A total hip replacement is a surgery to replace a diseased or injured hip joint. An artificial ball-and-socket joint is inserted to make a new joint.
Reasons for Procedure
This surgery is done when pain and stiffness limit your normal activities. This pain and stiffness is usually due to osteoarthritis. Surgery is done when other treatments have been tried and are no longer working. These other treatments include rest, medicine, and physical therapy.
Other reasons for surgery may include a broken hip, rheumatoid arthritis, bone tumors, and loss of blood supply to the bones of the hip.
What to Expect
Prior to Procedure your doctor may do the following:
- Physical examination
- X-rays
- Blood tests
- Magnetic resonance imaging (MRI)
- Computed tomography (CT) scan
In the time leading up to the procedure:
- Try to lose weight if you are overweight. This will decrease the amount of stress on your new joints.
- To enhance safety and recovery,Talk to your doctor about your medicines. You may be asked to stop taking some medicines up to one week before the procedure, like anti inflammatory drugs,blood thinners.
- Your doctor may suggest donating blood for the surgery. You will most likely lose some blood and fluid during this surgery. If you need a blood transfusion, the doctor can u:se the donated blood.
- If you become sick or have a fever just before the surgery, tell your doctor right away.
- Arrange for a ride to and from the hospital. Also, arrange for help at home.
- If you smoke, try to smoke less or stop smoking.
- Eat a light meal the night before the surgery. Do not eat or drink anything after midnight. If you have diabetes, ask your doctor if you will need to adjust your medicine.
Anaesthesia
Generally spinal & epidural anaesthesia will be used. It will block any pain and keep you asleep through the surgery. It is given through an injection in your back.An epidural catheter is kept in your back through which medicines will be given after surgery in the ward this will significantly reduce post surgery pain and help in your rehabilitation.
Description of the Procedure
Total Hip Replacement:
An incision will be made along your joint. The muscles will be moved aside. The damaged bone and cartilage of the hip joint will be removed. The remaining bone will be prepared for the prosthesis. The new artificial joint will be placed in position. Depending on the type of prosthesis, the doctor may use bone cement to hold one or both parts of the artificial hip firmly to your bone. Lastly, the incision will be closed with stitches or staples.
How Long Will It Take?
Total hip replacement will take about 1-1½ hours to finish.
How Much Will It Hurt?
You will have pain after the surgery. Pain medicine will be given to help with discomfort.
Average Hospital Stay
This procedure is done in a hospital setting. The usual length of stay is 4-6 days for a total hip replacement.Your doctor may choose to keep you longer, if recovery is delayed.The focus will be on regaining function.
Post-procedure Care:
At the Hospital
While you are recovering at the hospital, you may need to:
Walk with help, using a walker , on the day after surgery.Be careful. A fall can damage or dislocate the new joint. Do not try to walk without help.Take medicine to prevent blood clots.Wear compression boots or stockings.Begin physical therapy to regain mobility and strength.Breathe deeply and cough 10-20 times every hour.This will decrease the risk of fluid build-up in the lungs.
At Home
When you return home, do the following to ensure a smooth recovery.
- Keep the incision area clean and dry.Ask your doctor about when it is safe to shower, bathe, or soak in water.
- When seated, place a V-shaped pillow between your legs. This will help you to maintain correct positioning of your hip.
- Work with the physical therapist. You will learn how to move your hip and maintain proper alignment.
- You should also talk to your doctor and physical therapist about ways to prevent dislocations.
- Depending on your surgery, you may need to avoid crossing your legs, flexing your hips more than 90 degrees, and turning your feet very far inward or outward.Only take medicines recommended by your doctor. Do not take over-the-counter remedies without your doctor's approval.Maintain a healthy weight. Obesity can increase wear on your new joint.Avoid jogging and other high-impact sports. This can also increase wear on the joint, cause it to loosen, and cause pain.Be sure to follow your doctor’s instructions .
- Antibiotics may be needed before certain dental procedures or surgeries now that you have an artificial joint. This will prevent possible infections from entering the bloodstream. Make sure to let the dentist or doctor know that you have an artificial joint.
- Within six weeks, you should be able to resume normal, light activities. A replacement hip typically lasts 10-15 years.
Call Your Doctor
After you leave the hospital, contact your doctor if any of the following occur:
- Signs of infection like fever and chills,Redness, Swelling, Increasing pain, Excessive bleeding or discharge around incision site.
- Pain and/or swelling in the feet, calves, or legs.
- Cough, shortness of breath, chest pain
- Severe nausea or vomiting.
- Hip pain that you cannot control with the medicines you have been given or that becomes worse.
- Numbness, tingling, or loss of feeling in your leg, knee, or foot.
Possible Complications
- If you are planning to have a hip replacement, your doctor will review a list of possible complications, which may include:
- Hip dislocation occurs when the ball portion of the prosthesis dislocates from its normal position in the hip.
- Infection .
- Blood clots in the legs.
- Swelling or bleeding injury to nearby nerves or blood vessels
- Anesthesia-related problems
- Noisy or squeaky hip after surgery
Factors that may increase the risk of complications include:
Pre-existing medical conditions such as heart or lung problems, Obesity, Infection such as urinary tract infection or gum disease increases the risk of bacteria entering the bloodstream and infecting the joint. Previous problems with blood clots,Smoking.
Be sure to discuss these risks with your doctor before the surgery.
