Total Hip Replacement

Total hip replacement is a surgical procedure in which the damaged cartilage and bone is removed from your hip joint and replaced with artificial components. The hip joint is one of the body’s largest weight-bearing joints, located between your thigh bone (femur) and the pelvis (acetabulum). It is a ball and socket joint in which the head of the femur is the ball and the pelvic acetabulum forms the socket. The joint surface is covered by a smooth articular cartilage which acts as a cushion and enables smooth movements of your joint.

A number of diseases and conditions can cause damage to your articular cartilage. Total hip replacement surgery is an option to relieve severe arthritis pain that limits your daily activities. Total hip replacement may be recommended, if conservative treatment options such as anti-inflammatory medications and physical therapy do not relieve your symptoms.

The surgery is performed under general anesthesia. During the procedure a surgical cut is made over your hip to expose the hip joint and the femur is dislocated from the acetabulum. The surface of the socket is cleaned and the damaged arthritic bone is removed using a reamer. The acetabular component is inserted into the socket using screws or occasionally bone cement. A liner made of plastic or ceramic is placed inside your acetabular component. The femur or thigh bone is then prepared by removing your arthritic bone using special instruments, to exactly fit the new metal femoral component. The femoral component is then inserted to your femur either by a press fit or using bone cement. Then the femoral head component made of metal or ceramic is placed on your femoral stem. The muscles and tendons around your new joint are repaired and the incision is closed. With the Direct Anterior Approach (DAA), no muscles are cut.

After undergoing total hip replacement, you must take special care to prevent the new joint from dislocating and to ensure proper healing. Some of the common precautions to be taken include:

• Avoid combined movement of bending your hip and turning your foot inwards
• Keep a pillow between your legs while sleeping for 6 weeks
• Never cross your legs and bend your hips past a right angle (90 degrees)
• You should avoid sitting on low chairs
• You should avoid bending down to pick up things; instead a grabber can be used to do so
• You should use an elevated toilet seat

As with any major surgical procedure, there are certain potential risks and complications involved with total hip replacement surgery. The possible complications after total hip replacement include:

Infection

• Dislocation
• Fracture of the femur or pelvis
• Injury to nerves or blood vessels
• Formation of blood clots in the leg veins
• Leg length inequality
• Hip prosthesis may wear out
• Failure to relieve pain
• Scar formation
• Pressure sores

Total hip replacement is one of the most successful orthopedic procedures performed for patients with hip arthritis. This procedure can relieve pain, restore function, improve your movements at work and play, and provide you with a better quality of life.