Last Updated October 25th, 2021
About hip replacement
Hip arthroscopy or hip replacement is a surgery that involves the replacement of the hipbone with an artificial implant. This surgery helps patients move easily without pain.
If you have suffered from arthritis and it has taken a toll on your hips, or if your hip is injured due to a fracture or some other condition, you may be finding simple activities that involve movement of the hips, difficult. Patients report experiencing stiffness, pain, and extreme discomfort while performing common activities such as sitting, standing, walking, or climbing stairs.
Hip replacement surgery is worth exploring, especially if the symptoms have not reduced after making changes in everyday activities or the use of medications, or walking support. If pain is persistent even after prolonged periods of rest, doctors will evaluate you for a hip replacement procedure.
Types of hip replacement
Doctors may perform two types of hip replacements depending upon the symptoms presented by the patient
- Total hip replacement: This is the most common type of hip replacement where both acetabulum and femoral head is replaced with a prosthesis
- Partial hip replacement: During a partial hip replacement procedure, only the femoral head is replaced. This is performed on patients with certain kinds of fractures of the hip
Common causes for hip replacement surgery
Several ailments can cause acute pain in the hips and disability. Arthritis happens to be the most common cause. The most common types of arthritis are rheumatoid arthritis, traumatic arthritis, and osteoarthritis. Some of the conditions that give rise to problems with the hip joint are as follows:
Childhood hip disease
Hip problems in infancy and childhood may resurface during midlife as arthritis, even though the problems may have been treated earlier. Children with such issues may suffer deficient development of the hips with joints getting affected. Mobility issues and pain may plague such kids as they grow up.
Categorized under autoimmune diseases, it causes inflammation and thickening of the synovial membrane. The cartilage takes a beating because of the inflammation, resulting in stiffness and acute pain.
This type of arthritis can develop after a severe injury to the hip. A serious hip fracture with damage to the cartilage can also lead to this condition. This can cause pain in the hip and stiffness.
This condition is age-related and mostly people over 50 with a family history of osteoarthritis are prone to suffer this condition. They suffer pain because the cartilage that acts as a cushion for the bones of the hip wears off. This causes the bones to rub against each other resulting in stiffness and pain.
A fracture or dislocation in the hip area or any injury may impede the supply of blood to the femoral head. The condition, named osteonecrosis will eventually result in arthritis as it adversely affects the surface of the bone.
Reasons for a hip replacement surgery
Your doctor may advise hip replacement surgery for many reasons. The following experiences by patients call for hip replacement surgery.
A hip replacement surgery is beneficial when patients:
- Are unable to bend or walk due to pain that restricts movement
- Continue to have pain in the hips even after prolonged periods of rest in the day or night
- Experience a stiff hip that restricts movement in the leg or the capacity to lift it
- Do not find relief from pain relieving drugs
- When walking support or physiotherapy provides little relief
Assessment by orthopaedic specialist
For hip replacement surgery, there are no weight or age restrictions. The hip replacement surgeries have been a success, whether it was performed on younger patients suffering juvenile arthritis, or older patients that suffer a degenerative form of the condition. Orthopaedic surgeons make individual assessments on patients based on the extent of disability and pain. The decision is not based on age, as most of the patients who undergo hip replacement are between 50 to 80.
The orthopaedic specialist makes the following evaluation on patients before recommending surgery
The surgeon will ask questions about your health overall, and any specific issues. Specific questions pertaining to your hip and the degree of difficulty will be the focus of this session.
The specialist will conduct a physical examination to ascertain the mobility of the hip and its strength. X-rays help assess the extent of deformity and damage. At times, the doctor may also want to see the results of an MRI scan to evaluate the condition of tissues and bone.
Once the test results are ready, the surgeon usually discusses the evaluation with the patient.
What should patients expect after a hip replacement surgery?
Firstly, patients that are considering a hip replacement surgery should be aware of some of the complications and risks associated with the surgery and those that can occur even years after the surgery.
Patients must ask questions to be completely aware of the expectations of a hip replacement surgery and the change it will bring to their lives. Most importantly, they should have realistic expectations of the surgery, especially its benefits and limitations.
Benefits of hip replacement surgery are undoubtedly a marked reduction in hip pain and significant improvement in the ability to perform daily activities
If the decision is made to go with a hip replacement surgery, the surgeon may ask for a complete physical examination. This is necessary to ascertain that you can withstand the surgery and recovery process. Patients that are victims of cardiovascular disease may need to be evaluated by a cardiologist prior to the surgery. Other diagnostic tests that will be needed are chest X-ray, urine and blood samples, an electrocardiogram (ECG) to assist in planning for the surgery.
- Patients also need to inform the doctor about the medicines they are taking including vitamins and supplements.
