The ability to walk in a balanced, fluid motion is something that many of us take for granted. The hip joint is an essential part in creating this function. When pain and stiffness alter this ability and non-operative measures fail, I begin the discussion with my patients about total hip replacements. This surgery involves replacing the damaged hip with a properly functioning prosthetic joint, restoring the patient’s range of motion and relieving their pain.
Hip Anatomy and Background
The hip joint is a ball-and-socket joint with several components, including the pelvis, acetabulum (socket or cup), femur (thigh bone) and femoral head (ball). Like a ball sitting in a cup, the femoral head sits in the acetabulum socket, which is part of the pelvis. As a healthy hip joint, the head of the femur typically moves smoothly within the acetabulum, cushioned by a healthy layer of cartilage. When this cartilage breaks down or other issues occur because of arthritis or injury, pain and stiffness often manifest.
Common Causes of Hip Problems
Osteoarthritis is a type of disease where the articular cartilage, which cushions the bones of the hip joint, degrades and wears away. The bones then rub against each other, causing hip pain and stiffness.
Rheumatoid arthritis is an autoimmune disease, where the immune system attacks its own tissue in the body resulting in an inflamed synovial membrane (lining of the joint), too much synovial fluid and damage to the articular cartilage, leading to pain and stiffness.
Traumatic arthritis can follow a serious hip injury or fracture.
Is Surgery Right for You?
If non-operative treatments fail to provide adequate relief and you have significant arthritis, you may be a candidate for total hip arthroplasty. You should undergo a full evaluation and have any necessary testing done to make sure you are medically optimized for surgery. There are risks to surgery, so meeting with a surgeon will help you and your family weigh the pros and cons of surgery.
Preparing for Total Hip Arthroplasty Surgery
In addition to undergoing a medical evaluation, you will want to make social preparations for after surgery. Although you will be able to walk with crutches or a walker after surgery, you may need help with tasks such as cooking, shopping, bathing and laundry.
If you live alone, someone from your orthopedic surgeon’s office, a social worker or a discharge planner at the hospital can help you make arrangements in advance to have someone assist you at your home. A short stay in an extended-care facility during your recovery after surgery may also be arranged.
Understanding the Procedure
After you are admitted to Flagstaff Medical Center (or your local hospital), the actual surgery will usually take 1.5 to two hours, after the preparatory and before recovery time. The damaged cartilage and bone are removed, and the prosthetic hip is placed, with restoration of the hip alignment. The materials of the prosthetic vary and are typically made of metal, ceramic or plastic. Your anatomy and individual situation are considered when deciding on the type of implant used.
After surgery, you will be moved to the recovery room. After you awaken fully, you will be taken to your hospital room.
Recovery After Hip Replacement Surgery
The success of your surgery will depend significantly on how well you follow your orthopedic surgeon’s instructions regarding home care.
You may feel soreness, numbness and stiffness, which most patients find minor compared with the pain and limited function they experienced before surgery.
After surgery, I tell my patients to follow through with the following:
Participate in a regular, light, low-impact exercise to maintain strength and mobility. Do not overdo it, but do not stay in bed all day.
Avoid falls and injuries. Individuals who have undergone hip replacement surgery and experience a fracture may require more surgery.
Notify your dentist that you have had a hip replacement. You may benefit from taking antibiotics before any dental procedure within one to two years after surgery.
Even after you have recovered from your surgery, periodically follow-up with your surgeon for surveillance examinations and X-rays (radiographs) every three to five years, even if your hip replacement seems to be doing fine.
I welcome the chance to evaluate you and explore whether you are a candidate for hip replacement surgery. I practice in Flagstaff, Sedona and Prescott Valley, and perform these surgeries at Flagstaff Medical Center. I perform hip replacement from the anterior approach as well as the lateral and posterior approaches, depending on your needs. I look forward to meeting you. FBN
By Cody Martin, M.D.
Dr. Cody Martin is a fellowship-trained orthopaedic surgeon at Northern Arizona Orthopaedics providing care to patients in the Arthritis and Fracture Care Center, located in the Summit Center. To request an appointment with Dr. Martin, or any of the NAO physicians, please visit northazortho.com or call 928-774-7757.