What is Total Hip Replacement?

Hip replacement is a procedure that requires replacing the damaged hip joint with an artificial implant. This surgical procedure may be a total or hemi replacement and is usually done to relieve severe arthritis pain or repair extreme physical damage. Total hip replacement involves replacing the femoral head and acetabulum, while a hemi (short for hemiarthroplasty) replaces only the femoral head of the hip. This is the most successful form of orthopaedic surgery with a success rate of 97%.

Candidates for Hip Replacement

A total hip replacement is done when severe arthritis is progressively worsening, as is the case with osteoarthritis of the hip. There are many other conditions that may require a total hip replacement, including bone fractures, rheumatoid arthritis and aseptic necrosis of the hip.

Most people eventually turn to a total hip replacement when chronic pain combines with impaired walking and moving to make daily life a challenge. It’s often difficult to decide when a total hip replacement is warranted, as failure of the replaced joint is possible. Most orthopaedic specialists recommend replacement when pain begins to interfere with normal function and does not respond to pain medication and anti-inflammatories. This is an elective procedure and the decision must be made after weighing the benefits against the risks.

Possible Complications

Possible risks associated with a hip replacement include blood clots, which may lead to pulmonary embolisms, along with difficulty urinating, joint or skin infection, bone fracture, reduced range of motion and prosthesis failure in the future. As the surgery requires anesthesia, risks associated with anesthesia are also possible, such as heart arrhythmia and pneumonia.

Preparation for Surgery

Patients who plan to have total hip replacement typically donate their own blood to be used if a transfusion is necessary. Medications of all kinds, even aspirin, will also be discontinued 7 days prior to surgery so they will not affect blood clotting or platelets. A complete pre-operative analysis will also be necessary, including a chest X-ray, exam, EKG, urinalysis and blood tests.

Rehabilitation after Hip Replacement

Orthopaedic physical therapy begins right after surgery, continues through the hospitalization period and up to one year at home post surgery. The day after the procedure, an assessment will be performed, following by physical therapy. The therapist will monitor strength and range of motion, as well as the patient’s ability to stand. After discharge from the hospital, you may also check into a rehabilitation center for up to 14 days to continue your therapy.

During the beginning phases of physical therapy, a walking device will be used and pain will be carefully monitored. It’s normal to feel discomfort, although the procedure itself will lead to a great deal of relief.

Physical therapy is the best way to improve your chances of success following joint surgery and reduce the risk of contractures, which limit range of motion and come from the scar tissue that surrounds the joint. You’ll be given specific instructions to follow and be discouraged from heavy lifting as well as bending at the waist until fully recovered.