Definition | Reasons for Procedure | Possible Complications | What to Expect | Call Your Doctor

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Definition

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.

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:

  • Younger than 50
  • Of normal weight
  • Healthier than those who have the traditional total hip replacement surgery

Left Total Hip Replacement

Hip Replacement
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Reasons for Procedure

This surgery is done when pain and stiffness limit your normal activities. This pain and stiffness is usually due to osteoarthritis. Surgery is done when other treatments have been tried and are no longer working. These other treatments include rest, medicine, and physical therapy.

Other reasons for surgery may include a broken hip, rheumatoid arthritis, bone tumors, and loss of blood supply to the bones of the hip.

Possible Complications

If you are planning to have a hip replacement, your doctor will review a list of possible complications, which may include:

  • Hip dislocation, which is the most common complication—occurs when the ball portion of the prosthesis dislocates from its normal position in the hip
  • Infection
  • Blood clots
  • Swelling or bleeding
  • Injury to nearby nerves or blood vessels
  • Anesthesia-related problems, like pneumonia
  • Noisy or squeaky hip after surgery

Factors that may increase the risk of complications include:

  • Pre-existing medical condition, such as heart or lung problems
  • Obesity
  • Infection, such as urinary tract infection or gum disease—Having an infection increases the risk of bacteria entering the bloodstream and infecting the joint.
  • Previous problems with blood clots
  • Smoking

Be sure to discuss these risks with your doctor before the surgery.

What to Expect

Your doctor may do the following:

In the time leading up to the procedure:

  • Try to lose weight if you are overweight. This will decrease the amount of stress on your new joint. Pool exercise may be a good option.
  • To enhance safety and recovery, make home modifications:
    • Install safety bars, a raised toilet seat, a shower bench, and a hose. Install handrails on stairways and steps.
    • Remove throw rugs. Check to make sure extension cords are in a safe place.
    • Purchase a stable, firm-backed arm chair. When seated, your knees should remain lower than your hips.
    • Buy items to make daily activities easier, such as reachers and dressing aids.
    • Place items so that they are easy to reach. This way, you will be able to avoid bending.
  • Talk to your doctor about your medicines. You may be asked to stop taking some medicines up to one week before the procedure, like:
    • Anti-inflammatory drugs
    • Blood thinners
  • Your doctor may suggest donating your own blood for the surgery. You will most likely lose some blood and fluid during this surgery. If you need a blood transfusion, the doctor can use your own blood.
  • If you become sick or have a fever just before the surgery, tell your doctor right away.
  • Arrange for a ride to and from the hospital. Also, arrange for help at home.
  • If you smoke, try to smoke less or stop smoking.
  • Eat a light meal the night before the surgery. Do not eat or drink anything after midnight. If you have diabetes, ask your doctor if you will need to adjust your medicine.

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.

An incision will be made along your joint. The muscles will be moved aside. The damaged bone and cartilage of the hip joint will be removed. The remaining bone will be prepared for the prosthesis. The new artificial 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 small incisions. 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, an incision will be made over the outside of your hip. The muscles and tendons will be moved out of the way. Next, the damaged bone and cartilage of the hip joint will be removed. The remaining bone will be prepared for the prosthesis. The new artificial 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, an incision will be made over the groin and another over the buttock. The above process will then be followed.

Placement of Prosthesis

hip replacement hardware
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  • Total hip replacement: 1-1½ hours
  • Minimally invasive total hip replacement: 1 or more hours

You will have pain after the surgery. Pain medicine will be given to help with discomfort.

This procedure is done in a hospital setting. The usual length of stay is:

  • 4-6 days for a total hip replacement
  • 1-2 days for minimally invasive total hip replacement

Your doctor may choose to keep you longer, if complications occur. In some cases, you may need to stay in a rehabilitation 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:

Within six weeks, you should be able to resume normal, light activities. A replacement hip typically lasts 10-15 years.

Call Your Doctor

After you leave the hospital, contact your doctor if any of the following occur:

  • Signs of infection, including fever and chills
  • Redness, swelling, increasing pain, excessive bleeding, or discharge around incision site
  • Pain and/or swelling in the feet, calves, or legs
  • Cough, shortness of breath, chest pain
  • Severe nausea or vomiting
  • Hip pain that you cannot control with the medicines you have been given or that becomes worse
  • Numbness, tingling, or loss of feeling in your leg, knee, or foot

In case of an emergency, call for medical help right away.