Total Hip Replacement

Hip Replacement

This revolutionary concept of hip replacement is focused to remove the damaged hip joint completely and put in a new artificial one. Total hip replacement is ranks an one of the successful operations ever devised and has afforded pain relief and improved quality of life for millions of patients worldwide. Total hip replacement is one of the cost-effective surgical procedures available today.

During hip replacement, a surgeon removes the damaged sections of your hip joint and replaces them with parts usually constructed of metal, ceramic and very hard plastic. This artificial joint (prosthesis) helps reduce pain and improve function.

Conditions that can damage the hip joint, sometimes necessitating hip replacement surgery, include:

Osteoarthritis. Commonly known as wear-and-tear arthritis, osteoarthritis damages the slick cartilage that covers the ends of bones and helps joints move smoothly.

Rheumatoid arthritis. Caused by an overactive immune system, rheumatoid arthritis produces a type of inflammation that can erode cartilage and occasionally underlying bone, resulting in damaged and deformed joints.

Osteonecrosis. If there is inadequate blood supply to the ball portion of the hip joint, the bone may collapse and deform.

Risks associated with hip replacement surgery may include:

Blood clots. Clots can form in your leg veins after surgery. This can be dangerous because a piece of a clot can break off and travel to your lung, heart or rarely your brain. Your doctor may prescribe blood-thinning medications to reduce this risk.

Infection. Infections can occur at the site of your incision and in the deeper tissue near your new hip. Most infections are treated with antibiotics, but a major infection near your prosthesis may require surgery to remove and replace the prosthesis.

Fracture. During surgery, healthy portions of your hip joint may fracture. Sometimes the fractures are so small that they heal on their own, but larger fractures may need to be corrected with wires, pins, and possibly a metal plate or bone grafts.

Dislocation. Certain positions can cause the ball of your new joint to become dislodged, particularly in the first few months after surgery. If the hip dislocates, your doctor may fit you with a brace to keep the hip in the correct position. If your hip keeps dislocating, surgery is often required to stabilize it.

Change in leg length. Your surgeon takes steps to avoid the problem, but occasionally a new hip makes one leg longer or shorter than the other. Sometimes this is caused by a contracture of muscles surrounding the hip. In this case, progressively strengthening and stretching those muscles may help.

Loosening. Although this complication is rare with newer implants, your new joint may not become solidly fixed to your bone or may loosen over time, causing pain in your hip. Surgery might be needed to fix the problem.

Your prosthetic hip joint may wear out eventually, so if you have hip replacement surgery when you’re relatively young and active, you eventually may need a second hip replacement. However, new materials are making implants last longer, so a second replacement may not be needed.

Most artificial hip joints have a polished metal or ceramic ball that fits into a cup liner that’s made of very hard plastic. Some older types of prostheses used mainly in the last decade use a metal cup liner, which may last longer but can cause other problems. Metal-on-metal prostheses are more likely to release metal ions into your bloodstream, which can cause inflammation and bone erosion. Because of these concerns, metal-on-metal prostheses are now rarely used.

Before surgery you’ll meet with your orthopedic surgeon for an examination. The surgeon will:

Ask about your medical history and current medications

Do a brief general physical examination to make sure you’re healthy enough to undergo surgery

Examine your hip, paying attention to the range of motion in your joint and the strength of the surrounding muscles

Order blood tests, an X-ray and possibly an MRI

This preoperative evaluation is a good opportunity for you to ask questions about the procedure. Be sure to find out which medications you should avoid or continue to take in the week before surgery.