Total Hip Replacement

According to the Agency for Healthcare, hip replacement surgery is one of the most successful operations in all of medicine and more than 285,000 hip replacements are performed each year in the U.S. alone.

If you are deciding to have hip replacement surgery, it is best to understand the risk factors of this procedure, and what it can and cannot do.

A majority of the people who undergo hip replacement surgery experience a dramatic reduction of hip pain and a compelling improvement in their ability to complete the common activities of daily living.

What is a Total Hip Replacement?

Total hip replacement (also called total hip arthroplasty) occurs when the damaged hip joint and cartilage is removed and replaced entirely with new, durable prosthetic components. The damaged femoral head (ball) at the top of the thigh bone (femur) is removed and replaced with a metal stem that is placed into the hollow center of the femur. The femoral stem may be either cemented or “press fit” into the bone.

Then, a metal ceramic ball is placed on the upper part of the stem. This ball replaces the damaged femoral head that was removed. The damaged cartilage surface of the socket (acetabulum) is removed and replaced with a metal socket.The acetabulum is the part of a hip implant that forms the socket in the ball-and-socket structure of the hip joint. Screws or cement are sometimes used to hold the socket in place.

A plastic, ceramic, or metal spacer is inserted between the new ball and the socket to allow for a smooth gliding surface providing stability to the joint, which enables patients to move easily following recovery and physical therapy.

Who is a Candidate for Total Hip Replacement?

The decision to have hip replacement surgery should be a cooperative one made by you, your family, your primary care doctor, and your orthopaedic surgeon. The process of making this decision typically begins with a referral by your doctor to an orthopaedic surgeon for an initial evaluation.

There are no absolute age or weight restrictions for total hip replacements.

Recommendations for surgery are based on a patient’s pain and disability, not age. Most patients who undergo total hip replacement are age 50 to 80, but orthopaedic surgeons evaluate patients individually. Total hip replacements have been performed successfully at all ages, from the young teenager with juvenile arthritis to the elderly patient with degenerative arthritis.

There are several reasons why your doctor may recommend hip replacement surgery. People who benefit from hip replacement surgery often have:

  • Hip pain that limits everyday activities, such as walking or bending
  • Hip pain that continues while resting, either day or night
  • Stiffness in a hip that limits the ability to move or lift the leg
  • Inadequate pain relief from anti-inflammatory drugs, physical therapy, or walking supports

What to Expect After a Total Hip Replacement

Exercise is a critical component of recovery, particularly during the first few weeks after surgery. You should be able to resume most normal light activities of daily living within 2 to 4 weeks after your operation. Some discomfort with activity and at night is common for several weeks. Rehabilitation time will vary for each patient.

Your activity program should include:

  • A graduated walking program to slowly increase your mobility, initially in your home, and later, outside
  • Resuming other normal household activities, such as sitting, standing and climbing stairs
  • Specific exercises several times a day to restore movement and strengthen your hip. You probably will be able to perform the exercises without help, but you may have a physical therapist help you at home or in a therapy center the first few weeks after surgery

Results of a Total Hip Replacement

The success of your surgery will depend in large measure on how well you follow your orthopaedic surgeon’s instructions regarding home care during the first few weeks after surgery.

Realistic activities following total hip replacement include unlimited walking, golf, hiking, swimming, biking, driving, dancing, and other low impact sports. Hip replacements can last for many years with the appropriate activity modification.

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