Hip replacement surgery is a common procedure to treat severe cases of osteoarthritis and injuries (fractures) that affect the hip joint, resulting in pain and reduced mobility. The procedure involves removing the affected hip joint and replacing it with one made of metal, plastic or ceramic components. The surgery is usually performed when other treatment options have proven to be ineffective and once completed the patient can usually look forward to the disappearance of the pain and the regaining of mobility with the new joint.
The Procedure
There are two ways of performing the surgery – the traditional one where the incision on the side of the hip is 8 to 10 inches long and what is called the minimally invasive technique where the incision is usually 2 to 5 inches long. The minimally invasive technique is thought by many surgeons to reduce blood loss during surgery, reduce post-operative pain, shorten the hospital stay and minimize the scarring. The decision on what type of procedure to use will depend on patient related specifics.
In general the process is the same in both cases.
- The patient is given either general or spinal anesthesia to put him or her to sleep and prevent any sensation of pain during the surgery.
- An incision is made along the side of the hip though which the muscles connected at the top of the thigh bone are moved aside to provide access to the hip joint.
- The ball section of the joint is then removed by cutting the bone with a special surgical saw.
- The artificial joint is then put into place and attached to the thighbone using either special cement of some other material that will allow the new material to attach to the bone.
- The surface of the hip bone is then cleaned of any damaged cartilage and the replacement socket is attached.
- The ball is then inserted into the socket.
- A temporary drain may be put in place to drain any fluid that collects over the next few days.
- The muscles are then reattached and the incision closed.
The Recovery
A typical recovery will be as follows:
- The post-operative hospital stay is normally between 5 to 7 days.
- While in bed a cushion or other object is usually taped between the legs to ensure the new joint remains in place.
- A drainage tube will be placed in the bladder to allow for urination.
- A drip of glucose and / or any other substances or medications or pain relievers the doctor advises will be put in place.
- Physical therapy will normally begin the day after the surgery.
- Walking with the use of a walker or crutches may begin after 2 or 3 days.
- Physical therapy and exercise will continue for some months after the surgery until the muscles return to normal and the hip movement is free and without pain.
On Returning Home
The amount of rest and relaxation at home will depend on the health of the individual. It is important to not over do things and follow the doctor’s instructions. In general:
- Avoid climbing stairs until approved by the doctor.
- Sit in a chair with an upright back. Avoid the use of recliners.
- Remove all carpets and rugs from the floor to reduce the chances of tripping while walking.
- Avoid excessive bending that will place stress on the new joint. Use an elevated toilet seat to prevent bending the hip too much.
- Be careful in the presence of small children and pets who may jump on you and cause a fall.
- Get adequate rest and nutrition.
The next stage of the recovery process will be covered in the second part of this blog.
