What is Total Hip Arthroplasty?

Total hip arthroplasty, or total hip replacement, refers to a surgical procedure that involves the removal of a diseased hip, and replacing or substituting it with an artificial hip joint. An artificial or prosthetic hip is comprised of a ball and socket, and is compatible with the human body. Artificial hips are made to withstand wear and tear, and to resist degradation and corrosion.

During hip replacement surgery, the surgeon typically makes an incision over the hip through layers of tissue. The damaged hip is removed and replaced with an artificial hip, and then the incision typically is closed by using surgical staples. Following the procedure the patient is moved to the recovery area to be monitored for pain, bleeding, and stability of vital signs.

Total hip arthroplasty generally is performed in patients who have damage to their hip joint, either from injury or hip arthritis. When used in conjunction with physical therapy, total hip arthroplasty often can relieve pain. The procedure also can help restore function and range of motion to the hip joint.

Hip replacement surgery usually is performed after other non-surgical treatments have failed. If pain medications, exercise, and physical therapy fail to relieve hip pain and restore range of motion, total hip replacement may be a consideration. Typically, medical conditions that may necessitate total hip replacement are bone tumors, hip fracture, and osteonecrosis, which is a condition where blood supply to the ball of the hip is inadequate. Many times, osteoarthritis and rheumatoid arthritis also might require a hip replacement.

Total hip arthroplasty generally is a safe procedure; as with any surgical procedure, however, complications might arise. Although certain complications may be serious, most can be treated without incident. Some complications of total hip arthoplasty may include blood clots, infection, and fracture due to surgery. Rarely, healthy parts of the hip joint might fracture because of trauma during the hip replacement procedure.

Other complications of total hip arthroplasty may include loosening of the new joint, dislocation of the new joint, prosthesis breakage, and uneven leg length. Typically, the surgeon takes steps to prevent this problem; however, the newly implanted hip joint may cause one leg to be shorter or longer than the other one. Usually, this condition is caused by weakness of the muscles that surround the hip. When this is the case, stretching and strengthening these muscles can increase stability and even increase the length of the leg.

After surgery, blood thinning medications usually are given for several weeks to prevent blood clots. Early mobilization after surgery is encouraged to prevent blood clots by increasing circulation. Wearing elastic socks after surgery can exert pressure on the legs that may keep the blood from pooling in the veins, reducing the possibility that a clot may form.

Physical therapy and exercise typically are important to regain range of motion and the use of muscles and joints after total hip arthroplasty. As physical therapy progresses, weight-bearing on the hip usually increases, and pain and stiffness decrease. Follow-up appointments with the surgeon usually are important to make sure the hip is properly healing and to make sure there are no indications of infection to the surgical site. After approximately six to eight weeks after total hip arthroplasty, most patients can resume normal activities.