned into your thighbone
Techniques for hip replacement are changing and improving. As surgeons continue to form less invasive surgical methods, these techniques might reduce rehabilitation time and pain.
After the procedure
After surgery, you’ll be transferred to a recovery area for several hours while your anesthesia wears off. Hospital staff will observe your, consciousness, alertness, blood pressure levels, pain, pulse, alertness or comfort level, and your need for medications.
Preventing Blood clots
After your procedure, you’ll be at heightened risk of blood clots in your legs. Reasonable measures to limit this complication include:
Early movement. You’ll be urged to sit up and even attempt walking with walker or crutches quickly following the surgery. This will likely transpire the same day as your surgical procedure or on the following day.
Pressure application. Both during and after surgery, you may wear inflatable air sleeves or elastic compression stockings – comparable to a blood pressure cuff on your lower legs. The pressure exerted by the puffed sleeves assists to keep blood from pooling in the veins of the leg, decreasing the chance that clots will develop.
Blood-thinning drugs. Your surgeon may recommend an injected or oral blood thinner after surgery. Based on how quickly you walk, how busy you are and your overall risk of blood clots, you may require blood thinner medications for several additional weeks after surgery.
A physical therapist may aid you with some exercises that you can do in the hospital and at home to expedite recovery.
Exercise should be a routine for your day to regain the use of your muscles and joints. Your physical therapist will prescribe strengthening and movement exercises and will aid you in learning how to use a walking aid, such as crutches, a cane, or walker. As therapy progresses, you’ll usually increase the weight you put on your leg until you’re able to walk without assistance.
Home recovery and follow-up care
Before you exit the hospital, you and your caregivers will receive guidance on treatment and care for your replaced hip. For a steady transition:
Arrange to have a friend or relative prepare some meals for you
Place everyday items at waist level, so you can avoid having to bend down or reach up
Think about making some modifications to your home, such as getting a raised toilet seat if you have an usually low toilet
Six to 12 weeks post- surgery, you’ll have a follow-up appointment with your surgeon to make sure your hip is healing correctly. If rehabilitation is advancing as planned, most people return to their normal activities by this time — even if in a restrained fashion. Further recovery with increasing strength will often occur for six to 12 months.
Expect your new hip joint to decrease the pain you felt before your surgery and improve the range of motion in your joint. But don’t expect that you can do everything you did before your hip being in pain. High-impact activities — such as playing basketball, running or tennis — may be too demanding on your artificial joint. However, in time, you may be able to hike, swim, play golf or ride a bike comfortably.