Hip Replacement Overview

Hip replacement is a surgery to replace all or part of the hip joint with an artificial joint made of metal, ceramic, and/or plastic. This surgery is performed to relieve hip pain and improve mobility of the hip, most often in people with osteoarthritis of the hip. Osteoarthritis occurs when the wear and tear of aging causes the cartilage covering the joint surfaces to wear out, resulting in pain and stiffness.

The hip joint is made up of the hip “socket” (part of the pelvic bone.) and the round head on the top of the thigh bone (called the femoral head). A variety of materials are used to create an artificial hip joint. The socket is a durable cup of plastic, ceramic or metal, which may have an outer metal shell. A highly polished metal or ceramic ball is used to replace the femoral head. The ball is attached to a metal stem, which attaches to the thigh bone.

Types of Hip Replacement Surgery

Total hip replacement – Both the hip socket and the femoral head are replaced. The patient either has general anesthesia (i.e. put to sleep) or regional anesthesia (i.e. awake but numb from the waist down). The surgeon makes 10-12 incisions in the hip. After damaged bone and cartilage are removed, the hip socket and the femoral head are replaced with the artificial materials described above.

Minimally invasive total hip replacement - In this newer type of total hip replacement, the surgeon performs the procedure with only 1-2 small incisions, and possibly x-ray guidance. There is typically less pain and faster recovery compared with traditional hip replacement. Candidates for this surgery are typically thinner, younger, healthier, and very motivated to have a fast recovery.

Partial hip replacement Only one part of the hip joint is replaced with the artificial materials described above. Most often the hip socket is left intact and the femoral head is replaced.

Hip resurfacing This is a newer, emerging procedure that is more common in younger patients. The hip socket is replaced as in total hip replacement. The femoral head is covered with an artificial material that fits over the head of the femur and is fixed to the femur with cement around the femoral head and a short stem that passes into the thigh bone.

Risks and potential complications after hip replacement surgery include

  • Infection at the incision site
  • Infection deep around the prosthesis
  • Blood clots in the leg veins or pelvis
  • One leg feeling longer or shorter than the other
  • Nerve and blood vessel injury
  • Stiffness in the hip joint
  • Bleeding
  • Fracture
  • Dislocation (i.e. the ball sliding out of the socket)

 

Written by Laurie LaRusso, MS, ELS

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