Hip Replacement - Diagnosis, Surgery & Recovery
Chronic hip pain, hip arthritis, limping, or weakness in the lower extremities can indicate that you may need hip replacement surgery. Typically hip replacement surgery is recommended when the hip joint is damaged because of degenerative disease or trauma.
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What is Hip Replacement Surgery?
Hip replacement surgery is usually performed to replace the damaged hip joint with artificial implants to restore joint mobility and function. An orthopedic surgeon usually recommends this surgery to patients with severe hip joint arthritis or necrosis, who’ve become bedridden due to pain and joint instability. During the surgery, only the affected parts of the joint are removed, whether it is a small portion of the entire joint.
Hip replacement surgery is also known as hip arthroplasty. The aim of the procedure is to allow you to resume daily activities and exercise without any pain.
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Types of Hip Replacement Surgery
Total Hip Replacement
In total hip replacement surgery, a surgeon removes both the ball and socket from the damaged joint and replaces them with prosthetics made from metal, plastic, or ceramic. It can either be done traditionally (called the anterior approach) through the front of the leg or via a minimally invasive incision through the back of the joint (posterior approach), which is more conventional.
Partial Hip Replacement
In a partial hip replacement, a surgeon replaces only the ball of the hip joint, leaving the socket intact. It is also known as hemiarthroplasty. The primary aim of this surgery is to treat fractures and other traumatic hip injuries where the ball is cracked and cannot be pinned. It is not typically used to treat degenerative conditions where both parts of the joint have been damaged.
Hip Surfacing
In hip surfacing, the original joint remains in place but is covered with a thin metal sheet. In this procedure, only a few centimeters of bone are removed, enough to ensure a tight fit with the metal. It has a lower risk of dislocation since much of the original bone is preserved. Patients may be able to return to normal physical activity once they’re healed.
Diagnosis Before Hip Replacement Surgery
- Medical history: An orthopedic surgeon gathers information about your general health and asks questions about the extent of your hip pain and how it affects your ability to perform everyday activities.
- Physical examination: This test helps assess hip mobility, strength, and alignment.
- X-rays: It is an imaging test that provides images to help determine the extent of damage or deformity in your hip.
- Other tests: In some cases, other tests, such as a magnetic resonance imaging (MRI) scan, may be needed to determine the condition of the bone and soft tissues of your hip.
What is the Procedure of Hip Replacement Surgery?
During total hip replacement surgery, a surgeon removes the damaged part of the hip joint and replaces it with prosthetic components. The head of the thigh bone is removed and replaced with a metal stem that is placed into the hollow center of the femur. The stem may be secured in place, either with bone cement or is press fit into the bone. After that, a prosthetic (metal or ceramic) ball is placed on the upper part of the stem. This ball replaces the femoral head that was removed. After that, the damaged acetabulum is removed and replaced with a metal socket. A surgeon usually uses screws or cement to hold the socket in place.
There are two basic types of hip replacement procedures: traditional hip replacement and minimally invasive.
Traditional Hip Replacement Surgery
In this surgical procedure, a surgeon makes a 10- to 12-inch incision on the side of the hip, then splits or detaches the muscles from the hip, allowing the hip to be dislocated and fully viewed. After that, a surgeon removes the damaged femoral head and inserts a metal stem into the hollow center of the femur. A surgeon then places a metal or ceramic ball on the upper part of the stem. This ball replaces the damaged femoral head that was removed.
A surgeon removes the damaged cartilage surface of the socket (acetabulum) and replaces it with a metal socket, and may use screws or cement to hold the socket in place. A surgeon inserts a plastic, ceramic, or metal spacer between the new ball and the socket to allow for a smooth, gliding surface.
Minimally invasive hip replacement surgery
In this surgical procedure, a surgeon cuts less of the tissue surrounding the hip. The artificial implants used are same as those used for traditional hip replacement. However, specially designed surgical instruments are needed to prepare the socket and femur and to place the implants properly. Minimally invasive total hip replacement can be performed with either one or two small incisions. Smaller incisions allow for less tissue disturbance. In small incision surgery, a surgeon makes a single incision of around 3 to 6 inches. A surgeon usually makes the incision on the side or back of the hip. The muscles and tendons are split or detached from the hip but to a lesser extent than in traditional hip replacement surgery. They are routinely repaired after a surgeon places the implants. This encourages healing and helps prevent dislocation of the hip.
In multiple incision surgery, a surgeon performs a hip replacement through two separate small incisions. The reason behind two incisions is to approach the pelvis (cup) through one incision and the femur (thighbone) through a separate incision.
Approaching the hip in this manner may allow for less disruption of the underlying tissues compared to using one incision.
For this procedure, a surgeon often uses X-ray guidance during surgery to ensure proper placement of the implants.
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Frequently Asked Questions
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Is there a need for rehabilitation or physiotherapy after hip replacement?
In most cases, a healthcare provider suggests physiotherapy right after the surgery to restore strength and mobility. A doctor usually recommends physiotherapy for up to 3 months with an average of 2 weekly sessions to promote healing.
Is hip replacement surgery painful?
In some cases, patients experience swelling and pain at the joint after the hip replacement surgery. A doctor usually recommends medications and physiotherapy to help reduce the pain.
What is the use of walkers for hip surgery?
A doctor usually recommends using a walker after hip replacement surgery for the additional support and stability.
When can I return to work after a hip bone replacement?
In most cases, patients return to work within 4-12 weeks after the surgery. However, you must avoid lifting heavy objects as it can be tough on the hips.
Can both hips be replaced simultaneously?
Some patients have degenerative problems in both hips. In such cases, a doctor usually recommends bilateral total hip replacement. This surgery is safe and effective, with a high success rate.
