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Hip
Anatomy
Total Hip Replacement
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Artificial Hip Replacement
More than 168,000 artificial hip replacement
surgeries are performed yearly.
Hip replacement may become necessary if activities
such as walking, sitting, or even resting become
painful.
Who might be a candidate for artificial hip
replacement?
The most common condition that results in the need
for hip replacement surgery is arthritis. Osteoarthritis,
a degenerative, joint disease that affects mostly
middle-aged and older adults, causes the breakdown
of joint cartilage and adjacent bone in the hips.
Rheumatoid arthritis, which causes inflammation
of the synovial membrane and results in excessive
synovial fluid, can lead to pain and stiffness.
Traumatic arthritis, arthritis due to injury, can
cause damage to the articular cartilage of the hip.
The decision to replace the painful hip with
an artificial one is a decision made by the patient
and physician. Other, alternative treatments may
first be used, including assistive walking devices
and anti-inflammatory medications.
What happens before the surgery?
In addition to a complete medical history, your
physician may perform a complete physical examination,
including x-rays, to ensure you are in good health
before undergoing surgery. In addition, you may
also meet with a physical therapist to discuss
rehabilitation after the surgery and undergo blood
tests (or other tests).
How is a hip replaced with an artificial hip?
Although each procedure varies, generally, surgery
to replace a hip usually lasts a few hours.
The two most common types of artificial hip prostheses
used in replacement surgery are cemented prostheses
or uncemented prostheses. Sometimes, a combination
of the two types is used to replace a hip. A hip
prosthesis is made up of metal and plastic. A
cemented prosthesis is attached to the bone with
a type of surgical cement. An uncemented prosthesis
attaches to the bone with a fine mesh of holes
on the surface, in order for the bone to grow
into the mesh and attach naturally to the prosthesis.
The prosthesis (artificial hip) is comprised
of the following two components:
- metal ball component
- plastic socket component (which may have a
metal outer shell)
While undergoing surgery, the patient may be
under general anesthesia or awake with spinal
anesthesia.
After surgery:
Hip replacement surgeries usually require an in-hospital
stay of several days. Even while in the hospital,
the patient usually begins physical therapy exercises
to begin regaining range-of-motion in the hip. Physical
therapy will continue at home. Pain medication also
will be administered to keep the patient comfortable.
The incision will have stitches or staples that
will be removed after a few weeks.
Making certain modifications to your home may
help you during your recovery. These modifications
include the following:
- proper handrails along all stairs
- safety handrails in the shower or bath
- shower bench or chair
- raised toilet seat
- stable chair with firm seat cushion and firm
back with two arms, which will allow your knees
to be positioned lower than your hips
- long-handled sponge and shower hose
- dressing stick
- sock aid
- long-handled shoe horn
- reaching stick to grab objects
- firm pillows to raise the hips above the knees
when sitting
- removing loose carpets and electrical cords
that may cause you to trip
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