Hip Replacement Surgery

Xray after Hip Replacement

What is a Hip Replacement?

A hip replacement involves the surgical replacement of the hip joint with a prosthetic implant. A total replacement involves the replacement of the acetabulum (socket) and femoral head (ball) and the procedure is designed to provide pain relief and improved function and motion of the hip joint.

Who Needs a Hip Replacement?

Patients requiring a hip replacement will usually have the procedure to alleviate chronic arthritic pain, to repair severe damaged caused by a hip fracture or to treat avascular necrosis, protrusio acetabuli, and bone tumors. Osteoarthritis is the number one cause of hip replacement surgery. Signs that the procedure may be necessary include constant hip or groin pain that prevents the patient from sleeping through the night, or limits the performance of basic activities including climbing stairs, getting out of a chair, etc.

A hip replacement should only be undertaken after physical therapy and pain relief have been exhausted, however the procedure is statistically the most reliable and successful orthopedic surgery. The surgery may be performed under general or spinal anesthetic, and all surgical procedures do carry with them some degree of risk. Diabetics, who undergo the surgery, may experience a slower recovery process. Some patients may experience bone fractures, infection, dislocation, and adverse tissue reaction as a result of the surgery. Recovery from a hip replacement involves concerted rehabilitation therapy on the part of the patient.

Hip Replacement Procedure

A hip replacement involves removal of the head of the femur and the preparation of the bone for a new prosthetic femoral stem. With a new stem in place, the prosthetic ball is inserted into place at the hip socket. A total hip replacement (THR) usually involves an incision on the buttock (posterior-lateral) or the upper thigh (anterior-lateral). Access to the hip joint via the back (posterior) is another method which eliminates damaging the hip abductors. A hip replacement procedure may also be conducted using dual incisions: at the front of the thigh to facilitate the insertion of the implant socket and a smaller incision at the back of the thigh, through which the stem of the implant is inserted. Such double incision techniques aim to reduce damage to soft tissue, but may require the employment of computer guidance assistance systems due to possible impairment of positioning accuracy.

The anterior approach results in reduced tissue damage thus resulting in reduced pain for the patient and shorter recovery time. With this technique, surgery can be conducted between the sartorius muscle and tensor fascia latae eliminating the need to detach the tissue and muscle from the bone. The risk of dislocation is also lessened with this technique.

Hip Replacement Recovery

Post-surgery, patients can expect to return home within a few days and begin walking with assistance the day after surgery

Titanium hip joint used in hip replacement surgery

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Other Links to Hip Replacemnt Information

Wiki: Hip Replacement
About.com: Arthritis and Joint Replacement
BUPA: Hip Replacement Information
Video: Hip Replacements