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Total hip replacement (also known as total hip arthroplasty) is an effective treatment for end-stage arthritis of the hip. With total hip replacement, the socket (acetabulum) is replaced with a metal “cup” lined with an advanced plastic-bearing surface. The ball portion (femoral head) of the hip is replaced with a high-strength metal or ceramic ball that is mounted on a stem placed in the thigh bone (femur) to fix it rigidly in place. In this way, the damaged surfaces are replaced while leaving the majority of the bone around the hip intact.
Minimally Invasive Hip Replacement Surgery
Many years ago, hip replacement included a large incision and a week-long hospital stay. Currently, hip replacement can be performed through smaller incisions and patients achieve more rapid recovery. However, our main focus is on building a durable reconstruction that will last for years, and we use a surgical incision length that allows us to place the hip implants in optimal positions.
Hip Replacement Recovery and Physical TherapyPatients usually stay in the hospital for 2 to 4 days after hip replacement. During that time, we monitor vital signs and laboratory values. Most importantly, the physical therapists teach the patients how to get around with a new hip. The physical therapists initiate an intense schedule to maximize mobility. Patients usually are out of bed the day
after surgery (or, in some cases, the same day) and begin walking with a walker 1 to 2 days after surgery. Physical therapists are integral in teaching the patient to walk, dress, use the toilet, and bathe with a new hip while making sure walking is done safely.
Pain from Hip Replacement
Most patients experience some amount of pain after hip replacement. A dedicated team of pain physicians sees the patient during the hospital stay to make sure pain is well controlled. Most patients receive either a nerve block anesthetic or epidural anesthetic for 1 or 2 days after the operation. Patients are then transitioned to narcotic pain pills. Most of the time, patients are free of narcotic pain pills by 4 to 6 weeks after surgery.
Often, patients are mostly pain free by 8 to 12 weeks after surgery. Although some patients might continue to experience some amount of pain, the vast majority are extremely happy with the improvement in pain compared with before surgery.
Preventing Blood Clots
We use several strategies to minimize the chance of a blood clot forming after surgery, including nerve blocks, calf compression devices, and early mobilization. In addition, patients who have undergone hip replacement receive a blood thinner for 6 weeks after surgery. The blood thinner usually is aspirin unless the patient has a history of blood clots, in which case Coumadin is administered.
Will my legs be the same 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 this is the case. In rare cases, it is necessary to slightly lengthen the leg with the hip replacement to render the hip more stable. However, this is very uncommon. Many people with severe hip arthritis feel that the leg with the arthritis is shorter than the other leg. We can correct this to a certain extent, and it should be discussed before surgery.
How long does a hip replacement last?
Twenty years after surgery, 80% 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.
- Hip Arthritis
- Hip Treatments
- Direct Anterior Hip Replacement
- When Is It Time to Have a Total Hip Replacement
- Hip Replacement Risks
To make an appointment with one of our orthopedic specialists or to learn more about our services, centers and treatment options, please call 410-448-6400.