Joint Replacement (Hip)
What Is a Hip Joint Replacement Surgery?
The hip joints are large, ball-and-socket joints that enable the thighbone, or femur, to rotate in nearly every direction so you can stand, walk, and move freely throughout the day. However, the joint can become damaged through injury, years of wear and tear, or other forms of degeneration in the bone, cartilage, and other soft tissues of the hip joint.
Total hip replacement, or total hip arthroplasty, is a surgery that is performed to repair a hip joint that has been damaged. Total hip replacement can relieve pain and restore function and range of motion to the hip.
Who Is a Good Candidate for Hip Replacement Surgery?
Severe, chronic pain may require surgical intervention. There are several reasons why you might need total hip replacement, including bone or tissue loss around the joint or the joint becoming loose or unstable. Rheumatoid arthritis, osteoarthritis, and post-traumatic arthritis are usually the source of this hip pain and degeneration.
Patients who are over 55 with severe arthritis in the hip are most likely to need a hip replacement. Most patients who have total hip replacement say that it reduces or eliminates pain as well as improves hip function and their quality of life.
Visiting a medical doctor is recommended to discuss hip replacement if your condition meets any of these criteria:
- You have attempted conservative methods with no long-term success
- You have pain that limits your activities
- Your pain keeps you up at night
What to Expect Before Undergoing Surgery
Prior to your hip replacement, you will undergo a diagnostic process to determine the source of your chronic hip pain. In addition to an X-ray, your surgeon may need to schedule a CT or MRI scan. The information these scans provide will help your surgeon determine if you have osteoarthritis or another degenerative condition as well as the specific location of the damage and the extent of the damage.
Before recommending total hip replacement, your hip replacement surgeon may suggest other treatments, such as steroid injections, physical therapy, anti-inflammatory medications, pain medications, or bracing, in addition to avoiding activities that could make your symptoms worse.
What to Expect During Your Procedure
The procedure takes place in a hospital. After you are given general anesthesia, your surgeon will make an incision to expose the hip joint. Next, they will remove damaged bone and tissue to prepare for the femoral head (ball of the joint) and acetabular (socket) implants to be placed. First, the socket implant is placed into the prepared acetabular cavity. Then, the stem implant is placed into the femur, which is used to secure the ball implant for the new joint, before the incision is finally closed.
You will go to a recovery room while your anesthesia wears off, and you will be monitored. The average hospital stay after total hip replacement varies depending on your situation—such as the type of fracture you had, your overall health, and your age—but it is usually at least several days. Typical recovery requires four to six weeks before resuming normal use.
Your Recovery and Living With Your New Hip
Recovery from a hip joint replacement, including the rehabilitation phase, varies depending on your unique situation. Most patients undergo rehabilitation involving physical therapy with a certified physical therapist over the course of several months. You will likely wear a hip abduction brace to prevent your artificial hip from dislocating.
Be sure to attend all follow-up appointments. Total hip replacement is an elective procedure that is considered safe, though as with any surgery, there is a risk of infection, blood clots, and other possible complications. You will need to avoid high-impact activities, as these could lead to a hip fracture or complications with your implant.
You should seek out an experienced surgeon to perform your total hip replacement. This clinician should not only be skilled at performing the surgery but also knowledgeable about choosing patients who are appropriate for the procedure.
Other Forms of Hip Replacement
In addition to varying hip implants and means of securing a patient's new hip, there are various forms of hip replacement surgery, including cementless or uncemented, metal-on-metal or metal-on-polyethylene hip implants, and robotic-arm assisted hip replacement. Some methods are newer and minimally invasive, such as anterior hip replacement and hip resurfacing. Revision hip surgery is also sometimes required to relieve symptoms associated with a prior hip replacement surgery.
Anterior Hip Replacement:
At University Orthopaedic Surgeons, we were the first to offer anterior hip replacement surgery in East Tennessee, and we are now home to five doctors offering this technique. The anterior approach for total hip replacement requires a small incision where the surgeon operates between muscles and tissues, rather than through them. This results in significantly less downtime for patients as well as faster and more efficient recoveries with less chance for postsurgical dislocation. Historically, patients undergoing hip replacement surgery recover under the care of a nursing facility, whereas patients following the anterior approach are more frequently allowed to recover at home.
While many patients are candidates for the technique, only an experienced, skilled surgeon knows for sure who will benefit most from the procedure.
Revision Hip Replacement:
With several types of joint replacement surgery, such as hip replacement, the artificial joints have a particular lifespan and may require an additional surgery later on. This surgical procedure is known as revision joint replacement, given that the primary, or first, joint replacement is revised.
Hip revision surgery may be necessary when a patient's hip prosthesis has surpassed its lifespan or other complications have occurred. During revision hip replacement, the artificial hip is removed and then replaced with a new one. Depending on the severity of the damage or whether an infection is present, more than one revision surgery may be needed. For instance, the first surgery may be performed to remove the old prosthesis scar tissue and treat the joint with antibiotics. After the infection is cured, then revision surgery can be performed.
Hip revision procedures are more complicated than total hip replacement surgery and require the skills of a specialty-trained surgeon with extensive experience in performing the surgery. Recovery from hip revision is also more involved than recovery from a primary hip replacement.
Exceptional Care at University Orthopaedic Surgeons
Our years of experience and advanced training devoted to the care or orthopaedic issues, including those of the hip, make us who we are, but our compassionate care of our patients is what makes us dedicated to you. Our hip replacement specialists, Dr. Michael Eilerman, Dr. Michael McCollum, Dr. William Oros, Dr. Brian Tonne, and Dr. Kostas Triantafillou, are unparalleled experts in accurately diagnosing and effectively treating severe hip injuries and conditions in a broad range of patients, and they continuously strive to exceed our patients' expectations in the delivery of care.
To consult with a University Orthopaedic Surgeons hip replacement surgeon, please request an appointment online or call (865) 546-2663 for our UT Medical Center and Sevierville offices or (865) 218-9300 for our West Knoxville office.