Hip Replacement Surgery

This information is provided for educational purposes only and is not meant to substitute for consultation or specific instructions given by your doctor regarding this procedure. Always consult your doctor for diagnostic and treatment options for your specific medical condition.

Over the next few minutes, we’ll be sharing information to help you prepare for a hip replacement. We’ll also provide information about what to expect both during and after the procedure. A hip replacement surgery involves removing diseased or damaged parts of the hip joint and replacing it with new, artificial parts, called prostheses. The purpose of hip replacement is to restore hip joint function, increase mobility, relieve pain, and improve quality of life.

Joints are areas where two or more bones meet. The hip is a ball-and-socket joint where the thighbone or femur meets the pelvic bone. The pelvic bone has a cup-like depression called the acetabulum, or hip socket. The ball part of the joint is the head of the femur and fits into the socket. The hip joint can move in all directions, allowing for activities ranging from walking to exercising.

Normally, the hip socket and femur head have a smooth, pearly, white cartilage covering. This cartilage provides for easy, gliding movements and cushions the joints. Osteoarthritis of the hip, the most common form of arthritis, is a degenerative joint disease. This condition causes the cartilage to break down, producing rough and painful bone-on-bone contact.

Persons with significant joint disease may have difficulty putting on shoes, walking, and climbing stairs. Treatment for osteoarthritis may result in hip replacement.

Hip fracture, another common reason for hip surgery, may occur from a fall or from hip bones weakened due to osteoporosis. Other conditions that may cause hip joint degeneration and require hip replacement include rheumatoid arthritis, infections, and hip deformities.

Now that you have a description of what a hip replacement is, and an idea of why it’s done, let’s look more closely at what happens before, during, and after your surgery.

Before surgery, your doctor will determine more about your specific condition by doing a hip exam and x-rays. The hip exam may include checking the alignment of your pelvis, testing the flexibility of your hip joint, and looking for presence of arthritis. Some hip tenderness can occur during the exam. X-rays of the hip will help to further identify your specific problem.

An explanation of the surgical procedure and your new hip prosthesis will be provided. There are four main prosthetic or artificial parts for a hip replacement: the cup, the liner, the artificial joint stem, and a specially-sized ball. These may be made from various materials such as metals and plastics.

When preparing for your surgery, questions will be asked about your medical history. Be sure to let your doctor know if you're sensitive or allergic to any medications, latex, tape, or anesthesia. It's important to mention all medications and supplements that you’re taking.

Surgical risks and benefits will be discussed. The most common problem after surgery is hip dislocation. When this occurs, the replacement joint may become loose or not work as it should. More immediate complications that may occur are bleeding, infection, or blood clots in the leg or lungs. There may also be other risks specific to your medical condition. Be sure to ask questions if something isn't clear. You'll be asked to sign a consent form that gives your permission to do the surgery. You'll also be instructed not to eat or drink after midnight on the night before your procedure. Based on your medical condition, your doctor may request other specific preparation.

Prior to surgery, you'll be given a hospital gown to wear. Vital signs will be taken and an IV will be inserted.

During surgery, the diseased bone and cartilage will be removed from the hip socket. The cup and the liner will be inserted into the hip socket and may be cemented or secured with surgical screws. The femur head will be removed and the upper part of the femur bone will be hollowed out so the artificial joint stem can be inserted. A specially-sized ball, to replace the femur head, will then be attached to the joint stem, completing the hip prosthesis. Incision size will vary depending on the type of surgical approach that’s used.

After surgery, you'll go to a recovery area and then to a hospital room. Your rehabilitation will begin with simple exercises in your bed and gradually progress to walking and climbing stairs. This allows time for the prosthesis and the muscles surrounding the hip to heal.

Your doctor, physical therapists, and nurses will demonstrate safe movements and specific exercises. They will also explain body positions to avoid. It's important to ask for assistance to prevent injury, and to carefully follow the instructions you’re given.

Be assured that you'll receive pain medication to keep you comfortable as you gradually become more active. Certain assistive devices will help you keep your new hip in proper alignment. For example, a trapeze-bar is useful when changing positions while you're in bed.

A pillow or a special cushion placed between your legs keeps your new hip in place. Also, moving your feet up and down will help prevent blood clots and promote blood return to your heart. This exercise is sometimes called “ankle pumps”.

You'll be shown how to safely get out of the bed and sit in your chair. Positions such as bending over or bending forward to pull up a blanket, crossing your legs, or sitting in a low chair must be avoided.

Within the first few days after surgery, your rehab program will continue in the physical therapy department. Here, you’ll learn new exercises to further strengthen muscles and restore normal hip movement. Instructions will also be provided on how to use a walker.

Other aids are available to ease your recovery and prevent hip injury at home. An occupational therapist will teach you how to use these in a safe and effective way.

A “reacher” may be used to pull up your pants or pick up items without having to bend at the waist. A sock-aid is used to put on your socks without bending forward.

At home, it's important for you to continue your exercises because they're vital to your recovery.

In addition, be sure to keep the incision clean and dry and report any redness, drainage, or other problems to your doctor.

New medications may include antibiotics, blood thinners, and pain medications. Depending on your particular situation, you may receive different instructions to meet your specific needs. Generally, full recovery takes three to six months and includes outpatient rehab.

Hip replacement is a well established and effective treatment for degenerative joint disease. Research continues to focus on innovative surgical techniques and new prosthetic designs.