Are you nervous about getting a hip replacement? That might be driven by fears of losing some original body parts and worries over long recovery times and the potential for lost mobility.
However, the way the procedures are done has changed significantly over the past 20 years, with better materials, robotic assistance and muscle-sparing surgical approaches.
Conservative Treatments First
Surgery is not the first option when you have hip problems. It’s more likely that your doctor will start with medications, physical therapy and other more conservative treatments. But if you reach the point where hip pain makes it impossible to enjoy your life, that may be a good sign that a hip replacement is the answer. It can help you get back to do doing the things you enjoy, with little or no restrictions.
What Is a Hip Replacement?
During a hip replacement, your orthopedic surgeon will replace all or part of your hip – the top of your thigh bone (femur) and the socket (called the acetabulum) it fits into. The most common variety is a total hip replacement, where both parts are removed and replaced with prosthetics made of metal, plastic and ceramic. Far less common is a partial hip replacement, where only one section of the hip joint is replaced – often because of a hip fracture.
Most hip replacements are prompted by osteoarthritis, which degrades the cartilage that cushions your hip joint. When that cartilage fails, the head of your thigh bone grinds against the bone in the socket. The resulting pain can make it difficult to perform even simple activities like walking, getting out of a chair or tying a shoe.
There is no single cause of osteoarthritis, though there are several factors that increase your risk. These include age, family history, an injury to your hip joint, obesity and developmental dysplasia – the improper formation of your hip joint at birth. There are other potential threats to your hip joint, including:
- Rheumatoid arthritis
- Psoriatic arthritis
- Avascular necrosis
- Injury (from car accidents, falls and other traumas)
- Benign tumors
- Perthes disease
What Happens During the Surgery?
There are multiple approaches to the procedure, ranging from traditional surgery with large incisions (up to 12 inches) to minimally invasive surgeries using smaller incisions (as small as 3 inches). The procedure can be done from the back, side or front. The frontal approach has the advantage of minimizing muscle damage and recovery time.
Among the surgical steps:
- After making the initial incision, the surgeon works through the muscle tissue surrounding the hip joint. Muscle tissue may be cut or moved aside, depending on the surgical approach.
- The head of the thigh bone is cut off with a special saw, while any diseased tissue in the socket is removed.
- A ceramic or titanium stem is placed in the hollow center of the thigh bone and then mounted with a metal or ceramic ball.
- A metal cup with a plastic liner is used to replace the damaged socket. It is kept in place with cement or screws.
- Before ending the procedure, your team will test the stability of the joint and make sure the length of your leg matches the other side.
One of the most significant changes in recent years has been the addition of robotic support during surgery. Combined with advanced imaging, a robot can help your surgeon make precision adjustments during the procedure and get all the components exactly where they need to be.
What Recovery Looks Like
Improvements in these procedures have meant a significantly faster recovery time for the 350,000 hip replacement patients each year. In earlier days, you could expect to stay in the hospital for five days, as your body recovered from the damage done to muscles during the surgery.
Today, hip replacements are commonly done on an outpatient basis. In most cases, you can expect to return home on the day of your surgery, initially using a cane to help you get around. You should be walking without the cane within a couple of days and walking normally three to four weeks later. And after about three months, you should be back to regular activities, including jogging and playing golf.
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