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Hip replacement (also known as hip arthroplasty) is an effective treatment for chronic and debilitating hip arthritis.
In a total hip replacement, a metal cup, lined with an advanced plastic surface, replaces the socket. A high-strength metal or ceramic ball, mounted on a stem placed in the thighbone, fits into the cup. That way, the damaged surfaces are replaced while leaving the majority of the bone around the hip intact.
Minimally Invasive Hip Replacement
Many years ago, hip replacement involved a large incision and a week-long hospital stay. Now, the minimally invasive technique of direct anterior hip replacement uses smaller incisions allowing patients to recover more rapidly.
In this procedure, surgeons access the hip socket from the front of the body, known as the anterior side. In the direct anterior approach to hip replacement, no muscles are cut; surgeons work between the muscles in front of the hip.
On the leading edge of advancements in complex hip surgeries, UMMC has performed anterior hip surgery for many years and switched almost entirely to the anterior approach in 2016. As the technology and the implants have improved, the annual failure rate has fallen to about 1 percent.
University of Maryland's Hip Replacement Team
Not only are our hip surgeons an excellent choice for patients who require a first-time hip replacement, but they are also the referral surgeons for the entire state of Maryland for patients with especially challenging conditions, including failed hip replacements.
As part of an academic medical center, UMMC's physicians are responsible for training other doctors in the procedure as well.
Getting Your Hip Replacement at UMMC
We are committed to providing ongoing communication to both patients and referring physicians. Our hip specialists will talk through all the risks of hip replacement.
Recovery and Physical Therapy
Patients usually stay in the hospital for two to four days and are often out of bed the day after hip replacement (or, in some cases, the same day). They begin walking with a walker within one to two days.
During their hospital stay, we monitor vital signs and laboratory tests and begin physical therapy to teach the patient how to get around with a new hip. Physical therapists teach the patient to walk with a walker or crutches and help them improve muscle strength and joint motion.
If necessary, occupational therapists can help patients regain daily living skills, such as bathing, dressing and meal preparation. Case managers can arrange home care, home medical equipment and other support services.
Managing Pain from Hip Replacement
Most patients experience pain after hip replacement. Our physicians see the patient during the hospital stay to make sure pain is well controlled. During the procedure patients usually are given either a nerve block anesthetic or epidural anesthetic that lasts for one or two days after the operation.
Patients then transition to narcotic pain medications. Most of the time, patients need these for four to six weeks and are mostly pain free in eight to 12 weeks.
Preventing Blood Clots
We use several strategies to minimize the chance of a blood clot forming, including nerve blocks, calf compression devices and getting you on your feet early in the process. In addition, patients who have undergone hip replacement receive a blood thinner, usually aspirin, for six weeks after surgery.
Leg Length After Surgery
The vast majority of patients have the same leg length after the operation as before. We use several checks in the operating room to make sure of this. In rare cases, it is necessary to slightly lengthen the leg with the hip replacement to render the hip more stable.
In many people with severe hip arthritis, the leg with the arthritis is shorter than the other leg before surgery. We can correct this to a certain extent during surgery. You should discuss this with your doctor before surgery.
Durability of a Hip Replacement
Twenty years after surgery, 80 percent of hip replacements are still functioning well. Several factors determine how long a hip replacement lasts, including patient age and activity level, the type of implant used and the reason the hip was replaced.
Hip replacement materials continue to improve, and we are optimistic that current components will last longer than those used 20 years ago.
Make an Appointment
To make an appointment with one of our hip surgeons or to learn more about hip replacement surgery, please call 410-448-6400.