After years of a deteriorating hip joint, you are left with almost constant pain and decreased mobility. Eventually, your personal and social life suffers. You are no longer able to do all the things you could once do with ease. If you’ve exhausted all other attempts to relieve the pain and stiffness, it may be time for you and your doctor to consider hip replacement surgery. You don’t have to live with pain for the rest of your life. Hip replacement is a common surgery with a high success rate.
Depending on your age and the condition of your hip, total hip replacement surgery (total hip arthroplasty) may offer the best solution to your problem. Hip replacement hardware (ball and socket prosthesis) can last up to 20 years. And it can often be replaced if the first prosthesis wears out (though second surgeries are not always as successful as the initial hip surgery). If you are fairly young, your doctor may suggest delaying surgery. If so, medications or lifestyle changes may help control your symptoms until the time is right for joint replacement. Losing weight can take a tremendous amount of stress off your hip and knee joints.
Most hip replacement surgeries involve the traditional approach to the hip joint (lateral/posterior or posterior approach). With the common lateral approach, an incision (8-12 inches long) is made down the outside of your hip. The ball at the upper end of your femur (thigh bone) is cut off and replaced with a ball/metal stem component. The stem is placed into the marrow cavity of the thigh bone and the ball portion at the top fits into your new ceramic or plastic socket that is implanted into your pelvis (the cartilage from your hip socket is removed or smoothed).
The Birmingham Hip Resurfacing System (BHR) is relatively new (introduced in 1997). Long term studies are still in progress, but so far results have been favorable. The BHR method eliminates the need to cut off the ball at the top of the femur. Instead, the ball is left intact and merely resurfaced (reshaped) to allow an anatomically shaped metal sphere to be attached. The socket is replaced with a metal implant. The procedure is bone-saving and results in a stronger hip joint than the traditional total hip replacement. The chance of hip dislocation is greatly reduced. For younger and active people, this may be the procedure of choice.
Minimally invasive hip replacement surgery involves an anterior approach to the hip joint. An incision is made along the front of the hip, which allows a more direct route to the hip joint. The major hip muscles are not in this area, so there is minimal tissue/muscle damage during surgery. This usually results in a shorter hospital stay, a quicker recovery/rehab period, and less pain. The only downside to this method is there are few surgeons performing the anterior approach surgery. It requires a special surgery table (which few hospitals have) and special surgical training.
Total Hip Precautions
After traditional total hip replacement surgery, patients are required to follow strict precautions that restrict certain movement/positions of your new hip. This is to prevent your new hip from dislocating. They are commonly called total hip precautions, or total hip protocol, and include the following:
- Do not cross your legs
- Do not point your toes inward (no pigeon toes)
- Do not bend your new hip more than 90 degrees
Your doctor may also restrict the amount of weight you can put on your new surgery leg while walking. This is called your weight-bearing status. This should be strictly followed so you do not damage your new hip while it’s healing.
All surgeries carry risk. Hip surgery complications include, but are not limited to, infection, DVT (deep vein thrombosis- blood clot), dislocation of your new hip, leg length discrepancy, vascular damage, nerve damage, just to name a few.
Recovery after hip surgery depends on the amount of cartilage damage, your age, and your fitness level prior to surgery. Exercise before your surgery and your recovery will be easier. Approximately 4-6 months after surgery you should be fully healed, but you must take an active part in your recovery by doing daily exercises and taking daily walks.