As the largest joint in your body, your hips bear the brunt of your body weight. They support your ability to walk and move. When they hurt, it can negatively affect your quality of life. Once the hip joint becomes worn down, eventually you are in pain even when resting.
Osteoarthritis and rheumatoid arthritis are the biggest contributors to why hips wear out, although fractures and congenital conditions can also play a role. Both cause damage to the cartilage that covers the bones and allows the joints to move smoothly. Couple this with persistent pain, the need for walking aids, muscle weakness, stiffness and difficulty performing your job or activities of daily living, and you may be an ideal candidate for a total or partial hip replacement.
What is a hip replacement?
During hip replacement surgery, an orthopedic surgeon removes your worn out joint with a brand-new artificial joint made of metal, plastic, ceramic or a combination of these materials. Patients can either receive a partial or total hip replacement depending on the extent of the damage.
Total hip replacement, which replaces the head of the thigh bone and resurfaces the socket, is generally considered the gold standard for people with arthritic conditions. Partial hip replacements, where only the head of the thigh bone is replaced (allowing it to rotate in the body’s own hip socket) can be considered for people who don’t have underlying arthritic conditions.
New hip joints generally last about 15 years.
Who makes a good candidate?
Joint replacement is reserved for patients who have first tried other conservative approaches like losing weight, medications, injections and therapies that failed to provide relief. It can be performed on people of any age, but the best candidates are in good health, don’t smoke and aren’t overweight.
Being as healthy as possible before surgery contributes to a better surgical outcome and easier recovery.
The more common posterior approach has surgeons place the implant through the back, but it also involves cutting through muscle and tendons. The anterior approach allows the implant to be placed through an incision on the front of the hip. This technique is considered minimally invasive because it goes between the muscle instead of cutting through it. The advantage is less pain, blood loss and scarring and a shorter hospital stay. Because of the precision needed for this surgery, only a highly skilled surgeon should perform it. Your doctor can explain the pros and cons of each surgery in more detail, and which is right for you.
Some hospitals offer outpatient hip replacements—meaning an overnight stay in the hospital isn’t required. Your surgeon will consider your age, overall health, mobility, activity level and support system at home to determine if you are a good candidate.
Prior to surgery, you will be instructed how to prepare your home for optimal recovery. This could involve obtaining walking aids or assistive devices (cane, walker, elevated toilet seat), installing grab bars and/or a bench in the shower, replacing throw rugs to help avoid falls and making sure stairways have secured handrails.
How long does recovery take?
Recovery varies depending on the person’s age and overall health prior to surgery. Physical therapy plays a big role in recovery because it helps build up strength in the muscles that support your new joint.
One of the things you don’t want to happen during recovery is to dislocate your new hip. You can avoid this by making sure not to bend your hips or knees further than 90 degrees. Also avoid crossing your legs or lifting your leg up. Your physical therapist can review positions to help prevent this complication.
Set realistic expectations for what life after surgery may look like. You may be advised not to resume high impact sports, like running. Although it does take time and patience to adjust to your new hip, returning to normal activities without pain is the ultimate payoff.
Interested in learning more? Make an appointment with one of the orthopedic surgeons at St. Vincent Charity Medical Center.