For people who have suffered through years of hip pain and discomfort, hip replacement surgery can change their lives. Hip replacement surgery can be successful in relieving pain and increasing mobility.
In the past, some artificial hip joints weren’t able to withstand large amounts of stress and strain and tended to wear down with constant patient activity. Today's versions are sturdier with better wear characteristics, making them suitable for more active people. There are hip replacement devices made of ceramic instead of the traditional metal and high-density polyethylene (a tough plastic). Ceramic devices may last longer than traditional hip replacement devices, thereby decreasing the need for follow-up surgeries.
The hip joint is a “ball and socket” joint in the upper portion of the femur (thigh bone). A diseased hip joint can cause extreme pain and limit mobility. A hip replacement is a surgical procedure that removes the degenerated hip joint and replaces both the ball and socket with artificial parts. The parts are usually anchored in the bone of the thigh and pelvis.
Before hip replacement surgery is performed, joint damage is assessed by x-rays. During the surgery—which usually lasts 2-3 hours—diseased bone and cartilage is removed from the hip joint. Then, the head of the femur (the ball) and acetabulum (the socket) is replaced with a new, artificial joint, which is designed to allow smooth, gliding motion.
During the days after a hip replacement surgery, it is important to limit the movement of the hip joint. Physical therapy will begin soon after the surgery to strengthen the hip muscles and improve motion. People do not usually spend more than six days in the hospital after a hip replacement. Full recovery is expected within 3-6 months, depending upon the extent of the surgery, the health of the person, and the success of the rehabilitation.
Hip replacement is one of the most successful orthopaedic surgeries performed. Adverse effects are rare, but some people may experience a hip dislocation after a hip replacement surgery. In addition, others will have inflammation in the area of the hip joint, which is caused by the particles that wear off the artificial joint. Less common complications include infection, blood clots, and excessive bone growth.
Conditions such as osteoarthritis, rheumatoid arthritis, inadequate blood supply to the bone, external trauma, and bone tumors can lead to the breakdown of the hip joint. Before a hip replacement is performed, most people will try using non-surgical therapies, including canes and other walking aids, medicines, and physical therapy. If these therapies fail to relieve pain and improve mobility in the hip joint, hip replacement surgery may be recommended.
Hip replacement is traditionally performed primarily on older people, but as technology improves and hip replacement devices advance, doctors may recommend it for younger people with hip problems to improve their mobility and allow them to return to their prior activity levels.
People who may not be recommended for a hip replacement are those with Parkinson’s disease and other chronic diseases that result in severe muscle weakness. Also, doctors may not recommend hip replacement for people at high risk for infections, such as people with diabetes, those on steroids, or people who are in poor health thus making them less likely to recover from hip replacement surgery (and other surgeries).
Traditional hip replacement devices, composed of metal and polyethylene, tend to wear out in 15-20 years—which has become problematic in recent times since younger people are having hip replacements and people are living longer and being more active. The ceramic devices were developed to address this. Since the material is smoother than the metal and polyethylene used in traditional devices, the ceramic devices produce less friction with activity, and they may last longer than 20 years.
If you need to have a hip replacement, your surgeon will advise you which type of artificial joint she believes is the safest and most effective option for you based upon your age, activity level, and the condition of your hip.
American Academy of Orthopaedic Surgeons
National Institute of Arthritis and Musculoskeletal and Skin Diseases
Canadian Orthopaedic Association
Canadian Orthopaedic Foundation
Questions and answers about hip replacement. National Institute of Arthritis and Musculoskeletal and Skin Diseases. National Institutes of Health website. Available at: http://www.niams.nih.gov/Health_Info/Hip_Replacement/default.asp#8. Accessed May 10, 2012.
Osteonics ABC system and Trident system . Publication P000013. Food and Drug Administration website. Available at: http://www.fda.gov/cdrh/mda/docs/p000013.html. Accessed July 15, 2003.
Ceramic TRANSCEND hip articulation system. Publication P010001. Food and Drug Administration website. Available at: http://www.fda.gov/cdrh/mda/docs/p010001.html. Accessed July 15, 2003.
DynaMed Editors. Total hip arthroplasty. EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed/what.php. Updated March 10, 2010. Accessed April 2, 2010.
Last reviewed May 2012 by Brian Randall, MD
Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.
Copyright © 2012 EBSCO Publishing All rights reserved.
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