TOTAL JOINT CARE PLAN OrthoEdge Orthopedic Specialists Jacksonville Florida ortho edge fl

What to Know About Hip Replacement

Total hip replacement surgery is a successful, life-enhancing procedure that is performed on nearly half a million people in the United States each year. Osteoarthritis, also known as degenerative or “wear and tear” arthritis, is the most common reason for hip replacement surgery. Patients experiencing other hip conditions, such as osteonecrosis, fractures, and bone tumors are also candidates for hip replacement.

The goal of hip replacement surgery is to restore pain-free motion to the diseased parts of the hip joint. During the surgery, underlying deformities in the bone and cartilage are corrected by removing and replacing the head of the femur and resurfacing the hip socket.

More than 95% of people who’ve had a total hip replacement experience a dramatic improvement in their pain as well as their hip function. The success rate of hip replacement 10 years after surgery is 90%–95%, and at 20 years, 80%–85%. Some soreness and stiffness will persist for weeks after the procedure (and, for some patients, it may be months) but ultimately most people are glad they had surgery.

It’s important to acknowledge that a hip replacement is major surgery. In most instances (excepting emergency surgery necessitated by a hip fracture), it is an elective procedure. Wait until you’re absolutely ready for it and are prepared to work hard during the post-operative rehabilitation period. Similarly, consider it only when less invasive treatments no longer bring you relief.

In this article, we’ll review how to determine if you’re a candidate for a total hip replacement. We’ll also look at the benefits, risks and potential complications of this surgical process. Finally, we’ll examine what happens during and after hip replacement surgery, as well as how long you can expect the implant to last.

Are you a candidate for hip replacement surgery?

Hip replacement surgery is one of modern medicine’s most successful operations. It is very effective at relieving pain and helping patients regain lost mobility. During the procedure, your damaged bone surfaces are removed and replaced with plastic, metal and ceramic components.

In the past, hip replacement was reserved for older patients.

New technology has improved the quality of prosthetics, which are the artificial parts that replace damaged joints. Today’s hip implants withstand more strain and last longer. Because of these advancements, hip replacement can also be an effective, long-lasting treatment for younger patients. Millions of Americans with artificial hips are leading busy, productive lives.

Because of its invasiveness and complexity, total hip replacement surgery should be considered only when you have exhausted all reasonable non-operative measures to control pain. Ask yourself if you are physically and emotionally ready for the operation, as well as the subsequent rehabilitation period. The final decision rests with you.

Signs that it might be time for a Total Hip Replacement:

Pain in your hip prevents you from sleeping
Medication and using a cane aren’t delivering relief
Because of hip pain, you restrict social activities such as attending church, going shopping, going to sporting events, and/or traveling
You have difficulty getting in and out of chairs, cars and bathtubs
You have difficulty sitting for more than 30 minutes at a time
You have difficulty walking or climbing stairs
You feel a decrease in hip motion or the degree to which you’re able to bend
You find intercourse and/or sexual activities painful

How a healthy hip compares to impaired arthritic joints:

The hip is one of the largest joints in the body and one of its most important.

It is a ball-and-socket joint. The rounded head of the femur (thigh bone) acts as the “ball” and the acetabulum, which is part of the pelvis, acts as the “socket”. Because the size and shape of these bones fit well together, the hip joint is normally very sturdy. In fact, the hip supports most of the body’s weight, second only to the knee joint.

However, while the hip can withstand a significant amount of wear and tear, it’s not indestructible.

Medical conditions like osteoporosis can significantly impact joint health, because a bone’s overall strength and ability to resist fracture is determined by its bone mass and quality. Like other joints in the body, the hip is susceptible to injury, inflammation, and disease. If left untreated, these conditions can lead to painful and irreversible damage.

What are the benefits of hip replacement?

Reduced hip pain: Following the initial surgery-related discomfort (which should disappear within a few weeks), you should expect that your hip pain will either be eliminated or significantly reduced.
Restored mobility: As your hip pain subsides, your legs will become stronger with increased use. That means better mobility, less fatigue and easier movement.
Improved quality of life: With less pain and greater mobility, you should be able to perform daily tasks more easily and lead a more active, more independent life.

What should I know when considering a hip replacement?

