Overview

 

Hip replacement surgery, also called total hip arthroplasty, involves removing a diseased hip joint and replacing it with an artificial joint, called a prosthesis. Hip prostheses consist of a ball component, made of metal or ceramic, and a socket, which has an insert or liner made of plastic, ceramic or metal. The implants used in hip replacement are biocompatible — meaning they're designed to be accepted by your body — and they're made to resist corrosion, degradation and wear.

Hip replacement is typically used for people with hip joint damage from arthritis or an injury. Followed by rehabilitation, hip replacement can relieve pain and restore range of motion and function of your hip joint.

Two Types of Hip Fixation

There are two main types of fixation philosophies-cemented and porous. Both can be effective in the replacement of hip joints.` The physician (and the patient) will choose the best solution that is specific to the patient's needs.

Cemented Hip Implants :-

The cemented hip implant is designed to be implanted using bone cement (a grout that helps position the implant within the bone). Bone cement is injected into the prepared femoral canal. The surgeon then positions the implant within the canal and the grout helps to hold it in the desired position.

Porous Hip Implants :-

The porous hip implant is designed to be inserted into he prepared femoral canal without the use of bone cement. Initially, the femoral canal is prepared so that the implant fits tightly within it. The porous surfaces on the hip implant are designed to engage the bone within the canal and permit bone to grow into the porous surface. Eventually, this bone ingrowth can provide additional fixation to hold the implant in the desired position.



What to Bring to the Hospital ?

Below is a list of things you may want to bring with you to the hospital in preparation for your surgery. Talk with your physician, as he/she may have additional information about preparing for your hospital stay.

Your personal belongings should be left in the car until after surgery. Tell your family that your room will be assigned when you are in surgery or in recovery, at which point they can bring your personal items to your room.

Personal grooming items that you may want to pack include a toothbrush, toothpaste, hairbrush, eyeglasses/contacts, comb, deodorant, shaving cream/electric razor, shampoo, lotion, undergarments, and a robe.

Bring slippers or flat rubber-soled shoes for walking in the hallways.

Bring loose-fitting clothing for your trip home.

Bring any medications you are currently taking. You should also write down your medication information to be given to the hospital staff. Be sure to include the name, strength, and how often you take the medications. Please communicate any allergies you might have to your doctors and the nursing staff.

If you use a breathing exerciser (IBE), be sure to bring it with you from home, as you will probably need this right after surgery.

Leave jewelry, credit cards, car and house keys, checkbooks, and items of personal value at home. Bring only enough pocket money for items such as newspapers, magazines, etc.

During Surgery

The patient is first taken into the operating room and given anesthesia. After the anesthesia has taken effect, the skin around the upper thigh is thoroughly scrubbed with an antiseptic liquid. An incision of appropriate size is then made over the hip joint.

Inserting the Implant

The shell portion of the socket implant may be attached either by using a special kind of epoxy cement for bones, or by pressing the implant into the socket so that it fits very tightly and is held in place by friction. Some implants may have special surfaces with pores that allow bone to grow into them to help hold the implant in place. Depending on the condition of the patient's bone, the surgeon may also decide to use screws to help hold the implant in place.

When the shell portion of the socket implant is in place, the plastic liner is locked into place inside the shell.

Replacing the Ball Portion of the Joint

The implant that replaces the ball consists of a long metal stem that fits down into the femur. The metal ball is mounted on top of this stem.

Clearing and Shaping the Canal

The upper leg bone has relatively soft, porous bone tissue around the center. This part of the bone is called cancellous bone. It surrounds the canal, which mainly contains blood vessels and fatty tissue.

Special instruments are used to clear some of the cancellous bone from the canal, and then to mold the inside walls of the canal to fit the shape of the implant stem.

Closing the Wound

When all the implants are in place, the surgeon places the new ball that is now part of the upper leg bone into the new socket that is secure within the pelvic bone. If necessary, the surgeon may adjust the ligaments that surround the hip to achieve the best possible hip function.

When the ligaments are properly adjusted, the surgeon sews the layers of tissue back into their proper position. A plastic tube may be inserted into the wound to allow liquids to drain from the site during the first few hours after surgery. After the tube is inserted, the edges of the skin are sewn together, and a sterile bandage is applied to the hip. Finally, the patient is taken to the recovery room.



The Following are the Types of Hip Surgeries performed at We Care India partner Hospitals :

Frequently Asked Hip Replacement Questions

Hip Replacement

This page provides a brief introduction to hip replacement. It can help you make a list of questions to ask your doctor, but it is not meant to provide complete information. Check with your surgeon's office about more comprehensive resources and patient education materials. Read More....



What causes hip pain?





What is a hip replacement?

In a total hip replacement surgery, the painful parts of the damaged hip are replaced with artificial hip parts called a prosthesis, a device that substitutes or supplements a joint. The prosthesis consists of steel components: a socket, ball, and stem. The outer shell of the socket is usually made of metal and the inner shell consists of plastic, or the entire socket may be plastic. When the metal ball is joined with the socket, the new hip can allow for smooth, nearly frictionless movement.



How do I know if I need a hip replacement?

