Hip replacement is recognized as one of the most successful procedures in all of medicine. In the United States, over 193,000 people have their hips replaced each year, and over ninety percent of these are considered successful.
Total hip replacement is a surgical procedure where the worn out surfaces of the hip are replaced with man-made components. Over time, the cartilage that cushions the bones can wear away, cause pain and discomfort, and make simple pleasures like walking and shopping unbearable. Hip replacement can reduce or eliminate pain, allow easier movement and get you back to life.
There are many kinds and designs of hip implants available today, and no one design or type is best for every patient or their particular situation. Each surgeon selects the implant that they believe is best for their patient's needs based on a number of factors including age, activity level, the implant's track record, and his or her comfort with the instruments associated with the particular implant. If you have specific questions regarding implants, your surgeon will be happy to answer them for you.
Hip replacement surgery may be considered for those suffering from arthritic hip pain that severely limits the activities of daily living. It is only recommended after careful examination and diagnosis of your particular joint problem, and only after more conservative measures such as exercise, physical therapy and medications have proven ineffective.
With improvements in surgical techniques and post-op care, it is now common for many patients to be able to go home from the hospital after one or two days. Of course, each patient is different, but the goal should be for you to recover in the comfort and privacy of your own home as soon as possible.
Remember, this can vary from person to person, but most people will need to use an ambulation aid such as a walker for 4 weeks or so. Driving may be possible in 4 to weeks, and activities such as golf and bowling can be resumed in as few as 10 to 12 weeks. Some activities such as running or jogging are not recommended after hip replacement. Most people will be able to go straight home from the hospital, though some patients, particularly those that live alone, may need to spend a few days at a rehab center or nursing home. Keep in mind that healing and recovery times can vary.
Even though hip replacement surgery is considered a very successful procedure, it is major surgery, and as with any surgery, there are risks you need to be aware of. Possible complications include:
- Blood clots in your leg veins
- Implant loosening
- Nerve or blood vessel damage
- Hip dislocation
- Change of leg length
Your surgeon and healthcare team will be taking great care to minimize the risk of these and other complications. Keep in mind that complications are relatively rare, but they need to be understood by you and your family. Your surgeon will be happy to answer any questions that you may have.
You will experience some discomfort after surgery, but be assured we will be doing everything we can to keep you as comfortable as possible. Pain after hip replacement surgery is quite variable from person to person, and not entirely predictable, but modern medications and improved anesthetic techniques greatly enhance our ability to control pain and discomfort after surgery.
Hip resurfacing is a procedure similar to hip replacement in that the worn and painful surfaces of the hip are resurfaced with manmade components. The main difference is that with hip resurfacing, far less bone is removed than with a hip replacement. Rather than having the entire femoral head, or "ball" of the hip removed as with hip replacement, hip resurfacing involves reshaping the femoral head to receive a metal "cap." The socket side of the hip or acetabulum is relined very similarly to a hip replacement. Hip resurfacing is most commonly recommended for younger patients with severe arthritis of the hip who may be faced with multiple surgeries over their lifetime.
There are a number of potential advantages to hip resurfacing. These include:
- Bone preservation – with total hip replacement, the entire femoral head or "ball" is removed and a metal stem is inserted into the femoral canal. If the hip later needs to be revised, a longer and larger stem is needed, requiring additional bone removal and a more difficult operation. With hip resurfacing, the femoral neck and part of the femoral head is preserved, making revision surgery (if needed) much less difficult.
- Less risk for dislocation – with hip resurfacing, the femoral head size is typically larger than with hip replacement, allowing for better range of motion and improved stability. This is important for younger, more active patients.
- Low-wear bearing – the new generation of hip resurfacing implants feature metal-on-metal bearing surfaces. This configuration has been shown in the lab to result in very low rates of wear over time, compared to metal and plastic.
The best candidates for hip resurfacing are typically younger patients (under 60 years of age) with isolated bone disease and who have strong bone around the hip joint. Those who are less likely to be candidates for the procedure include patients older than 60, as well as those with problems in the bone around the hip joint. This includes patients who have bone loss as a result of their arthritis, patients with osteoporosis and patients with cysts within the bone.