Hip replacement surgery (total or partial) is also called as total hip arthroplasty. It is a surgical procedure to replace a worn out or damaged hip joint with an artificial joint or prosthesis.
The aim of hip replacement surgery is to replace the damaged parts of the hip joint in order to relieve hip pain that can’t be controlled by other treatments.
A surgeon removes the damaged sections of hip joint and replaces them with implants usually constructed of metal, ceramic and very hard plastic. This artificial joint helps in reducing pain and improve function.
In a healthy hip, ends of femur (thighbone) are covered by smooth cartilage. The cartilage also covers the socket (known as the acetabulum) in the pelvis into which the ball end of the femur fits. This cartilage allows the ball to glide easily inside the socket and acts as a cushion . The surrounding muscles support the joint, allowing it to move freely.
Why one needs hip replacement surgery?
Hip replacement surgery is a treatment for pain and disability in the hip. This surgery may be an option after a hip fracture or due to severe pain due of arthritis.
Types of arthritis that may affect the hip joint are:-
- Rhematoid Arthritis
- Traumatic Arthritis.
The most common reason for Hip Replacement is osteoarthritis.Osteoarthritis causes loss of cartilage in the hip joint. Damage to the bones and cartilage results in limited movement and may cause pain. Such people with severe pain may be unable to do normal activities like bending at the hip, walking or sitting, because of the pain.
Other forms of arthritis, such as rheumatoid arthritis and arthritis that results from a hip injury, can also lead to damage of hip joint.
Hip replacement may also be used as a method of treating certain hip fractures which lead to severe pain in normal activities like walking or even moving the leg.
Who is offered hip replacement surgery
A hip replacement is a major surgery .If medical treatments like Physiotherapy, Medicines and Steroid Injections are not effectively controlling pain due to arthritis or fracture, hip replacement becomes an option. It is at the discretion of healthcare provider to recommend a hip replacement surgery depending on the medical history of the patient.
One is offered hip replacement surgery for following reasons:
- Severe pain, swelling and stiffness in hip joint
- Hip pain is so severe that it interferes with quality of life and sleep
- Mobility is reduced and everyday tasks, such as getting out of the bath and shopping, are difficult or impossible
- Feeling depressed because of the pain and lack of mobility
- Not able to have a normal social life
One also needs to be able to cope with a major operation and the rehabilitation afterwards.
- A hip replacement operation can be performed using either local or general anesthesia
- The surgery may take up to 2 hours to complete. The steps are as follows:-
- Surgery begins by making an incision along the side of the hip joint that is to be replaced.
- The muscles supporting the hip joint are detached and the damaged ball of the hip joint is cut from the top of the femur.
- The femoral component of the artificial joint (prosthesis) is inserted into the femur and the acetabular component of the artificial joint is inserted into the prepared socket area in the pelvic bone.
- The artificial ball and socket are then fitted together. The surgeon then reattaches the muscles to the top of the femur.
- Drainage tubes are inserted to drain any fluid and/or blood from the new joint and the incision is then closed.
Antibiotics are usually given during and after the surgery to prevent the development of infection in the new joint.
Minimally invasive hip replacement appears to be as safe and effective as conventional surgery, with the added benefit of causing less post-operative pain.
Hip Replacement Surgery requires about 5-7 days of hospital stay for proper recovery. It is important that one starts moving the new joint after surgery. Physical therapist helps with that and plans for exercise rehabilitation program. At home it is important to keep the surgical area clean and dry and follow the instructions of the healthcare provider.
Continues follow up with surgeon is also required in order to monitor the wear of the artificial joint. For full recovery few months may be required. High-impact activities like running or playing basketball may be o stressful on artificial joint. But in time swimming, hiking or riding a bike gets comfortable.
Techniques for hip replacement are evolving. Surgeons have developed less invasive surgical techniques, which reduce recovery time and pain. During minimally invasive hip replacement surgery, surgeon makes a smaller incision and requires a smaller area for surgery than during a traditional hip replacement surgery. This results in less cutting of the surrounding skin, muscle and other soft tissues. Minimally invasive techniques allow for an easier recovery in the shorter time and provide equal or better results in the long term.
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