- The skin should be infection free before surgery. Any irritation needs treatment before the surgery
- Further, if the patients are obese or overweight, the doctor will insist on weight loss before surgery to reduce the stress on the hips
- Major dental procedures such as tooth extractions or any periodontal tasks should be done prior to the hip replacement surgery to offset the risk of infection
- Patients that are prone to urinary tract infections should ideally complete the urinary tract evaluation before the surgery
- Certain modifications in your home that will help in the recovery process, such as strong handrails for the stairways, safety bars in the bath and shower, and a strong chair
- Toilet seat at a higher level will also benefit the patients recovering after a hip replacement
The procedure usually requires admission to a hospital. In most cases, it is possible for patients to go back home the same day of the surgery.
The types of anesthesia are epidural, general anesthesia, or regional nerve block anesthesia. The anesthesia team will decide the type of anesthesia that is best for surgery,
Artificial hip joints are of many designs and types and are made of two basic components- socket and ball component. Usually, the ball is made of ceramic or metal and the socket is metal, plastic, or ceramic. The decision about the type of prosthesis is made by the orthopaedic surgeon depending upon the type that best meets the patient’s needs.
The hip replacement surgery takes about 1 to 2 hours. During the surgery, the surgeon removes the cartilage and bone, which is damaged. The new implant, which may be plastic, metal, or ceramic, is positioned inside. This will restore the alignment of the hip.
Patients rest in the recovery room for a few hours after surgery.
Post-op care and things to keep in mind
It is important to adhere to the advice of the orthopaedic surgeon with respect to home care following the surgery.
During the first few weeks post-surgery, doctors do not advise complete rest. Patients can begin activities that are not strenuous such as walking inside the house. A physiotherapist will also train the patients in the right exercises for the hip to strengthen it and improve mobility.
Doctors advise against excessive activity or even weight gain as the hip replacement implants can wear out or loosen, causing them to become more painful. Patients should not perform any activities that are high impact such as jumping, running, or jogging.
Some of the activities that patients can perform after a hip replacement surgery are walking, dancing, biking, golf, and swimming. A modified lifestyle with low impact physical activity will ensure the hip replacements endure for several years.
Pain relief medicines during the first few weeks of surgery help patients manage pain. The wound should be dry at all times and must have a bandage around it to avoid any risk of injury. The stitches may take about 2 weeks to heal
Proper healing of tissues takes place with a balanced diet with plenty of fluids. The doctor will usually prescribe an iron supplement.
Possible complications of hip replacement surgery
Fortunately, the risk of complications following hip replacement surgery is much less. Statistics show that the complication rate is very low. The risk of medical complications, such as a stroke or heart attack is extremely rare.
Patients do report superficial infection in the wound. This can happen during the days following surgery. In some patients, the infection can occur even after a few years. Any infection that occurs in the body will spread to the replacement spot.
Patients sometimes report leg inequality following a hip replacement surgery. One leg may feel shorter than the other, although the surgeon will have taken the steps to reduce this occurrence, In certain cases, the surgeon may have shortened or lengthened the leg to improve stability and the working of the hip.
Doctors usually treat minor infections using antibiotics. If it is a severe infection, doctors may consider surgery and removal of the prosthesis.
Risk of blood clots, implant dislocation
One of the serious complications of hip replacement surgery is the development of blood clots in the pelvic region or veins in the legs. The clots can be fatal if they reach the lungs. Medications to prevent this occurrence is in the form of blood-thinning medicines, exercises using the ankle, and the use of a support hose. Patients must move around as much as possible.
Patients at times suffer implant dislocation following hip replacements surgery. This happens if the ball slips out of the socket, and this risk is very high during the initial few months after the surgery. Fortunately, such occurrences of dislocation are not very common among patients.
After several years of hip replacement surgery, some patients report loosening or wear out of the hip prosthesis. In such cases, doctors may consider revision surgery.
Guidelines to make the hip implant last longer
- Patients must take care to prevent bacterial infections such as skin infections or due to dental procedures or urinary tract infections. In some cases, doctors may prescribe preventive antibiotics, especially before these procedures.
- Patients must report to the medical specialist if they experience chills, fever, or hip pain. If there is any draining of fluid from the wound in the hips, it could be a sign of infection.
- Engage in regular light exercises to strengthen and improve mobility of the hip
- Take extra care to prevent falls and injuries
- Regular follow up appointments with the orthopaedic surgeon to find out the condition of the hips even in the absence of any symptoms
Hip replacement surgery scores high on safety and effectiveness and is a solution to pain relief, improved mobility, and better quality of life. Patients will benefit from a complete solution such as assistance with consultation, scheduling surgery, support with post-op care, and help processing insurance claims.
goficure offers all these services as well as handling logistics of transportation to the hospital, both during admission and discharge after the surgery so that the patient is not under any stress.
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