Hip arthritis is a complex, progressive disease. Once you have it, it will never get better, and it generally will get worse. There are no exercises, diets, vitamins, or supplements that will make any difference.
The rate of joint deterioration varies greatly from person to person. As hip arthritis progresses, individuals will experience worsening pain and declining function, but some people will find this less debilitating than others.
Eventually, your pain and disability will no longer respond to medication. Although you often might experience days or weeks when your hip pain is minimal, this is not a sign your arthritis is “’getting better.”
Hip replacement surgery is an elective procedure. You will never need a hip replacement if you are willing to live with the pain.
More than 98% of patients who have a hip replacement operation have no major complications that leave them in any way dissatisfied with their replacement.
There can be consequences to waiting too long. Don’t try to “save your joint” by becoming totally sedentary. It won’t slow down the disease’s progression; in fact, it will only accelerate the loss of muscle and bone strength.
Recent studies suggest that people who choose to have surgery before advanced joint damage occurs tend to recover more easily and have better outcomes. If you’ve already tried conservative measures and your pain and disability are not responding, it’s likely time to consider surgery. Similarly, if you know that sooner or later you are going to need to have the operation, you may reasonably conclude there is no point in waiting.
Full recovery from the surgery takes about three to six months. Factors influencing your recovery include the type of surgery performed, your overall health, and the success of your rehabilitation.
Your pre-surgical state will impact your post-surgical recovery more than the surgery will. If you have co-morbidities like obesity, a lack of conditioning, chronic disease, or emotional or psychological distress, these factors will influence your the rate of your recovery.
You have a 90-95% chance that your joint will last 10 years, and an 80-85% chance that it will last 20 years.

What happens during a hip replacement?

At OrthoEdge, our fellowship-trained doctors are experts in robotic-assisted orthopedic surgery for total hip replacements. Our team’s shared goal is to ease your pain, restore your quality of life, and quickly and safely get you moving freely again. We are committed to ensuring that you and your family understand every step of the surgical process and are comfortable with your treatment plan.

During a total hip replacement, the surgeon removes the damaged cartilage and bone from the surfaces of your hip joint. The head of the femur is removed and the acetabulum (the hipbone socket, into which the femoral head fits) is hollowed out. Your orthopedic surgeon then replaces these surfaces with new components:

a short, angled metal shaft (the stem) is inserted into the femur
a ceramic ball, which replaces the damaged femoral head, is placed on the stem
a metal socket (or cup), which is pressed into the hollowed out acetabulum
a high-density polyethylene spacer is inserted between the new ball and the socket to allow for a smooth gliding surface.

The femoral stem and acetabular cup may be either “press fit” into the bone or secured with “bone” cement. The video below provides a good illustration of the procedure.

Hip replacement surgery is performed under anesthesia in a hospital or ambulatory surgical center setting. Most patients stay one to two days in the hospital before going home.

pulse gif OrthoEdge Orthopedic Specialists Jacksonville Florida ortho edge fl

How long does it take to recover from hip replacement surgery?

You will need help at home for three to four weeks. Patients who do not have help at home will be discharged to a rehabilitation facility, where the average stay is 12 days.

Full recovery from the surgery takes about three to six months. Within 12 weeks, many patients are able to resume their recreational activities, such as walking, yoga, golfing, and cycling.

Factors influencing your recovery include the type of surgery performed, your overall health and activity level, and the success of your rehabilitation.

You will work with a physical therapist to regain strength, mobility, coordination and joint function. It is very important that you fully understand the recovery process and follow the post-op physical therapy regimen prescribed for you. (The American Academy of Orthopaedic Surgeons has an excellent and extensive webpage devoted to what you can expect after surgery.)

How long can I expect the implant to last?

Thanks to improvements in surgical techniques, prosthetic designs, bearing surfaces and fixation methods, 80%– 85% of total hip implants last 20 years.

With normal use and activity, the surfaces of the implant will eventually begin to wear down. Think of your joint as a car tire; once you’ve driven it thousands of miles, the tread gets worn and the tire needs to be replaced. The same is true of the mechanical components in your joint implant. Excessive activity or weight may speed up this normal wear and may cause the hip replacement to loosen and become painful.

hip replacement patient doing muscle-strengthening exercises

What are the potential risks and complications of hip replacement surgery?

Joint replacement in general is highly successful and has a low rate of complications.

However, as with any major surgical procedure, it is important for patients to be well informed about the possible risks of joint replacement surgery. These risks include:

Postoperative urinary retention is a common complication, especially in men
Dislocation or instability of an implanted joint
Infection around an implanted joint
Failure of the prosthetic’s components can result in pain and loss of function
Periprosthetic fracture (a fracture that occurs in association with an orthopedic implant). These are associated with significant morbidity and increased mortality in some cases.
Damage to nerves or blood vessels
Blood clots (deep vein thrombosis): In the post-surgical period blood clots may form in the calf or thigh. Medications to reduce clotting and mechanical devices that encourage blood flow in the legs are utilized to reduce this risk.
Wound irritation, inflammation or infection
Limb length discrepancies

Over time, a hip implant can fail for a number of reasons. In this instance, additional surgery may be required. Your doctor may recommend that you have a second operation to remove some or all of the parts of the original prosthesis and replace them with new ones. This procedure is called revision total hip replacement.

OrthoEdge's Total {Joint} Care process:

At OrthoEdge, joint replacement surgery is a joint endeavor. We take seriously our responsibility to help patients overcome their fears and concerns about the treatments we provide. We believe a total joint care plan—an open dialogue, empathy, and a true partnership between doctor and patient—is critical to achieving great patient care, faster recovery, and lasting results. More knowledge, less anxiety, and increased confidence for you and your family—that’s the OrthoEdge difference.