What is a total hip replacement?

Total Hip Replacement (THR) is a procedure commonly known as Total Hip Arthroplasty. In this procedure, damaged bone and cartilage are removed, and prosthetic elements are replaced. THR is one of the most economical and reliable orthopaedic surgical procedures.

When should someone consider total hip replacement surgery?

Such conditions that lead to chronic hip pain and disability, and also full hip replacement surgery, are as follows:

Osteoarthritis: Osteoarthritis is age-related; with age, it causes cartilage wear and tear, thereby rubbing bones against each other that cause stiffness and pain to the hip. Other individuals may experience osteoarthritis by inheritance of a family history of arthritis.
Rheumatoid arthritis: It's an autoimmune condition that is characterized by the inflammation of synovial membranes. Cartilage damage leads to pain and stiffness.
Posttraumatic arthritis: A severe hip injury or a fracture may damage the cartilage leading to surgery in the future.
Osteonecrosis (or avascular necrosis): It is an injury, a dislocation or a fracture that briefly cuts off blood supply to the femoral head; the bone surface collapses, and eventually arthritis develops.
Childhood hip disease: Sometimes, infants and children develop hip problems that, even after treatment, eventually lead to arthritis. These often occur with anomalies of hip growth, including when the joint surfaces are involved.

THR or complete hip surgery may be recommended if,

Hip pain persists, even after medication and physical therapy
It hurts even while walking on your own or using crutches/cane/walker for support
Hip pain hampers your sleep
You cannot climb the stairs or get down from it
If hip pain makes it hard for you to get up from a seated position.

THR has no age or weight restrictions, although it is mostly performed on patients between 50 and 80 years of age.

How to prepare yourself for total hip replacement surgery?

You need to follow your physician's advice, clarify all your doubts with him/her, and stop tobacco usage, if any. Moreover, if you have decided to have this surgery, this is a big question in itself; ensure that you discuss everything with your family and doctor and maintain realistic expectations.

Here are some of the ways through which you can best prepare for a complete hip replacement:

Medical check-up: You undergo a full body examination to ensure you are fit for the surgical procedure. Patients who have chronic medical conditions, such as heart condition, may need to be reevaluated by a cardiologist.
Tests: X-ray scans, MRI scans, blood and urine samples, and EKGs must be taken.
Skin preparation: Your skin should be irritation—and infection-free. If it's not, discuss it with your doctor beforehand.
Medications: At the outset you'd know which medicines you could continue, which you could start, and which to avoid
Weight loss: For those who are overweight, a little weight loss would reduce the strain on the hip post the surgery as well as risks due to the surgery
Dental check-up: If you plan any major dental procedure, also get it done before THR to avoid infection.
Urinary examination: These patients whose history says recurrent or recent urinary infection should be given urinary examination test. Men with prostatic disease too have to undergo their prescribed treatment before THR.
Sociological planning: Ensure a supporting hand in front for the time of convalescence. You may need support in daily activities, follow-up treatment and psychological support.
Home preparation: You can prepare your home accordingly before the surgery. However, it entails securely fixing handrails in your shower and along the stairways, a raised toilet seat, a stable chair, and so on.

What is the surgical procedure for total hip replacement?

The total hip transplant procedure takes 1-2 hours and it's done in the following steps:

You receive anesthesia, generally as general anesthesia but can be as spinal, epidural, or regional nerve block anesthesis.
A cut is made through the tissue layers over the hip.
The diseased/damage bone and cartilage are removed leaving only the healthy parts.
A socket of new is implanted into the pelvis bone.
A metal rod was driven up on top of the thighbone or femur, and a ball was fitted on top.

In other words, the damaged ball part of the femoral head is reshaped. The damaged ball part of the femoral head is removed and replaced by a metal stem. This is then placed inside the hollow center of the femur and topped by a metal/ceramic ball. Similarly, the acetabulum is removed and placed with a metal socket. In some cases, the surgeon might employ screws or cement to size the new ball and socket. Within the space between the new ball and socket, a plastic, metal, or ceramic spacer is placed so an even surface can be created that can glide.

Finally, you are taken to the recovery room. After waking up from the effects of anesthesia, you are either taken to the hospital room or discharged.

What are the benefits of a hip replacement?

Hip replacements are generally very successful procedures. In most cases, patients who receive a hip replacement experience a significant resolution of their symptoms, particularly pain and stiffness.

Once fully recovered, you should have improved mobility and range of motion (the ease with which you can move your hip). A hip replacement often makes walking, climbing stairs, and performing many other activities easier.

What are the risks of a hip replacement?

Complications from a hip replacement are rare but can occur. The most common complications include:

Blood clots in your legs (deep vein thrombosis) or lungs (pulmonary embolism).
Problems with the prosthesis, such as it working loose or coming apart.
Breaks in the bone around the prosthesis.
Stiffness in your joint.

What is recovery after total hip replacement?

Recovery is very vital for the success of the THR procedure. In this regard, you must be very careful during this phase and strictly adhere to instructions.

Management of pain: Medications will be prescribed for post-surgical pain.
Wound closure care: You will have stitches, staples, or sutures to close your wound; avoid water contact with that area until it is closed and dried. Stitches and staples are taken out after 2 weeks of surgery.
Diet: Fluid intake and diet will be encouraged, supplemented by perhaps taking an iron tablet.
Activity: Exercise is important in rehabilitation following THR. You can begin with some gentle activities such as walking and resume normal activities within 3-6 weeks. You would be placed on a progressive course of increase in mobility, return to certain activities such as sitting, climbing stairs, and standing, and specific exercises to strengthen the hip and allow movement to return.

You will know that you will have numbness in the area and stiffness that will eventually go away. Do all your follow-ups and avoid falls or other types of injury to avoid the possibility of another surgery.

How long does a hip replacement last?

Typically, prosthetic hips used in hip replacement should remain for a lifetime. Most of the people who experience hip replacement still retain their implants for life.

Uncommon but possible: some patients may need additional surgeries performed on their hip at later times. Your surgeon will discuss this with you.