Hip Replacement

Overview

Hip replacement surgery is a complicated orthopedic procedure that may be needed if your hip has been damaged by arthritis, a fracture, or other activities.

While the surgery will likely relieve your hip pain, you may not be able to do everything you did before surgery. If you participate in high-impact activities, such as running, you may not be able to do these again. However, you will be able to do other activities such as a hike or ride a bicycle.

Hip replacement candidates

You may be a candidate for a hip replacement if you:

• Have moderate to severe hip arthritis that is impacting your ability to do everyday activities.
• Have issues related to a broken hip or bone death in the hip area.
• Your symptoms are not relieved from nonsurgical therapies.
• Have a limp associated with joint degeneration.
• Are having trouble sleeping due to moderate to severe hip pain.

Hip replacement risks

When you have hip replacement surgery with an experienced surgeon, hip replacement is generally safe. When complications do occur, they may include:

• Blood clots — A blood clot can form in the leg after surgery, break off and travel to your heart or brain.
• An infection can occur at the incision site or in tissue near the artificial hip. An infection can be treated with an antibiotic.
• Healthy areas of the hip joint may fracture during surgery. If the fracture is large, it may need to be surgically repaired.
• The ball of the new joint can be dislodged in the months after surgery. If this occurs, you may need a brace to keep the hip in place.
• Leg length differences — In rare cases, the artificial hip can make one leg shorter or longer than the other. If this occurs, strengthening or stretching exercises may help.
• Hip pain due to a loosening new joint — While rare, if your new joint is not solidly attached to the bone, it may loosen, and surgery is needed to fix the issue.
• Second hip replacement — If you had an initial hip replacement at a young age, you might need a second hip replacement.
• Complications from artificial materials used — If your surgeon used metal on metal prostheses in the hip, the metal might be released into the bloodstream, which can lead to inflammation and erosion in the bone.

Hip replacement preparation

In preparation for a hip replacement, you will visit the clinic to meet with a practice coordinator and orthopedic surgeon. Your practice coordinator will outline the process and what you need to do to prepare for the procedure. Your surgeon will perform a physical exam to make sure you can withstand surgery, as well as examine your hip to evaluate your range of motion and strength of surrounding muscles. You will likely also need blood tests and an X-ray during this visit.

Guidelines to prepare for surgery include:

• Stop taking nonsteroidal anti-inflammatory medications such as ibuprofen and aspirin. These medications may interfere with the body’s ability to clot blood, which could lead to excess blood loss.
• Patients who are blood thinners will be advised on when to stop them before surgery.
• Stop taking any herbal supplements about a week before surgery.
• Tylenol is approved until surgery day.
• Inform your doctor of any dental work you are having within two weeks of your surgery. Dental procedures can allow bacteria to enter the bloodstream, leading to an infection.
• Prepare your home before surgery, so you are comfortable when recovering after surgery.
• Plan to have a friend or caregiver with you around the clock for the first week after surgery.
• Do not eat or drink after midnight on the day before surgery.

Hip Replacement expectations

A hip replacement is performed under general anesthesia or with a spinal block that numbs your lower body.

During the procedure, your surgeon will make an incision in the front of the hip, where he or she will remove damaged bone or cartilage. The surgeon will then implant an artificial socket in the pelvic bone, replacing the damaged socket. He or she will then replace the ball that sits on top of the femur with an artificial ball, which is attached to the stem that fits into the thigh.

Hip replacement duration

Unless your procedure is outpatient and you go home that day, you will stay in the hospital for up to four days depending upon how quickly you are recovering. Before being discharged, your doctor will make sure:

• You are not in severe pain.
• You can get in and out of bed by yourself.
• You can eat, drink, and use the bathroom.

If you need additional assistance after surgery performing any of these activities, you may need to be moved to a rehabilitation or skilled nursing facility