Is It Time for a Hip Replacement?

Total Hip Replacement

Hip replacement (total hip arthroplasty) is surgery to replace a worn out or damaged hip joint. The surgeon replaces the old joint with an artificial joint(prosthesis). This surgery may be a choice after a hip fracture or for severe pain because of arthritis. The most common reason for a total hip replacement (also called total hip arthroplasty) is osteoarthritis although there are several other reasons why it may be necessary, like disease or injury. In this surgery, the affected bone and cartilage are taken out and replaced with prosthetics, most often made out of plastic or metal. This artificial joint (prosthesis) helps reduce pain and improve function.

Like other joints the hip consists of a “ball and socket” and the damaged bones, cartilage, and other tissue must be removed. The femoral head (or tip of the thigh bone) is removed and a metal stem affixed into the femur itself with its round metal head tucked into the socket of the hip. Most regular, very light activities can be resumed several weeks post hip replacement surgery. Also called total hip arthroplasty, hip replacement surgery may be an option for you if your hip pain interferes with daily activities and more-conservative treatments haven’t helped or are no longer effective. Arthritis damage is the most common reason to need hip replacement.

Why it’s done

Conditions that can damage the hip joint, sometimes necessitating hip replacement surgery, include:

  • Commonly known as wear-and-tear arthritis, osteoarthritis damages the slick cartilage that covers the ends of bones and helps joints move smoothly.
  • Rheumatoid arthritis. Caused by an overactive immune system, rheumatoid arthritis produces a type of inflammation that can erode cartilage and occasionally underlying bone, resulting in damaged and deformed joints.
  • If there is inadequate blood supply to the ball portion of the hip joint, the bone may collapse and deform. You might consider hip replacement if you’re experiencing hip pain that:
  • Persists, despite pain medication
  • Worsens with walking, even with a cane or walker
  • Interferes with your sleep
  • Affects your ability to go up or down stairs
  • Makes it difficult to rise from a seated position

Physical therapy

A physical therapist may help you with some exercises that you can do in the hospital and at home to speed recovery. Physical or occupational therapy is an absolute must in order to gain strength and to help prevent further complications.

Activity and exercise must be a regular part of your day to regain the use of your joint and muscles. Your physical therapist will recommend strengthening and mobility exercises and will help you learn how to use a walking aid, such as a walker, a cane or crutches. 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 leave the hospital, you and your caregivers will get tips on caring for your new hip. For a smooth 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
  • Consider making some modifications to your home, such as getting a raised toilet seat if you have an unusually low toilet 
Six to 12 weeks after surgery, you’ll have a follow-up appointment with your surgeon to make sure your hip is healing properly. If recovery is progressing well, most people resume their normal activities by this time — even if in a limited fashion. Further recovery with improving strength will often occur for six to 12 months.

 

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