Hip Replacement Surgery

What is a hip replacement?

Hip replacement surgery, also referred to as hip arthroplasty, is a surgical procedure for relieving pain in the hip. It is a surgical procedure of replacing parts of the hip joint with artificial implants. The hip joint consists of a ball (at the top of the femur, commonly referred to as the thigh bone) and a socket (in the pelvis, commonly referred to as the hip bone). Hip replacement surgery involves the replacement of one or both parts. The purpose of the procedure is to enable you to return to your normal activities without pain.

Who Can Benefit from Hip Replacement Procedure?

Hip replacement may be life-changing for those who suffer from any form of hip arthritis leading to chronic pain and disability. It is usually performed when non-surgical options of treatment have been exhausted or the hip joint has deteriorated beyond repair. A number of conditions may necessitate a hip replacement. These include:

1. Osteoarthritis (OA)
2. Rheumatoid Arthritis (RA)
3. Osteonecrosis (Avascular Necrosis)
4. Hip Fractures
5. Tumours 
6. Post-Traumatic Arthritis
7. Developmental Dysplasia of the Hip (DDH)
8. Paget’s Disease of Bone
9. Inflammatory Conditions
10. Failed Previous Hip Surgery

What Are the Types of Hip Replacement Surgery?

Hip replacement surgeries are classified depending on which part of the hip joint is replaced:

• Partial Hip Replacement: In this procedure, only the ball (head of the femur) is replaced; the socket is left untouched. This procedure is often used for cases where the socket is not damaged e.g., hip fractures.
• Total Hip Replacement/Total Hip Arthroplasty: In this surgical procedure, both the ball and the socket are replaced with artificial parts. This is one of the most common types of hip replacement surgeries and is suited for patients with severe joint damage.

What Are the Surgical Approaches to Hip Replacement?

Surgeons can access the hip joint during surgery using minimally invasive or traditional techniques. Each of these techniques has unique benefits, and your orthopaedic surgeon will recommend the best for you.

• Minimally invasive hip replacement requires one or two small incisions through which the surgeon can move muscles aside instead of cutting through them. This procedure decreases muscle damage, post-operative pain, and recovery time while lowering the risk of dislocation and shortening time spent in the hospital. 
• The traditional approach to hip replacement utilizes a single, larger incision that provides access to the hip joint. Often, this means cutting through or detaching muscles and tendons, which are then repaired after the placement of the implant. 

The Hip replacement surgery can be performed through various approaches:

• From the Front (Anterior Approach):The surgeon accesses the hip joint from the front side of the body. This is a minimally invasive approach and often less disrupting to the muscles surrounding the hip joint, making it easier for faster recovery.
• From the Side (Lateral Approach):The surgeon enters the hip joint from the side. It provides excellent access for the treatment of certain conditions and is commonly used in traditional hip replacement surgeries.
• From the Back (Posterior Approach):The surgeon approaches the hip from the backside, thus viewing the joint well along with surrounding structures. The procedure is applied widely and thus can be offered to the patients with most common hip disorders.

What happens during a hip replacement procedure?

A typical, straightforward hip replacement surgery involves the following steps.

• Once you are brought into the operating room, an intravenous line will be put in your hand or arm. If necessary, you may also be given a urinary catheter at this time.
• You will be administered either general anesthesia (for the whole body) or regional (Spinal or epidural anesthesia) making below-the-waist area numb.
• During the surgery, the surgeon will position you properly to access your hip joint. The location of the incision depends on the chosen surgical approach: front, back, or side.
• If a total hip replacement procedure is chosen by the healthcare provider, he/she will remove the head of the femur. All damaged cartilage will be removed to prepare the socket. A prosthetic stem will be inserted into the femur (with or without cement), and a ceramic or metal replacement head will be attached to the top of the stem. Also, a new cup will be fixed in the acetabulum to complete the joint replacement procedure. If a partial hip replacement is selected by the surgeon, only the head of the femur will be replaced.
• After assembling the new joint, the surgeon checks the range of motion and stability of the hip by  moving your leg to ensure that everything is functioning properly. The layers of tissue are then closed with stitches.
• After surgery, you will be monitored in the recovery room and then be transferred to the hospital room. The discharge from the hospital varies according to individual recovery; it usually requires a short hospital stay(2-3 days).

Recovering effectively After Hip Replacement Surgery

Preventing Blood Clots

There is an increased risk of blood clots in the legs after hip replacement surgery. To reduce this risk, your healthcare team advises: 

• Early Mobilization: You will be motivated to get out of bed as soon as possible after surgery and start walking with the help of a walker or crutches. This helps promote circulation and lowers clotting risks.
• Compression Techniques: You may be given elastic compression stockings or inflatable air sleeves for your legs during and after your procedure. These devices work by squeezing and then releasing pressure to promote blood flow and prevent pooling of blood in the veins.
• Medications: Your physician may prescribe medications that thin the blood. This can either be a tablet or injection. This usually will be required for a few  weeks depending on your general mobility, activity level, and risk of clotting.

Physical Therapy and Activity

To regain strength and improve joint mobility, regular physical activity is essential:

• A physical therapist will show you exercises to reestablish movement and strengthen the muscles surrounding your hip.
• You'll be shown how to use assistive devices like crutches or walkers.  Over time, you’ll slowly increase the weight you place on your operated leg until you are comfortable walking independently.

Preparing for Home Recovery

Enabling a smooth transition from the hospital to the home helps in a smoother and comfortable recovery process:

• Reorganize Your Space: Place frequently used items within easy reach to avoid unnecessary bending or stretching.
• Home Modifications: Consider installing assistive equipment such as a raised toilet seat or a shower chair to minimize stress in daily activities.
• Keep Essentials Nearby: Place items such as your phone, tissues, medications, books, and TV remote within arm's reach of your recovery area.

The Department of Orthopaedics, Joint Replacement & Spine Surgery at Marengo Asia Hospitals focuses on advanced treatments for joint-related, spine, and bone diseases. Our teams of expert surgeons provide high-tech approaches with regard to hip replacement and other joint procedures. Whether it’s a partial or total hip replacement, our highly skilled surgeons ensure every patient receives individualized care and the best possible outcome.

If you are experiencing continuous pain and discomfort in the hip or have reduced mobility, seek advice from our expert surgeons. They will guide you through the possible options for treatment to regain movement and enhance the quality of life.