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hip joint replacement

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Hip Replacement Movie

Alternative Names
total hip replacement, THR, total hip arthroplasty

Definition

Hip joint replacement is a surgical procedure to replace the hip joint. The new joint is artificial and has 2 parts. The first part is the hip's socket, called the acetabulum. This is a cup-shaped bone in the pelvis. The second part is the "ball" or head of the femur, also called the thighbone.

These artificial parts together are called a prosthesis. The artificial socket is often made of high-density plastic. The artificial ball, which is attached to a stem, is usually made of a strong, stainless metal. The goal of the surgery is to relieve pain and improve mobility and function in the hip joint.

Who is a candidate for the procedure?

This surgery is most commonly done to relieve severe arthritis, which can wear down the hip joint.

People with other conditions, such as injury, bone tumors, and avascular necrosis (a loss of bone caused by a lack of blood supply to it), may also need a hip joint replaced.

An individual is usually advised to consider this surgery when the following conditions apply:

How is the procedure performed?

The surgeon first removes the diseased bone and cartilage. Replacement pieces are implanted into healthy areas of the pelvis and thighbone. These pieces are then cemented in place.

One method does not require cement and is called a "cementless" hip joint replacement. This allows bone to grow into the prosthesis, and it may last longer than a cemented hip. This can be an important advantage for younger people.

The surgery is usually done in the operating room under general anesthesia, which means the person is put completely to sleep. The procedure usually takes 2 to 3 hours to perform.

What happens right after the procedure?

After the surgery, the person is taken to the surgery recovery room. This allows a brief period of close observation. Vital signs, such as the blood pressure and pulse, are checked frequently. Close attention is paid to the circulation and sensation in the legs and feet.

The hip is usually braced with pillows or a special device that holds the hip in the correct position. The person is given fluids through an intravenous tube to replace fluids lost during surgery. A tube may have been placed near the incision to drain fluid. A urinary catheter is often used to drain urine from the bladder until the person is able to use the bathroom.

Pain medication will be given as needed. While in the hospital, the individual will begin physical therapy to strengthen the hip. He or she will also learn how to perform the activities of daily living in ways that can prevent injury to the new hip. For example, proper ways to bend and sit are taught. Most people are sent home from the hospital 5 to 7 days after the surgery.

What happens later at home?

By the time the person leaves the hospital, he or she should be able to get around using crutches or a walker. Physical therapy may be continued after discharge.

If a person needs extra time to gain enough independence to maneuver at home, he or she may go to a rehabilitation center after leaving the hospital. Complete recovery from this surgery usually takes 3 to 6 months.

What are the potential complications after the procedure?

Surgery may be complicated by bleeding, infection, or an allergic reaction to the anesthetic. Pain medications or antibiotics may cause stomach upset, allergic reactions, or rash.

The most common complications of a hip joint replacement include:

Before leaving the hospital, the person is taught exercises to help prevent this. The individual will also learn which activities to avoid, such as crossing the legs, to prevent hip dislocation.

Any new or worsening symptoms should be reported to the healthcare professional.


Author:Gail Hendrickson, RN, BS
Date Written:04/12/00
Medical Review:Steve Houseworth, MD
Date Written:10/24/2006
Reviewer:Reginald Finger, MD
Date Reviewed:10/24/2006
Contributors
Potential conflict of interest information for reviewers available on request