The hip is a ball and socket joint. It allows the upper leg to move in all directions - front to back and side to side. Watch the video below to see the anatomy of the hip and how it functions.
When a condition becomes so painful that it limits your mobility and function and fails to respond to more conservative treatment, hip replacement surgery may become necessary.
The procedure involves removing the diseased hip joint and replacing it with an artificial one, called a prosthesis. Prostheses are made of metal, ceramic, plastic, or all three. They are designed to be accepted by the body, as well as to resist wear and tear.
Depending on your needs, your surgeon may perform a traditional or minimally invasive replacement.
Traditional vs. mini-incision replacement
Traditional hip replacement surgery involves making a 6- to 8-inch incision on the side of the hip. The video below illustrates a total hip replacement surgery:
Mini-incision hip replacement enables the surgeon to perform the surgery through one or two small incisions. The advantages of a mini-incision hip replacement are a faster recovery period, less muscle damage, shorter hospital stays and less pain.
There are risks and benefits to both traditional and mini-incision hip replacement. When you see your physician for an evaluation, the pros and cons of each procedure will be reviewed with you.
Why hip replacement is done
The procedure, also called total hip arthroplasty, is a surgery to replace a worn out or damaged hip with a prosthesis.
When a stiff, painful hip joint begins to interfere with your everyday life and nonsurgical treatments are no longer effective, hip replacement may be an option.
Surgery to replace the hip is considered in the following cases:
The goal of the surgery is to replace the parts of the hip joint that have been damaged and to relieve hip pain that cannot be controlled by other treatments.
When to consider surgery
Symptoms of hip pain that might lead you to consider having surgery include:
- Pain that is not helped by pain medication
- Pain that persists, even while using a cane or walker
- Pain interfering with sleep
- Difficulty climbing stairs
- Difficulty standing up
- An inability to enjoy daily life because of pain
Joint replacement is a generally safe procedure, but as with any surgery, there are risks you must be aware of.
Some possible complications of the surgery include:
- Hip dislocation, which occurs when the ball portion of the prosthesis dislocates from its normal position in the hip.
- Infection at the incision site or in your hip. Depending on its severity, an infection may require antibiotics or possibly repeat surgery.
- Blood clots. Blood thinning medications are usually given after surgery to prevent clots from forming.
- Swelling or bleeding at the surgery site.
- Injury to nearby nerves or blood vessels, which can occur during surgery.
- Anesthesia-related problems, such as pneumonia.
Be sure to discuss these risks with your doctor before the surgery.
What to Expect
Before your surgery, your physician will explain the procedure to you and give you the opportunity to ask any questions you may have.
You will be asked to sign a consent form that gives your physician permission to do the procedure. Be sure to read the consent form carefully and ask questions if anything is unclear.
After deciding to have surgery, you will be asked to obtain lab work and attend our UC Irvine Health Joint Replacement class. Depending on other medical issues, you may be asked to get medical clearance from your primary care physician or cardiologist.
The time before your procedure is a good time to prepare yourself and your home for your recovery. Some things you may want to do include:
Lose weight. If you are overweight, try to lose some before your surgery. This will decrease the amount of stress on your new joint. Non-impact exercise, such as swimming, can aid your efforts.
Make modifications at home. Some modifications you can make include installing safety bars, a shower bench and handrails. Check for tripping hazards, such as throw rugs and extension cords. Place important items within easy reach, and purchase items that will make your daily activities easier, such as dressing aids.
Talk about medications with your doctor. You may need to stop taking some medications up to one week before your procedure, including anti-inflammatory drugs, such as aspirin, and blood-thinning medications. Notify your doctor if you have a history of bleeding disorders.
Arrange transportation. Make plans for a friend or loved one to bring you to and from the hospital. Also, make plans to have someone assist you when you are at home.
Eat a light meal the night before the surgery. Do not eat or drink anything after midnight. If you have diabetes, ask your doctor if you will need to adjust your medicine.
Hip replacement procedure
In a total hip replacement procedure, damaged bone and cartilage is removed and replaced with a prosthesis. The whole procedure generally takes between 60 and 90 minutes.
- The doctor will make an incision along your joint and move the muscles aside.
- The damaged bone and cartilage of the hip joint will be removed. The doctor will then prepare the remaining bone for the prosthesis.
- The new plastic and metal joint is then placed in position. Depending on the type of prosthesis, the doctor may use bone cement to hold one or both parts of the artificial hip firmly to your bone.
- Finally, the incision will be closed with absorbable sutures.
After the surgery you will be taken to the recovery room for observation. Once your vital signs are stable and you are awake, you will be transferred to your room.
Most hip replacement surgery patients have an in-hospital stay of two days. While you are recovering, you may need to:
- Use a walker for assistance
- Be especially careful to avoid falls
- Take medicine to prevent blood clots
- Wear compression stockings
- Breathe deeply and cough 10-20 times per hour; this lowers the risk of fluid buildup in the lungs
After your surgery, you will need to begin moving your new joint. You will meet with a physical therapist soon after the procedure and plan an exercise program to follow in the hospital and after you are discharged.
Your pain will be controlled with medication to make participating in physical therapy and exercise easier. Physical therapy continues until you regain your muscle strength and have good range of motion in your new joint.
When you return home, you can do the following things to ensure that your recovery is smooth and complete:
Keep the incision area clean and dry.
Ask your doctor about when it safe to shower, bathe or soak in water.
When seated, place a V-shaped pillow between your legs. This will help you to maintain correct positioning of your hip.
Continue exercising to strengthen muscles around your new joint. Adhere to a few simple restrictions to reduce the chance of dislocating your new joint.
Only take medicines recommended by your doctor. Do not take over-the-counter remedies without your doctor’s approval.
Inform your dentist of your surgery. You may need antibiotics for some dental procedures. This will decrease the risk of bacteria entering the bloodstream and traveling to the prosthesis.
Maintain a healthy weight. Obesity can increase wear on your new joint.
Avoid jogging and other high-impact sports. This can increase wear on the joint. Instead, opt for non-impact activities, such as swimming and cycling.
Be sure to follow your doctor’s instructions.
Most patients will be able to resume their normal physical activity within six weeks.
When to call your doctor
After you leave the hospital, contact your doctor if any of the following occurs:
Signs of infection, including fever and chills.
Redness, swelling, increasing pain, excessive bleeding, or discharge around incision site.
Pain or swelling in the feet, calves or legs.
Shortness of breath, coughing or chest pain.
Severe nausea or vomiting.
Hip pain that worsens and can't be treated with pain medication.
Numbness or loss of feeling in your leg, knee or foot.
Pain, burning, urgency or frequency of urination, or blood in the urine.
To learn more, call 714-456-7012 or schedule an appointment online ›