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What is hip replacement surgery?

Hip replacement (total hip arthroplasty) is surgery to replace a worn-out or damaged hip joint. The surgeon replaces the old joint with an artificial joint (prosthesis). This surgery may be a choice after a hip fracture or for severe pain because of arthritis.
Various types of arthritis may affect the hip joint:
• Osteoarthritis. This is a degenerative joint disease that affects mostly middle-aged and older adults. It may cause the breakdown of joint cartilage and adjacent bone in the hips.
• Rheumatoid arthritis. This type of arthritis causes inflammation of the synovial lining of the joint. It causes extra synovial fluid. It may lead to severe pain and stiffness.
• Traumatic arthritis. This is arthritis is caused by an injury. It may also damage the hip cartilage.
The goal of hip replacement surgery is to replace the parts of the hip joint that have been damaged. It also helps relieve hip pain that can’t be controlled by other treatments.
A traditional hip replacement involves an incision several inches long over the hip joint. A newer approach uses 1 or 2 smaller incisions to do the surgery. This is called minimally invasive hip replacement. But the minimally invasive procedure is not suited for all people who need a hip replacement. Your healthcare provider will figure out the best procedure for you.

Why might I need hip replacement surgery?

Hip replacement surgery is a treatment for pain and disability in the hip. Osteoarthritis is the most common reason for hip replacement surgery.
Osteoarthritis causes loss of joint cartilage in the hip. Damage to the cartilage and bones limits movement and may cause pain. People with severe pain from a degenerative joint disease may not be able to do normal activities that involve bending at the hip. These activities include walking and sitting.
Other forms of arthritis such as rheumatoid arthritis and arthritis that results from a hip injury can also damage the hip joint.
Hip replacement may also be used to treat certain hip fractures. A fracture is an injury often from a fall. Pain from a fracture is severe. Walking or even moving the leg causes pain.
If other medical treatments don't control your arthritis pain, your healthcare provider may recommend a hip replacement. Some medical treatments for a degenerative joint disease may include:
• Anti-inflammatory medicines
• Glucosamine and chondroitin sulfate
• Pain medicines
• Limiting activities that are painful
• Assistive devices for walking such as a cane
• Physical therapy
Your healthcare provider may have other reasons to recommend a hip replacement surgery.

What are the risks of hip replacement surgery?

Any surgery can have complications. Some possible complications may include:
• Bleeding
• Infection
• Blood clots in the legs or lungs
• Dislocation
• Need for revision or additional hip surgery
• Nerve injury that causes weakness, numbness, or both
You may have other risks depending on your specific health condition. Discuss any concerns with your healthcare provider before the surgery.

How do I get ready for hip replacement surgery?

• Your healthcare provider will explain the procedure to you and offer you the chance to ask any questions that you might have about the procedure.
• You may be asked to sign a consent form that gives your permission to do the procedure. Read the form carefully and ask questions if something is not clear.
• In addition to a complete health history, your healthcare provider may do a physical exam to make sure that you are in good health before having the surgery. You may have blood tests or other diagnostic tests.
• Tell your healthcare provider if you are sensitive to or are allergic to any medicines, latex, tape, and anesthesia (both local and general).
• Tell your healthcare provider about all the medicines you are taking. This includes prescription and over-the-counter medicines, and herbal supplements.
• Tell your healthcare provider if you have a history of bleeding disorders or if you are taking any blood-thinners (anticoagulants), aspirin, or other medicines that affect blood clotting. You may need to stop taking these medicines before the surgery.
• Tell your healthcare provider if you are pregnant or think you may be pregnant.
• You will be asked to fast for 8 hours before the surgery. This usually means after midnight.
• You may get medicine (sedative) before the surgery to help you relax.
• You may meet with a physical therapist before your surgery to talk about rehabilitation.
• If you smoke, stop before your surgery. Smoking can delay wound healing and slow down the recovery period.
• Lose weight if you need to.
• Do conditioning exercises as prescribed to strengthen muscles.
• Arrange for someone to help around the house for a week or two after you are discharged from the hospital.
• Based on your health condition, your healthcare provider may order other specific tests or exams.
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