Things to Consider Before Hip Replacement Surgery
Hip replacement surgery the second most common joint replacement procedure, closely following knee replacements. Many people have hip arthritis, but it can be difficult to know when the right time to have a hip replacement surgery is. Furthermore, there is confusion about what to expect from hip replacement surgery. Learn the basics you need to know about hip replacement surgery.
1. Hip Arthritis
The word ‘arthritis’ means ‘inflammation of the joint.’ Most people think of arthritis as the wearing away of cartilage in a joint—this is the end result of inflammation within the joint. Over time, the inflammation can lead to cartilage loss and exposed bone, instead of a normal, smooth joint surface.
The most common type of hip arthritis is osteoarthritis. This is often referred to as “wear-and-tear” arthritis, and it results in the wearing away of the normally smooth cartilage until bare bone is exposed. Other types of arthritis include rheumatoid arthritis, gouty arthritis, and lupus arthritis.
2. Are You Ready for Hip Replacement?
Hip replacement surgery is performed when the hip joint has reached a point when painful symptoms can no longer be controlled with non-operative treatments. In a hip replacement procedure, your surgeon removes the damaged joint surface and replaces it with an artificial implant.
A total hip replacement is a major surgery, and deciding to have the surgery done is a big decision. You have to consider whether you’re too young for a hip replacement and you’re likely to need to have it redone. But there can be consequences in delaying joint replacement surgery. As well, older age is a concern and may be an exclusion factor for a hip replacement.
Treatment of hip arthritis should begin with the most basic options and progress to the more involved, which may include surgery. Not all treatments are appropriate for every patient.
Hip replacement is generally reserved for patients who have tried all of the other treatments and are still left with significant pain during normal activities. Patients who have occasional pain, are able to participate in athletic activities, or have not tried non-operative treatments are probably not ready for a hip replacement. Non-operative treatment options include:
- Weight Loss
- Activity Modifications
- Anti-Inflammatory Medications
- Joint Supplements
Hip resurfacing might be used as an alternative in younger patients (those under age 60).
4. How Long Do Replacements Last?
Most patients understand that hip replacements can wear out over time, but exactly how long is a hip replacement supposed to last? Studies show that common types of hip replacements can last more than 20 years.
One very large study found that 80 percent of hip replacements were functioning well after 15 years in the younger (less than 65) patients, and 94 percent of the older (over 65) patients.
5. Hip Replacement Implants
Hip replacement surgery removes the damaged joint lining and replaces the joint surfaces with an artificial implant that functions similar to a normal hip. The typical implant is made of metal (stainless steel or titanium), and older types had a plastic spacer in between the metal ball and socket. These implants will wear out over time, and hip replacements are done infrequently in younger patients because of the concern of the implant wearing out too quickly.
New materials have been tried in order to provide the best possible functioning with long-lasting results. Some newer implants such as ceramic hip replacements have promise, others may not turn out to be better.
6. Steps of Replacement Surgery
When a hip replacement is performed, the bone and cartilage on the ball-and-socket hip joint is removed. This is performed using precise instruments to create surfaces that can accommodate the implant perfectly. An artificial hip replacement implant is then placed in to function as a new hip joint.
Not every hip replacement surgery is performed in exactly the same way. Variations in technique exist which allow surgeons to perform this procedure slightly differently. However, the basic steps of performing a hip replacement are relatively unchanged. Variations include the anterior approach hip replacement and the mini-hip replacement.
Hip replacement surgery has become quite common, but there are still risks. Fortunately, about 90 percent of patients who undergo hip replacement surgery have good results.
You should have a thoughtful discussion with your doctor prior to hip replacement surgery and make sure to have your questions answered.
Potential risks of hip replacement surgery include:
- Blood clots
- Blood loss
- Infection of a joint replacement
- Hip dislocation
- Leg length difference
- Hip implant loosening
It is important to understand the possible risks of surgery for a variety of reasons. By understanding what could possibly go wrong, you can keep an eye out for signs and symptoms of a complication of hip replacement surgery. Often, if these problems are identified early, steps can be taken to prevent them from becoming more severe.
Hip replacement surgery is usually very successful, but the success of the procedure is partly due to the rehabilitation period that follows the surgery. For patients to expect a good result from hip replacement surgery, they must be an active rehab participant.
Rehabilitation after hip replacement begins immediately. Patients will work with a physical therapist as soon as the surgical procedure has been performed. The emphasis in the early stages of rehab is to maintain motion of the hip replacement and to ensure that the patient can walk safely. A physical therapist can teach you important skills that help you move around, climbs stairs, getting in and out of the car, without risk to be replaced if joint or causing significant pain.
As rehabilitation moves along to later phases, your therapist will help restore normal gait mechanics, strength of the lower extremities, and mobility of your new hip joint. By participating in an active therapeutic recovery, you can resume your presurgical level of activity, and you may even be able to surpass that level of activity.