ABOUT THE HIP
The hip is one of the largest weight bearing joints in the body. It is a ball-and-socket joint that has two main parts — the femoral head and the acetabulum.
The femoral head is a ball-shaped bone at the top of the femur (thigh bone). The acetabulum is the socket in the pelvis, into which the femoral head fits. To stabilize the joint, ligaments connect the ball to the socket. The joint capsule is lined with a thin membrane called the synovium. The synovium produces a viscous fluid, which lubricates the joint. Small fluid-filled sacs called bursae cushion the joint where there is friction between the tendons, muscles and bones.
Large muscles enable movement of the hip, in addition to providing additional stability. They are the gluteals, abductors, iliopsoas, quadriceps and hamstrings.
WHAT IS A HIP REPLACEMENT?
A hip replacement (also called a hip arthroplasty) is a surgical procedure to replace damaged bone and cartilage in the hip with prosthetic components. The prosthetic components may be metal or ceramic.
The damaged cartilage is usually replaced with a plastic or ceramic spacer to ensure that the new ball moves smoothly within the socket.
WHO MAY NEED A HIP REPLACEMENT?
A hip replacement surgery is an option for individuals who suffer from pain that majorly impacts their daily life. Candidates for hip replacement surgery have already gone through more conservative treatment options, such as pain management and physical therapy.
Most patients are between 50 and 80 years of age. Occasionally, hip replacement surgery will be performed on a younger patient suffering from juvenile arthritis.
Hip replacement surgery may be recommended if:
- Pain makes it hard to walk or if it causes stiffness that limits mobility in the leg
- Pain is persistent, causing discomfort even when resting or sleeping
- Anti-inflammatory medications and physical therapy do not provide relief
“Occasionally patients with hip arthritis will complain of pain on the outside portion of their hip. But sometimes bursitis and tendinitis can also cause significant pain. A hip injection in this area is easily performed in the office. Patients who have failed initial treatment for hip arthritis sometimes will benefit from a differential injection of cortisone into the hip joint. If the relief is significant, there’s a good chance that hip replacement surgery could be helpful." — Chris Vasilakis, M.D.
BEING EVALUATED FOR A HIP REPLACEMENT
Your doctor will perform a full exam before discussing the option of hip replacement surgery with you. They’ll discuss your medical history and any previous treatment you’ve gone through for your hip. You’ll also discuss the severity of your pain and how it limits you from daily activities or sports you love.
The doctor will then do a physical exam to look at the alignment and strength of the hip, as well as your mobility. If necessary, an x-ray or MRI may be performed to look at the hip bones and surrounding tissues.
HOW IS A HIP REPLACEMENT PERFORMED?
A hip replacement is a major surgery, so you will be under anesthesia for the procedure. This means you will not feel any pain. There are two main types of anesthesia:
- General, which puts you to sleep
- Nerve block, which numbs you from the waist down while you are awake
The surgery takes several hours as your doctor removes all of the damaged cartilage and bone, preparing to place the new implant in the hip. After the implant is positioned perfectly, your doctor will conclude the surgery by stitching up the incision.
You’ll then be taken to a recovery room, which is where you will wake up. As you wake up from surgery, you’ll be closely monitored to ensure there are no issues with the anesthesia (there rarely are). From there, you’ll be taken to your hospital room — most patient stay 1-2 days.
While in the hospital, the medical staff will help you manage your pain in a safe and effective way. Your doctor will work with your nurses to manage the type of medication you receive, the dosage and the frequency. If you have known allergies to a pain medication, your doctor should know before the surgery.
Many patients are surprised by how quickly they are up and walking after surgery. Usually, your physical therapist will come the day after surgery to get you up and out of bed. You won’t be expected to walk far, but it’s important to start the recovery process. You’ll learn exercises to strengthen the hip and restore movement.
ARE THERE HIP REPLACEMENT COMPLICATIONS?
At Mountainstate Orthopedic Associates, the outcomes of hip replacement surgery are positive. Our patients report a reduction in pain within a few weeks of surgery (if not sooner) and almost all report that they were able to return to the activities they love.
Hip replacement surgery has a low rate of complication when proper recovery protocol is followed. This means taking care of the wound, eating a nutritious diet and following the exercises prescribed by the physical therapist.
When complications do occur, it’s typically an infection of the wound or a blood clot. Keeping the wound clean and making sure you get up to move as often as you can drastically reduces the risk of these complications.
HOW CAN MOA HELP?
Mountainstate Orthopedic Associates is one of the region’s leading orthopedic practices. We take pride in the education and experience of our doctors.
From your initial appointment to the conclusion of your surgery, we strive to keep you informed and active in the decision making process. It’s always our policy to be conservative with our course of treatment, only recommending surgery if it is truly needed.
If you have a hip injury/concern, get in touch — we’ll schedule an appointment and create a plan to help you improve your hip pain and function.