Hip Replacement

If your hip has been damaged by arthritis, a fracture or other conditions, common activities such as walking or getting in and out of a chair may be painful and difficult. You may even feel uncomfortable while resting. If medications, changes in your everyday activities, and the use of walking aids such as a cane are not helpful, you may want to consider hip replacement surgery. By replacing your diseased hip joint with an artificial joint, hip replacement surgery can relieve your pain and help you get back to enjoying normal, everyday activities.

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Frequently Asked Questions (FAQ’s)

The information presented below is only for informational purposes. Your surgeon will talk to you about details regarding your specific procedure.

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What are some causes of chronic hip pain?

There are numerous reasons why you may need a hip replaced. They are:

• Hip pain limits your everyday activities such as walking, bending.
• Hip pain continues while resting, either day or night
• Stiffness in a hip limits your ability to move or lift your leg.
• You have little pain relief from anti-inflammatory drugs.
• You have harmful or unpleasant side effects from your hip medications.
• Other treatments such as physical therapy don't relieve hip pain.

What can I expect during my surgical evaluation?

Your orthopedic surgeon will review the results of your evaluation with you and discuss whether hip replacement surgery is the best method to relieve your pain and improve your mobility. Other treatment options such as medications, physical therapy, or other types of surgery also may be considered. He/she will explain the potential risks and complications of hip replacement surgery, including those related to the surgery itself, and those that can occur over time after your surgery. The orthopedic evaluation consists of several components:

• A medical history, in which your 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 every day activities.
• A physical examination to assess your hip's mobility, strength, and alignment.
• X-rays to determine the extent of damage or deformity in your hip.
• Occasionally, blood tests, or other tests such as an MRI (Magnetic Resonance Imaging) or a bone scan may be needed to determine the condition of the bone and soft tissues of your hip.

What can I expect from a hip replacement?

The vast majority of individuals who undergo hip replacement surgery experience a dramatic reduction of hip pain and a significant improvement in their ability to perform the common activities of daily living. However, hip replacement surgery will not enable you to do more than you could before your hip problem developed. Following surgery, you will be advised to avoid certain activities for the rest of your life including jogging and high-impact sports. Even with normal use and activities, an artificial joint (prosthesis) develops some wear over time. If you participate in high-impact activities or are over-weight, this wear may accelerate and cause the prosthesis to loosen and become painful.

How can I prepare for hip replacement surgery?

If you decide to have hip replacement surgery, you may be asked to have a complete physical by the surgeon before your surgery. This is needed to assess your health and find conditions that could interfere with your surgery or recovery. Several tests, such as blood samples, a cardiogram, chest X-rays and urine sample may be needed to help plan your surgery. Your skin should not have any infections or irritations before surgery. You may also be advised to donate your own blood prior to surgery. It will be stored in the event you need blood after surgery. You should tell your orthopedic surgeon about any medications you are taking prior to surgery. They will advise you which medications you should stop or can continue taking before surgery. If you are overweight, your doctor may ask you to lose some weight before surgery to minimize the stress on your new hip.

Although infections after hip replacement are not common, an infection can occur if bacteria enter your bloodstream. Since bacteria can enter the bloodstream during dental procedures, treatment of significant dental diseases (including tooth extractions and periodontal work) should be considered before your hip replacement surgery. Routine cleaning of your teeth should be delayed for several weeks after surgery. A urological evaluation before surgery should be considered by individuals with a history of recent or frequent urinary infections. Older men with prostate disease should consider a urologic evaluation and treatment before having hip replacement surgery.

You will be able to walk with crutches or a walker soon after surgery; you will need some help for several weeks with such tasks as cooking, shopping, bathing, and laundry. If you live alone, your surgeon's office, a social worker, or a discharge planner at the hospital can help you make advance arrangements to have someone assist you at your home. A short stay in an extended care facility during your recovery after surgery also may be arranged.

What type of anesthesia is used during the procedure?

The most common types of anesthesia for hip replacement surgery are general anesthesia (which puts you to sleep throughout the procedure) or spinal anesthesia (which allows you to be awake but anesthetizes your body from the waist down). The anesthesia team will discuss these choices with you and help you decide which type of anesthesia is best for you.

What is the actual hip replacement procedure like?

The surgical procedure takes a few hours. Your orthopedic surgeon will remove the damaged cartilage and bone, then position new metal and plastic joint surfaces to restore the alignment and function of your hip.

Many different types of designs and materials are currently used in artificial hip joints. All of them consist of two basic components: the ball component (made of a highly polished strong metal) and the socket component (a durable plastic cup which may have an outer metal shell). A special surgical cement may be used to fill the gap between the prosthesis and remaining natural bone to secure the artificial joint.

A non-cemented prosthesis has also been developed which is used most often in younger, more active patients. The prosthesis may be coated with textured metal or a special bone-like substance which allows bone to grow into the prosthesis. A combination of a cemented ball and a non-cemented socket may be used. Your orthopedic surgeon will choose the type of prosthesis that best meets your needs.

After surgery, you will be moved to the recovery room where you will remain for one to two hours while the recovery from anesthesia is monitored. After you awaken fully, you will be taken to your hospital room.

What are possible complications of hip replacement?

The complication rate following hip replacement surgery is low. Serious complications, such as joint infection, occur in less than 2 percent of patients. Major medical complications, such as heart attack or stroke, occur even less frequently. However, chronic illnesses may increase the potential for complications. Although uncommon, when these complications occur they can prolong or limit your full recovery. Blood clots in the leg veins or pelvis are the most common complication of hip replacement surgery. Your orthopedic surgeon may prescribe one or more measures to prevent blood clots from forming in your leg veins, such as special support hose, inflatable leg coverings, and blood thinners.

What can I expect after the surgery?

You will stay in the hospital for a few days. After surgery, you will feel pain in your hip. Pain medication will be given to make you as comfortable as possible. To protect your hip during early recovery, a positioning splint, such as a V-shaped pillow placed between your legs, may be used. Walking and light activity are important to your recovery and will begin the day after your surgery. Most hip replacement patients begin standing and walking with the help of a walking support and a physical therapist the day after surgery. The physical therapist will teach you specific exercises to strengthen your hip and restore movement for walking and other normal daily activities.

When can I return to normal activities and what care is required after the surgery?

The success of your surgery will depend in large measure on how well you follow your orthopedic surgeon's instructions regarding home care during the first few weeks after surgery. You will have stitches or staples running along your wound or a suture beneath your skin. The stitches or staples will be removed about two weeks after surgery. Avoid getting the wound wet until it has thoroughly sealed and dried. A bandage may be placed over the wound to prevent irritation from clothing or support stockings.

Some loss of appetite is common for several weeks after surgery. A balanced diet, often with an iron supplement, is important to promote proper tissue healing and restore muscle strength. Be sure to drink plenty of fluids. Exercise is a critical component of home care, particularly during the first few weeks after surgery. You should be able to resume most normal light activities of daily living within three to six weeks following surgery. Some discomfort with activity, and at night, is common for several weeks.

Your activity program should include:

• A graduated walking program initially in your home and later outside.
• Walking program to slowly increase your mobility and endurance.
• Resuming other normal household activities.
• Resuming sitting, standing, walking up and down stairs.
• Specific exercises several times a day to restore movement.
• Specific exercises several times a day to strength your hip joint.
• May wish to have a physical therapist help you at home.

Download a brochure from Depuy Orthopedics about Hip Replacement