Hip Replacement Surgery

Total hip replacement surgery has been shown to provide successful outcomes for 90-95 percent of those who qualify. According to the American Academy of Orthopaedic Surgeons, over 193,000 hip replacements are performed each year. The procedure has helped countless patients achieve a return to function and activity.

Current developments in hip replacement surgery involve using new, advanced materials to extend the life of the total joint replacement. These materials include titanium, ceramic and new plastic joint liners.

Who is a candidate?

We recommend waiting to have a total joint replacement until your pain becomes unbearable, normal activity can no longer be completed, and nonsurgical treatments have failed. While waiting for a joint replacement, you can minimize your discomfort with several nonsurgical options such as medication, cortisone injections, activity modification, weight loss, and the use of a cane or brace.

Since hip prosthesis rarely lasts longer that 15 to 20 years, and outcomes of revisions are less effective than original replacements, young people are not good candidates for the surgery. It is also not recommended for the extremely obese, those with a terminal illness, those with nerve disease, or those lacking ample skin around the hip.

Types of hip prosthesis

Acrylic with Cement Fixation

This is the first type of hip prosthesis developed. Essentially, the prosthesis is secured to the hip with a cement adhesive. Over time (10 to 15 years) the cement will erode and need to be replaced. Usually these implants are used in older, less active adults or in people with weaker bones. The recovery time for this prosthesis is faster than other methods.

Without Cement Fixation

The difference between the cement and uncemented version of the hip prosthesis is the lattice grid that comprises the socket part of the uncemented prosthesis. After the diseased bone and cartilage has been removed, the latticed grid is inserted into the socket. After a while during healing, the remaining hip bone will grow into the grid much like ivy grows into a trellis and suture itself to the prosthesis. The new bone grows into the implant, securing it in place. This is a much more natural cohesion and lasts longer than the traditional prosthesis. Also, it affords much more mobility to the active hip replacement recipient than the cemented type.

Ceramic-on-ceramic

This technology presents the possibility of longer-lasting joints because it involves less wear and tear. This is important as total hip replacement becomes increasingly common in younger patients. Traditional artificial hip systems have a plastic insert and a metal head, and although they have demonstrated successful outcomes, it has been learned that these materials can degrade and wear out over time. This can also cause bone loss and loosening of the joint.

The procedure

The surgery itself, lasting between two to three hours, is performed on those who experience the chronic and debilitating effects of hip disease. An incision is made in the side of the patient's thigh. The surgeon then removes the diseased bone and cartilage and fits the prosthesis into the joint. The prosthesis is inserted, and the incision is sutured.

Risks

Complications related to total hip replacement surgery are uncommon but can include blood clots, differing leg lengths, dislocation, infection, nerve damage, broken bone, heart attack and stroke. Please consult our physicians if you have questions about the risks of your hip replacement surgery.

Recovery

Therapy and activity are key components to your recovery from total hip replacement. The sooner patients get moving with their joint replacement through therapy sessions, the more likely they are to achieve a full return to activity. However, activities such as driving, kneeling, bending and jumping are usually not allowed for some weeks after surgery. Activities should not cause pain or move the joint around. Most patients will achieve a full recovery within 3-6 months.

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