Total Hip Replacement

Total hip replacement is a surgical procedure in which the damaged cartilage and bone is removed from the hip joint and replaced with artificial components. The hip joint is one of the body’s largest weight-bearing joints located between the thigh bone (femur) and the pelvis (acetabulum). It is a ball and socket joint in which the head of the femur is the ball and the pelvic acetabulum forms the socket. The joint surface is covered by a smooth articular cartilage which acts as a cushion and enables smooth movements of the joint. Injury and diseases such as arthritis can cause damage to the articular cartilage, making the bones rub painfully against each other.

Total hip replacement surgery is an option to relieve hip pain that limits your daily activities. It involves the replacement of the damaged parts with prostheses and is recommended if conservative treatment options such as anti-inflammatory medications and physical therapy do not relieve the symptoms.

Procedure

Total hip replacement surgery is performed under general anesthesia. During the procedure a surgical cut is made over the hip to expose the hip joint and the femur is dislocated from the socket (acetabulum). The replacement surgery can be performed either through an open approach with a large incision on the skin or minimally invasively through 3 to 4 small incisions by arthroscopy (using a thin lighted tube with camera to view the operation site) or robotic surgery (robotic arms are controlled by your surgeon).

The surface of the socket is cleaned and the damaged or arthritic bone removed using a reamer. The acetabular component is fixed into the socket. A liner made of plastic, ceramic or metal is placed inside the acetabular component. The femur or thigh bone is then prepared by removing the arthritic bone using special instruments, to exactly fit the new metal femoral component. The femoral component is then inserted into the femur either by a press fit or using bone cement. Then the femoral head component made of metal or ceramic is placed on the femoral stem. All the new parts are secured in place using special cement. The muscles and tendons around the new joint are repaired and the incision is closed.

Post-operative care

After undergoing total hip replacement, you must take special care to prevent the new joint from dislocating and ensure proper healing. Some of the common precautions to be taken include:

  • Avoid combined movement of bending your hip and turning your foot inwards
  • Keep a pillow between your legs while sleeping for 6 weeks
  • Never cross your legs and bend your hips past a right angle (90°)
  • Avoid sitting on low chairs
  • Avoid bending down to pick up things; instead use a grabber
  • Use an elevated toilet seat

As with any major surgical procedure, there are certain potential risks and complications involved with total hip replacement surgery. These may include:

  • Infection
  • Dislocation
  • Fracture of the femur or pelvis
  • Injury to nerves or blood vessels
  • Formation of blood clots in the leg veins
  • Leg length inequality
  • Wear out of prosthesis
  • Failure to relieve pain
  • Scar formation
  • Pressure sores

Total hip replacement is one of the most successful orthopedic procedures performed for patients with hip arthritis. This procedure can relieve pain, restore function, improve your movements at work and play, and provide you with a better quality of life.