Total Hip Replacement

Hip replacement surgery removes damaged or diseased parts of a hip joint and replaces them with new, man-made parts. The goals of this surgery are to:

Relieve pain
Help the hip joint work better
Improve walking and other movements

Who Should Have Hip Replacement Surgery?

The most common reason for hip replacement is osteoarthritis in the hip joint. Your doctor might also suggest this surgery if you have:

Rheumatoid arthritis (a disease that causes joint pain, stiffness, and swelling)
Osteonecrosis (a disease that causes the bone in joints to die)
Injury of the hip joint
Bone tumors that break down the hip joint.

Your doctor will likely suggest other treatments first, including:

Walking aids, such as a cane
An exercise program
Physical therapy
Medications.

These treatments may decrease hip pain and improve function. Sometimes the pain remains and makes daily activities hard to do. In this case, your doctor may order an x ray to look at the damage to the joint. If the x ray shows damage and your hip joint hurts, you may need a hip replacement.

Healthy, active people often have very good results after hip replacement surgery. But your doctor may not suggest this surgery if you have:

A disease that causes severe muscle weakness
Parkinson's disease
A high risk of infection
Poor health.

How Should I Prepare for Surgery?

To prepare for surgery, you can:

Learn what to expect before, during, and after surgery
Ask the doctor for booklets about the surgery
Ask someone to drive you to and from the hospital
Arrange for someone to help you for a week or two after coming home from the hospital
Put things you need in one place at home (for instance, put the remote control, radio, telephone, medicine, tissues, and wastebasket next to your chair or bed)
Place items you use every day at arm level to avoid reaching up or bending down
Stock up on food
Make and freeze meals.

What Should I Do After Surgery?

Soon after surgery, you will meet a respiratory therapist and a physical therapist. The respiratory therapist may ask you to breathe deeply, cough, or blow into a device to check your lungs. Deep breathing helps to keep fluid out of your lungs after surgery.

The physical therapist will teach you how to sit up, bend over, and walk with your new hip. The therapist will also teach you simple exercises to help you get better. In some cases, within 1 to 2 days after surgery, you may be able to sit on the edge of the bed, stand, and even walk with help.

Most people spend 10 days or less in the hospital after hip replacement surgery. To be completely well takes about 3 to 6 months, based on:

The type of surgery
Your health
How quickly exercises help.

After you go home, be sure to follow the doctor's instructions. Tips for getting better quickly are:

Work with a physical therapist.
Wear an apron to carry things around the house. This leaves your hands and arms free for balance or to use crutches.
Use a long-handled "reacher" to turn on lights or grab things you need. Your nurse at the hospital may give you one or tell you where to buy one.

What Problems Can Happen After Hip Replacement Surgery?

The most common problem soon after hip replacement surgery is hip dislocation. Because man-made hips are smaller than normal ones, the ball can come out of the socket. This can happen if you are in certain positions, such as pulling the knees up to the chest.

Sometimes, a person's body reacts to the man-made joint. If that happens, there is usually inflammation (or swelling), and then special cells might eat away some of the bone, causing the joint to loosen. To treat this problem, your doctor may suggest medicines or surgery to replace the joint. Most people (more than 90 percent) who have hip joints replaced do not need more surgery. Researchers are trying out joints made of different materials that last longer and cause less inflammation.

Less common problems after surgery are:

Infection
Blood clots
Bone growth past the normal edges of the bone.

Risks of problems after hip replacement surgery are much lower than they used to be.

Will Exercise Help After a Total Hip Replacement?

Exercise can reduce joint pain and stiffness. It can increase muscle strength and joint range of motion (how much you can move the joint). Most physical therapists begin with exercises that:

Increase range of motion
Make muscles strong.

Your doctor or physical therapist will decide when you can do harder exercises. Your doctor may say not to jog or play basketball or tennis. These can damage or loosen the new hip joint.

Exercise goals after hip replacement surgery are to:

Increase muscle strength
Increase your blood circulation and overall fitness
Avoid injuring the new joint.

The types of exercise that may help you meet these goals are:

Walking
Bicycling (on a bike machine)
Swimming
Cross-country skiing.

Hip Procedure Medical Animations

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