Total hip replacement surgery is a major surgical operation that is done to replace the entire ball and socket joint of the hip. A two-piece artificial device is implanted in the bone to take the place of the joint. This procedure may be done on patients suffering from the disease osteoarthritis, in which there is a loss of cartilage in the joints. Total hip replacement surgery may also be done on patients who fall and fracture a hip.
Osteoarthritis is a disease that causes the cartilage that cushions the joints degrades causing two surfaces of bone to rub against one another. This can be painful and reduce mobility and quality of life for the patient. The physician may first try conservative treatment, which involves rest and pain medication. If conservative therapy for osteoarthritis in the hip is unsuccessful, the patient may want to consider total hip replacement surgery.
A patient suffering from the bone disease osteoporosis, in which the bones become fragile, is at risk of experiencing a hip fracture after a fall. During a hip fracture, the round head of the long bone of the leg, the femur, breaks off at the hip joint. This leaves the patient unable to walk or put any weight on the affected leg.
To diagnose a hip fracture or osteoarthritis, the physician may request X-rays of the hip area. A computed tomography (CT) scan or magnetic resonance imaging (MRI) can also give the physician a better picture of any disease or fracture in the hip joint. If the patient needs a hip replacement, the surgery will be performed by an orthopedic surgeon.
Patients will be under general anesthesia for the surgery, and the average hospital stay is five to seven days. To perform the total hip replacement surgery, the orthopedic surgeon will make a vertical incision in the skin on the side of the body at the hip level. The head and neck of the femur will be removed and the canal in the center of the femur will be hollowed out. This hollow canal will be filled with bone cement. A metal prosthetic device with a long stem and a round head will then be inserted into the center of the femur.
The cement fills the cavity and bonds with the bone to hold the prosthesis in place. To complete the second half of the artificial joint, bone is first removed from the round socket in the pelvic bone, known as the acetabulum. Reshaping of the acetabulum is done to accommodate a round plastic cup that is inserted in the cavity and held in place with metal screws. The head on the metal prosthesis in the femur should fit into the round cup and create a new hip joint.
Patients may initially need to take pain medication and antibiotics after the surgery. Complete recovery may take from three to six months. Once the tissue around the artificial joint has healed, the patient should be able to walk and slowly return to activities without pain.