If you have difficulty walking or performing everyday activities such as getting dressed, it may be time to consider hip replacement surgery.

Doctors generally try to delay total hip replacement for as long as possible in favor of less invasive treatments. However in patients with advanced joint disease, hip replacement offers the chance for relief from pain and a return to normal activities.



How do I prepare for hip replacement surgery?

If you and your surgeon decide that total hip replacement is right for you, a date will be scheduled for your surgery. Several things may be necessary to prepare for surgery. For example, your surgeon might ask you to have a physical examination by your primary care physician. This will help to ensure that other health problems you may have, such as diabetes or high blood pressure, will be identified and treated before surgery.

You doctor may suggest that you lose weight and initiate an exercise program. If you smoke, be sure to speak with your doctor about it, as smoking can dangerously increase surgical risks and slow down the healing process.

You should also finish any dental work that may be underway to prevent germs in your mouth from entering the bloodstream and infecting the joint. It is likely that you will need blood during hip surgery, and your surgeon may place an order with the blood bank in case a transfusion is needed. If you prefer, or if your surgeon feels it is needed, you may want to donate your own blood ahead of time to reduce the risk of your body reacting to the blood transfusion. Read the Surgery Calendar for more information on how to prepare for surgery.



How long does the surgery take? What is the recovery time?

In the weeks immediately following surgery, you may need walking aids such as a cane or crutches. Within a few months, however, you should be able to return to normal activities.

For more information, please read, Your Hip Surgery and After Hip Surgery.



How is the implant affixed in the body?





The decision as to whether to use a cemented or press-fit component depends upon many factors, including the manufacturer’s intended use of the product, surgeon philosophy and the patient’s condition.



What can I expect after surgery?

When you are back in your hospital room you will begin a gentle rehabilitation program to help strengthen the muscles around your new hip and regain your range of motion. On the day of surgery you may be asked to sit on the edge of the bed and dangle your feet. You will also learn how to protect your new hip while doing daily activities.

As soon as possible, usually within the next 24 hours, your physical therapist will help you start walking a few steps at a time. As you heal you will progress from walker to crutches and then a cane. Before you are dismissed from the hospital, an occupational therapist will also show you how to perform daily tasks at home with your new hip. For example, he or she will instruct you on how to go to the bathroom, how to dress yourself, how to sit or stand, how to pick up objects and many others.

After about two to four days, or when your surgeon determines that you have recovered sufficiently, you will be discharged. You may be transferred to a rehabilitation facility for a few more days, as determined by your surgeon. Upon returning to your home, you will need to continue taking your regular medications and continue exercising as directed by your surgeon or physical therapist. Walking, remaining active and practicing the required exercise are the quickest ways to full recovery. Read the Surgery Calendar to learn more on what to expect after surgery.



How long will a joint replacement last?

Longevity of the prosthetic hip varies from patient to patient. It depends on many factors, such as a patient's physical condition, activity level, and weight, as well as the accuracy of implant placement during surgery. It is useful to keep in mind that prosthetic joints are not as strong or durable as a natural, healthy joint, and there is no guarantee that a prosthetic joint will last the rest of a patient's life.

As with car tires or brake pads, the rate of wear depends partly on how the hip joint is used. Activities that place a lot of stress on the joint implants, as may be the case with heavier and more active patients, may reduce the service life of the prosthesis. Implant loosening and wear on the plastic portions of the implant can lead to the necessity for revision surgery to replace the worn components, or all of the components. Your doctor will be in the best position to discuss these issues with you, taking into account your particular clinical circumstances, the type of implants used, and your post-surgical lifestyle.

Talk with your doctor about the following points, and how they might affect the longevity and success of your hip replacement : -






Will an implant set off a metal detector?

Patients have reported mixed experiences at airports: some detectors go off and some don't.
You may be provided with a special card to keep in your wallet explaining that you have a hip implant.



Are there any complications?

Some common complications specific to hip replacement surgery include loosening or dislocation of the implant and a slight difference in leg length.

Your healthcare team will discuss these possible complications with you and the precautions taken against them.



How old is the average patient?

In the U.S., the average joint replacement patient is around 65-70 years old, however patients of all ages have received hip implants.



Will a hip implant last a lifetime?

The longevity of a prosthetic hip (how long it will last) varies from patient to patient. It depends on many factors, such as a patient's physical condition and activity level, body weight and the surgical technique. A prosthetic joint is not as strong or durable as a natural, healthy joint, and there is no guarantee that a prosthetic joint will last the rest of a patient's life. All prosthetic hips may need to be revised (replaced) at some point.



What activities can I do or not do after receiving a hip implant?

Typically, patients are advised to avoid high impact sports such as jogging, basketball, racquetball, gymnastics, etc.
Safer activities may include walking, golf, swimming, and bicycling.
Your doctor will advise you on safe activities for your particular condition.



What about sex?

Doctors generally allow patients to resume sexual activities as soon as they feel able. In the months following surgery, patients are generally advised to take it easy and modify their positioning to keep pressure off of the joint while it’s healing. As always, it is best to consult with your doctor about what’s safe for your particular condition.

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