Hip Replacement

(Arthroplasty, hip)

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Definition | Body Parts Involved | Reasons for Procedure | Complications | What to Expect | Outcome | Call Doctor If

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Definition

A surgical procedure to remove a diseased or injured hip joint and insert an artificial ball-and-socket joint. The artificial joint is called a prosthesis.

Parts of the Body Involved

Hip

Reasons for Procedure

Hip replacement is most often performed to alleviate hip pain and disability due to arthritis. This procedure is considered when pain and stiffness limit normal activities and are not relieved by other measures, such as rest, medications, or physical therapy.

Risk Factors for Complications during the Procedure

• Pre-existing medical condition
• Obesity
• Urinary tract infection or gum disease; both increase the risk of bacteria entering the bloodstream and infecting the joint

What to Expect

Prior to Procedure

Your doctor will likely do the following:

• Physical exam
• X-rays of joint
• Blood tests
• Possibly a bone scan
• Possibly an MRI scan – a test that uses magnetic waves to make pictures of the inside of the body

In the time leading up to the procedure:

• If you are overweight, shed excess pounds to decrease the amount of stress on your new joint
• Make home modifications to make recovery easier:
  • Install safety bars, a raised toilet seat, a shower bench and hose, and handrails on stairways and steps
  • Remove throw rugs and extension cords
  • Purchase a stable, firm-backed arm chair that allows the knees to remain lower than the hips
  • Purchase reachers and dressing aids to make daily activities easier to complete
• Review your regular medications with the surgeon to determine if any, such as antiinflammatory medications, should be stopped before surgery
• Arrange for a ride to and from the hospital
• Arrange for help at home after returning from the hospital
• The night before, eat a light meal and do not eat or drink anything after midnight

During Procedure - IV fluids, blood, anesthesia

Anesthesia - General

Description of the Procedure - The surgeon makes an incision along the joint, moves aside muscles, and removes damaged bone and cartilage. The remaining bone is prepared to receive the prosthesis and the new plastic and metal joint is placed in position. Depending on the type of prosthesis, the surgeon may use cement to hold one or both parts of the artificial hip. The incision is closed with stitches or staples, which will be removed in about two weeks.

After Procedure - Be extra careful to prevent falls and maintain correct hip placement

How Long Will It Take? A few hours

Will It Hurt? Anesthesia prevents pain during surgery. You'll likely experience pain while recovering but receive drugs to relieve the discomfort.

Possible Complications:

• Infection
• Blood clots occurring in a vein or traveling to the lungs
• Excessive swelling or bleeding
• Injury to nearby nerves or blood vessels
• Anesthesia-related problems
• Reaction to the prosthesis

Average Hospital Stay: 4-6 days

Postoperative Care:

• Breathe deeply and cough 10 to 20 times every hour to decrease the risk of fluid build-up in the lungs that can cause pneumonia.
• Keep the incision area clean and dry.
• Expect to get up and walk with help using a walker on the day after surgery.
• Be cautious; a fall can damage the new joint.
• Place a V-shaped pillow between your legs to maintain correct positioning of the hip.
• To help maintain proper alignment and prevent dislocations, do not cross your legs, flex your hips more than 90 degrees, or turn your feet very far inward or outward.
• Only take medications recommended by your doctor; do not take over-the-counter remedies without your doctor's approval.
• Inform your dentist of your surgery; you'll need antibiotics before all future dental procedures to decrease the risk of bacteria entering the bloodstream and traveling to the prosthesis. Delay dental cleaning for several weeks after the surgery.
• Maintain a healthy weight; obesity can increase wear on the joint, cause it to loosen, and cause pain.
• Refrain from jogging and other high-impact sports, which can increase wear on the joint, cause it to loosen, and cause pain.

Outcome

Within 6 weeks, you should be able to resume normal light activities. To speed your recovery and protect future joint function, follow the recommended activity and rehabilitation program.

Call Your Doctor If Any of the Following Occurs

• Signs of infection, including 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, or severe nausea or vomiting
• Increased hip pain

SOURCE:

American Academy of Orthopaedic Surgeons

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Last reviewed March 2001 by Medical Review Board