A total hip replacement is a surgery to replace a diseased or injured hip joint. An artificial ball-and-socket joint is inserted to make a new hip. The artificial joint is called a prosthesis.
A minimally invasive total hip replacement is also a surgery to replace a diseased or injured hip joint. This surgery only requires one or two tiny incisions and special instruments. People eligible for this surgery are typically:
This surgery is done when pain and stiffness limit your normal activities. This pain and stiffness is usually due to arthritis . Surgery is done when other treatments have been tried and are no longer working. These other treatments include rest, medicines, and physical therapy.
Within six weeks, you should be able to resume normal light activities. A replacement hip typically lasts 10-15 years.
If you are planning to have a hip replacement, your doctor will review a list of possible complications, which may include:
Factors that may increase the risk of complications include:
Be sure to discuss these risks with your doctor before the surgery.
Your doctor may do the following:
In the time leading up to the procedure:
General anesthesia will be used. It will block any pain and keep you asleep through the surgery. It is given through an IV in your hand or arm.
The doctor will make an incision along your joint. The muscles will be moved aside. The damaged bone and cartilage of the hip joint will be removed. The doctor will then prepare the remaining bone for the prosthesis. The new plastic and metal joint will be placed in position. Depending on the type of prosthesis, the doctor may use bone cement to hold one or both parts of the artificial hip firmly to your bone. Lastly, the incision will be closed with stitches or staples.
This surgery may be done with one or two incisions.
For both types, special tools are used that fit into these small incisions. In some cases, x-rays will be used to help guide the doctor.
For the one-incision surgery, the doctor will make an incision over the outside of your hip. The doctor will move the muscles and tendons out of the way. Next, the damaged bone and cartilage of the hip joint will be removed. The doctor will prepare the remaining bone for the prosthesis. The new plastic and metal joint will then be placed in position. Depending on the type of prosthesis, bone cement may be used to hold the artificial hip in place. Lastly, the incision will be closed with staples or stitches.
In a two-incision surgery, the doctor will make an incision over the groin and another over the buttock. The above process will then be followed.
You will have pain after the surgery. Pain medicine will be given to help with pain.
This procedure is done in a hospital setting. The usual length of stay is:
Your doctor may choose to keep you longer, if complications arise. In some case, you may need to stay in a rehab unit. The focus will be on regaining function.
While you are recovering at the hospital, you may need to:
When you return home, do the following to help ensure a smooth recovery:
After you leave the hospital, contact your doctor if any of the following occurs:
In case of an emergency, CALL 911 .
RESOURCES
American Academy of Physical Medicine and Rehabilitation
http://www.aapmr.org/
National Institute of Arthritis and Musculoskeletal and Skin Diseases
http://www.niams.nih.gov/
CANADIAN RESOURCES
The Arthritis Society
http://www.arthritis.ca/
Canadian Orthopaedic Association
http://www.coa-aco.org/
References:
Activities after hip replacement. American Academy of Orthopaedic Surgeons website. Available at: http://orthoinfo.aaos.org/topic.cfm?topic=A00356 . Accessed November 18, 2008.
Antibiotic prophylaxis for bacteremia in patients with joint replacements. American Academy of Orthopaedic Surgeons website. Available at: http://www.aaos.org/about/papers/advistmt/1033.asp . Published February 2009. Accessed November 10, 2009.
Dental work after a joint replacement. American Academy of Orthopaedic Surgeons website. Available at: http://orthoinfo.aaos.org/topic.cfm?topic=A0022 . Updated April 2009. Accessed September 24, 2009.
Geerts WH, Pineo GF, Heit JA, et al. Prevention of venous thromboembolism: the Seventh ACCP Conference on Antithrombotic and Thrombolytic Therapy. Chest . 2004;126(suppl 3):338S-400S.
Hip fracture. EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed/what.php . Updated July 2009. Accessed July 21, 2009.
Hip replacement. National Institute of Arthritis, Musculoskeletal, and Skin Diseases website. Available at: http://www.niams.nih.gov/Health_Info/Hip_Replacement/default.asp . Accessed November 17, 2008.
Lindström D, Azodi, Sadr O, et al. Effects of a perioperative smoking cessation intervention on postoperative complications: a randomized trial. AnnSurg . 2008;248:739-745.
Minimally invasive hip replacement surgery. American Academy of Orthopaedic Surgeons website. Available at: http://orthoinfo.aaos.org/topic.cfm?topic=A00404 . Accessed November 17, 2008.
Skerker RS, Mulford GJ. Frontera: Essentials of Physical Medicine and Rehabilitation . Philadelphia, PA: Hanley and Belfus; 2002 (chap 56).
Last reviewed November 2009 by John C. Keel, MD
Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.
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