Hip Replacement Surgery: Procedures, Types, and Risks

Hip replacement surgery involves surgically removing a worn or arthritic hip joint and replacing it with a prosthetic joint, typically made from metal and plastic components. This procedure is usually recommended when other treatment options have not effectively reduced pain. The primary aim is to alleviate hip pain and enhance mobility, allowing for smoother and more comfortable everyday activities such as walking.

How Do You Know If You Need Hip Replacement Surgery?

Hip replacement surgery can be necessary if hip pain is affecting your quality of life. Declining quality of life indicators include:

• Inability to sleep soundly due to pain
• Having trouble with simple chores like dressing or climbing stairs
• Being unable to fully engage in the activities you love

Your doctor could first suggest additional therapies like joint injections, walking aids, painkillers for inflammation or pain, or physical therapy. If the above therapies are ineffective in reducing pain and stiffness, hip replacement surgery can be required to restore function and enhance quality of life.

Types of Hip Replacement Surgeries

A number of factors influence the kind of hip replacement you might require. Your doctor will consider each of the following factors when deciding how to treat you.

1. Total and Partial Hip Replacement Surgeries:

Both the ball and the socket are replaced during total hip replacement (also known as total hip arthroplasty). Only the ball is replaced during a partial hip replacement (the head of the femur).

2. Anterior, Posterior, and Lateral Hip Replacements:

An orthopedic surgeon can access the hip from a variety of positions. There are three typical ways to reach the hip joint:

• From the front (anterior approach to hip replacement)
• From the side (lateral approach to hip replacement)
• From the back (posterior approach to hip replacement)

3. Traditional and Minimally Invasive Hip Replacement Surgery:

Minimally Invasive Hip Replacement Surgery:

The goal of minimally invasive hip replacement is to lessen the impact of surgery on healthy tissues, including blood vessels and muscles. Orthopaedic doctors today employ minimally invasive procedures with all surgical routes to access the hip, despite the fact that only anterior hip replacement has been promoted as such. Your surgeon will discuss with you what strategy would yield the best outcome.

When doing minimally invasive surgery, the surgeon separates the muscles to access the hip joint through one or two tiny incisions. This strategy may offer benefits like:

• Reduced danger of muscle injury
• Fewer pains
• Faster and simpler recovery
• Less stumbling
• Reduction in hospital stay
• Decreased risk of hip dislocation

Not all patients are candidates for minimally invasive hip replacement. Your age, weight, degree of fitness, and other characteristics will assist the surgeon in determining whether you are a good candidate.

Traditional Hip Replacement Surgery:

A typical hip replacement involves a single, big incision that allows the surgeon to obtain access to the hip, which is commonly done from the side (lateral approach) or from the rear (back approach) (posterior approach).

Because the surgeon must cut through or detach several muscles and tendons to reach the joint, recovery following a typical hip replacement can be lengthy. (When the hip implants are in place, the muscles and tendons are healed.) You may be at risk of dislocation until all of the supporting components in your new hip have healed.

Before the Procedure

Prior to your hip replacement surgery, your orthopedic surgeon will conduct a full physical examination and ask about your symptoms, lifestyle, and any medications or supplements you’re currently taking. They will assess the mobility of your affected hip by comparing it with the other side, checking how your joints move, and how well the surrounding muscles function.

To ensure you’re ready for surgery, several diagnostic tests may be required. These commonly include:

• X-rays of your hip to assess joint damage.
• Blood tests, including a basic metabolic panel (BMP), help check your body’s overall condition and readiness for surgery.
• Urinalysis is performed to detect infections or identify other potential health issues.

Additional imaging, such as an MRI or CT scan, may be used to get a more detailed view of the joint. Your surgeon may also recommend an electrocardiogram (EKG) to assess heart health before proceeding.

During the Procedure

Hip replacement surgery consists of extracting the damaged or worn parts of the hip joint and substituting them with a prosthetic implant. Before surgery begins, you’ll receive regional anesthesia, often called a spinal block, which numbs the lower part of your body while keeping you relaxed but awake.

Once you’re under anesthesia, the surgeon will carefully remove worn-out bone and cartilage and insert the prosthetic components, which are typically made from metal, ceramic, or high-grade plastic. These components are crafted to replicate the natural movement and function of your hip joint.

The entire surgical process usually takes about one to two hours, though the exact duration may vary based on the specific type of hip replacement being performed and your overall health.

The Aftermath of Hip Replacement Surgery

You will most likely be hospitalized for four to six days and may be required to sleep with a wedge-shaped cushion between your legs to keep the new hip joint in place. A drainage tube will most likely be inserted into your bladder to assist you in going to the bathroom. Physical therapy normally begins the day following surgery, and you should be able to walk with a walker, crutches, or a cane within a few days. Physical therapy will be required for several weeks to months after surgery.

Activities to be Avoided After a Hip Replacement

Pivoting or twisting on the affected limb should be avoided for six to twelve months after hip replacement surgery. You should also avoid crossing the concerned leg past the body’s midline, turning the involved leg inward, and bending the hip past 90 degrees. This includes bending forward at the waist as well as squatting.

Your physical therapist will teach you skills and give you adaptive equipment to help you follow any of the above tips and precautions while going about your regular activities. Ignoring your therapist’s advice could result in the dislocation of your surgical replacement hip joint, necessitating another surgery.

Certain sports or hard activities should be avoided even after your hip joint has recovered. The replacement joint is intended for normal daily activity.

A Few Home Remedies to Follow After Hip Replacement Surgery

You can take a few basic steps to make life easier when you return home after hip replacement surgery, such as:

1. Reduce the number of stairs climbed. Make the appropriate arrangements so that you only have to climb the stairs once or twice a day.
2. Sit in a chair with a solid, straight back. Recliners are not permitted.
3. Remove all throw rugs and keep the floors and rooms clear of debris.
4. Make use of an elevated toilet seat. This can help you avoid bending your hips too far.
5. Keep boisterous pets at bay until you have fully recovered.

How Safe is Hip Replacement Surgery?

Hip replacement surgery has been conducted for many years, and surgical procedures are constantly being refined. However, like with any surgery, there are hazards. Blood clots are a particular concern because you won’t be able to walk much at first. Your doctor will prescribe blood thinners to help avoid blood clots. Infection and bleeding are additional possibilities, as are the hazards of employing general anaesthesia.

Other less common problems that you and your doctor should be aware of are:

• Following surgery, your legs may not be of similar length.
• You must avoid crossing your legs or sitting too low since the joint may become dislocated.
• Fat fragments in the bone marrow may become loose, enter the bloodstream, and enter the lungs, causing severe breathing issues.
• Nerves in the hip area can be affected by swelling or pressure, resulting in numbness.
• Replacement parts may become loose, broken, or contaminated.

Frequently Asked Questions