Hip Replacement
(Hip Arthroplasty; Total Hip Replacement; Minimally Invasive Total Hip Replacement; Mini-incision Hip Replacement)
Definition
A total hip replacement is surgery to replace a diseased or injured hip joint. An artificial ball-and-socket joint is inserted to make a new hip.
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Reasons for Procedure
Hip bones support a lot of weight and are surrounded by powerful muscles. Disease or injury to these bones can be very painful and impair movement. A hip replacement can return someone to normal movement. It may be done because of a broken hip, bone tumors, or loss of blood flow to the hip. It may also be done for severe arthritis that is no longer responding to other treatment.
Possible Complications
Problems are rare, but all procedures have some risk. The doctor will go over some problems that could happen, such as:
- Excess bleeding
- Problems from anesthesia, such as wheezing or sore throat
- Infection
- Blood clots
- Hip dislocation—happens when the ball portion of the artificial joint comes out of its normal position in the hip
- Injury to nearby nerves or blood vessels
- Noisy or squeaky hip after surgery
Things that may raise the risk of problems are:
What to Expect
Prior to Procedure
The surgical team may meet with you to talk about:
- Anesthesia options
- Any allergies you may have
- Current medicines, herbs, and supplements that you take and whether you need to stop taking them before surgery
- Fasting before surgery, such as avoiding food or drink after midnight the night before
- Tests that will need to be done before surgery
The team may also ask about support at home.
Anesthesia
The doctor may give:
- General anesthesia—you will be asleep
- Spinal or epidural—the lower half of the body will be numbed
- Nerve block—the area around the major nerves will be numbed
Description of the Procedure
A hip replacement may be an open surgery or minimally invasive.
Open Surgery
An incision will be made along the joint. The muscles will be moved aside. The damaged bone and cartilage of the hip joint will be removed. The remaining bone will be prepared for the artificial joint. The artificial joint will be put in place. Bone cement may be used to hold one or both parts of the artificial hip to the bone. The incision will be closed with stitches or staples.
Minimally Invasive Technique
A few small incisions will be made. Tools will be passed through these incisions. Images may be taken to help guide surgery. The muscles will be moved aside. The damaged bone and cartilage of the hip joint will be removed. The remaining bone will be prepared for the artificial joint. The artificial joint will be put in place. Bone cement may be used to hold one or both parts of the artificial hip to the bone. The incision will be closed with stitches or staples.
How Long Will It Take?
- Total hip replacement: 1 to 1.5 hours
- Minimally invasive total hip replacement: 1 or more hours
Will It Hurt?
Pain and swelling are common in the first few weeks. Medicine and home care can manage pain.
Average Hospital Stay
The usual length of stay is 1 to 3 days. If you have problems, you may need to stay longer.
Post-procedure Care
At the Hospital
After the procedure, the staff may:
- Give you pain medicine or medicine to prevent blood clots
- Put compression boots or stockings on your legs
- Ask you to get up and walk using a walker
At Home
Support will be needed for physical activity. You may need to ask for help with daily activities and delay your return to work for a few weeks. It will take about 6 weeks before you can begin light activities.
Call Your Doctor
Call your doctor if you are not getting better or you have:
- Cough, shortness of breath, chest pain
- Redness, swelling, more pain, a lot of bleeding, or leaking from the incision
- Signs of infection, such as fever and chills
- Severe nausea or vomiting
- Pain or swelling in the feet, calves, or legs
- Pain that you cannot control with medicine
- Numbness, tingling, or loss of feeling in your leg, knee, or foot
If you think you have an emergency, call for medical help right away.
RESOURCES
American Academy of Physical Medicine and Rehabilitation
http://www.aapmr.org
National Institute of Arthritis and Musculoskeletal and Skin Diseases
http://www.niams.nih.gov
CANADIAN RESOURCES
The Arthritis Society
http://www.arthritis.ca
Canadian Orthopaedic Association
http://www.coa-aco.org
REFERENCES:
Elective total hip arthroplasty. EBSCO DynaMed website. Available at:https://www.dynamed.com/procedure/elective-total-hip-arthroplasty#MANAGEMENT. Updated May 5, 2020. Accessed July 15, 2020.
Minimally invasive total hip replacement surgery. Ortho Info—American Academy of Orthopaedic Surgeons website. Available at: http://orthoinfo.aaos.org/topic.cfm?topic=A00404. Updated June 2014. Accessed July 15, 2020.
Ninomiya JT, Dean JC, et al. What's New in Hip Replacement. J Bone Joint Surg Am. 2015 Sep 16;97(18):1543-1551.
6/14/2017 DynaMed Systematic Literature Surveillancehttp://www.dynamed.com/topics/dmp~AN~T566765/Elective-total-hip-arthroplasty: Wilson SH, Wolf BJ, et al. Comparison of lumbar epidurals and lumbar plexus nerve blocks for analgesia following primary total hip arthroplasty: a retrospective analysis. J Arthroplasty. 2017;32(2):635-640.
Last reviewed March 2021 by EBSCO Medical Review Board Warren A. Bodine, DO, CAQSM Last Updated: 4/9/21