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Hip Replacements: What You Need to Know

Jun 20, 2014 07:00AM ● By Cate Reynolds
The hip is one of the body’s largest joints. It helps move your legs for everything from walking and running to sitting and even going up and down stairs.

This ball-and-socket joint is tough, stable, and rarely dislocates. But sometimes, it can become damaged or diseased by osteoarthritis, rheumatoid arthritis, bone tumors, or injury. This damage can cause pain and stiffness, as well as limit daily activities.

Total hip replacement surgery, also known as total hip arthroplasty, removes the damaged or diseased parts of the hip joint, replacing them with new, prosthetic parts.

According to the Agency for Healthcare Research and Quality, part of the U.S. Department of Health and Human Services, surgeons perform more than 285,000 total hip replacements each year in the United States. Studies show the procedure can significantly relieve pain and increase mobility for most patients.

If you are considering hip replacement surgery, here’s what you should know:

The decision should be a cooperative one. Patients should make the decision after talking with family members, their primary care physician, and a qualified orthopedic surgeon. An orthopedic surgeon will evaluate a patient’s medical history, as well as conduct a physical examination and call for tests like x-rays or magnetic resonance imaging (MRI) to determine the best treatment to relieve pain and increase mobility.

Not all hip joints are the same. All artificial hip joints include two components: a ball, made of metal or ceramic, and a socket, a cup made of plastic, metal, or ceramic that may have an outer metal shell. The replacement joint may be “press fit,” meaning it will fit so the surrounding bone can grow onto it, or it may be cemented in place. A qualified orthopedic surgeon will choose the joint material and fit that best meets a patient’s needs. Most total hip replacement joints last between 15 and 20 years. If only part of the hip joint is damaged or diseased, surgeons may recommend a partial hip replacement. This procedure involves replacing the diseased head of the femur with an artificial ball joint.

Pain management options vary. During surgery, the most common types of anesthesia used are general anesthesia and spinal, epidural, or regional nerve block anesthesia. After surgery, patients do experience some pain but care teams provide medication as needed to keep them comfortable.

You will walk the day of or after surgery. Surgeons want patients to walk soon after surgery – even if it is just a few steps – to help prevent blood clots, pneumonia, and bed sores.

Physical therapy is essential. Physical therapy often begins the day after surgery. Therapists teach exercises to strengthen the hip and restore movement. The more patients move, the better their outcome. Physical therapy often continues months after surgery.

Recovery can take up to a year. Most patients are usually back home two to three days after the operation and back to work within three months. But it can take between six months and a year to complete physical therapy and regain most mobility and strength.

New hips require new measures. New, artificial hip joints may activate metal detectors in airports and some secured buildings. Orthopedic surgeons may give patients a card, confirming their hip joint replacement, which can be used in this situation. In addition, surgeons suggest regular light exercise to maintain strength and mobility in the new hip, even after physical therapy is completed. The American Academy of Orthopaedic Surgeons also recommends patients notify their dentists about their new hips, as most will require patients to take antibiotics before any dental procedure.

Most importantly, talk with your primary care physician or a qualified orthopedic surgeon to find out if a total hip replacement is right for you.

Provided by University of Maryland Baltimore Washington Medical Center.