If your hip joint is diseased or you have broken your hip you will undergo hip replacement or arthroplasty. Your hip is removed and replaced with artificial part or prosthesis. Hip replacement surgery helps increase mobility, improves the joint function, relieves pain and if broken, repairs the break. Almost 332,000 hip replacements are performed in the U.S. every year.
A hip prosthesis includes a ball component make of metal or ceramic and a socket which generally has a liner made of plastic ceramic or metal. Implants are biocompatible or are accepted by your body. A new hip will resist degradation, wear and tear as well as corrosion. A replaced hip due to disease or injury will alleviate pain and increase activity.
You may need hip replacement surgery if you have osteoarthritis, rheumatoid arthritis, a broken hip or a hip bone tumor. If there is inadequate blood supply (osteonecrosis) to the hip or any portion of the joint replacement surgery is necessary.
Additional reasons to have hip surgery include persistent pain, pain that becomes unbearable when walking or using a cane or walker, poor sleep due to hip pain and trouble rising from a seated position.
Hip replacement surgery is usually safe and the success of recovery is high. The same risks with all surgeries are also part of hip replacement risks. Complications of this type of surgery consist of:
- Blood clots that form in your leg veins. This is the result of decreased leg movements after surgery plus pressure on the veins during surgery. Your doctors will prescribe blood thinning medications, compression stockings, and specific exercises to increase blood flow.
- Infection is always an issue after surgery. Infections can be treated with antibiotics but if the infection is near your prosthesis, repair and or repeat surgery may be necessary.
- Fractures are a definite risk in hip replacement surgery. There are times when healthy portions of your hip joint fracture. The fracture may be so small they heal on their own, but larger fractures may need surgical correction.
- It is common to have one leg shorter or longer than the other leg after surgery. Most surgeons take steps to avoid this problem, but often a new hip may cause one leg to be different than the other. Surgeons suggest this may be due to weakness in the muscles around the hip. Strengthening and stretching those muscles help with stability.
- Joint stiffening is a definite possibility. The soft tissues around the hip joint harden or there is ossification. Additional medications or radiation therapy may be needed to keep your hip joint from stiffening.
Your new hip will wear out over time. Hip replacements performed when you are young often require additional hip replacement surgery when you are older.
Hip replacement surgery takes about two hours from start to finish. It comprises:
- An incision make over the front or side of your hip.
- Diseased, damaged bone and cartilage is removed leaving the healthy bone.
- The prosthetic socket in implanted into the pelvic bone and replaces the damaged socket.
- The round top of your femur is replaced with a prosthetic ball that is attached to a stem implanted into your thighbone.
The new joint is manufactured to simulate the gliding motion of a healthy hip joint.
New materials and techniques for hip replacement therapy are continually being discovered. It is hoped that new techniques will reduce recovery time and pain. There are ongoing studies to determine whether or not minimally invasive hip replacement therapy is can be successful.
Recovery and Long Term Prognosis
There is an increased risk of blood clots in your legs after hip replacement surgery. To prevent these clots early mobilization is encouraged. You will be required to walk the same day as the surgery. Pressure applications like elastic compression stockings or inflatable air sleeves will be prescribed. The pressure keeps blood from pooling in your lower legs. Blood thinning medications are generally prescribed.
Physical therapy and prescribed exercises are necessary after hip surgery.
Home recovery for a week or so will include limited walking, bending or reaching. Simple modifications such as handrails and raised toilet seats may be necessary. Take care to follow all your doctor”s instructions. Within six to eight weeks you will be released to go about your normal duties; with some limitations. You may not be able to do high impact exercises any more and jumping rope will definitely not be a possibility. Physical therapists suggest swimming as an awesome exercise to keep your hip flexible and prevent stiffening.
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