Hip Replacement Care

Hip replacement surgery is a safe and effective procedure that can relieve your pain, increase motion, and help you get back to enjoying normal, everyday activities.
 
A total hip replacement is a surgical procedure whereby the diseased cartilage and bone of the hip joint is surgically replaced with artificial materials. The normal hip joint is a ball and socket joint. The socket is a “cup-shaped” component of the pelvis called the acetabulum. The ball is the head of the thighbone (femur). Total hip joint replacement involves surgical removal of the diseased ball and socket and replacing them with a metal (or ceramic) ball and stem inserted into the femur bone and an artificial plastic (or ceramic) cup socket.

Causes

Total hip replacements are performed most commonly because of progressively worsening of severe arthritis in the hip joint.
 

  • Osteoarthritis. This is an age-related “wear and tear” type of arthritis. It usually occurs in people 50 years of age and older and often in individuals with a family history of arthritis. The cartilage cushioning the bones of the hip wears away. The bones then rub against each other, causing hip pain and stiffness. Osteoarthritis may also be caused or accelerated by subtle irregularities in how the hip developed in childhood.
  • Rheumatoid arthritis. This is an autoimmune disease in which the synovial membrane becomes inflamed and thickened. This chronic inflammation can damage the cartilage, leading to pain and stiffness. Rheumatoid arthritis is the most common type of a group of disorders termed “inflammatory arthritis.”
  • Post-traumatic arthritis. This can follow a serious hip injury or fracture. The cartilage may become damaged and lead to hip pain and stiffness over time.
  • Avascular necrosis. An injury to the hip, such as a dislocation or fracture, may limit the blood supply to the femoral head. This is called avascular necrosis (also commonly referred to as “osteonecrosis”). The lack of blood may cause the surface of the bone to collapse, and arthritis will result. Some diseases can also cause avascular necrosis.
  • Childhood hip disease. Some infants and children have hip problems. Even though the problems are successfully treated during childhood, they may still cause arthritis later on in life. This happens because the hip may not grow normally, and the joint surfaces are affected.

 

Preoperative Period Of Hip Replacement – What Should You Expect?

 

  • Anti-inflammatory medications are often discontinued one week prior to surgery because of the effect of these medications on platelet function and blood clotting.
  • Other preoperative evaluations include complete blood counts, electrolytes (potassium, sodium, chloride), blood tests for kidney and liver functions, urinalysis, chest X-ray, EKG, and a physical examination.
  • The physician will determine which of these tests are required, based on your age and medical conditions.
  • Any indications of infection, severe heart or lung disease, or active metabolic disturbances such as uncontrolled diabetes may postpone or defer total hip joint surgery.
  • If the condition of the hip allows it, some doctors will recommend a preoperative exercise program to build muscle and increase flexibility. This can help with recovery.

 

Postoperative Period Of Hip Replacement – What Should You Expect?

  • After surgery, the patient is taken to a recovery room for immediate observation that generally lasts between one to four hours.
  • If unusual symptoms of numbness or tingling are noted by the patient, recovery room nurses are available and should be notified by the patient. Upon stabilization, the patient is transferred to a hospital room.
  • During the immediate recovery period, patients are given intravenous fluids. Intravenous fluids are important to maintain a patient’s electrolytes and replace any fluids lost during surgery. Pain-control medications are commonly given through a patient-controlled-analgesia (PCA) pump whereby patients can actually administer their own dose of medications on demand.
  • Measures are taken to prevent blood clots in the lower extremities. Patients are placed in elastic hose (TEDs) after surgery. Compression stockings are often added, which help by forcing blood circulation in the legs.
  • Patients are encouraged to actively exercise the lower extremities in order to mobilize venous blood in the lower extremities to prevent blood clots.
  • Patients may also experience difficulty with urination.As a result, catheters are often placed into the bladder to allow normal passage of urine.
  • Immediately after surgery, patients are encouraged to frequently perform deep breathing and coughing in order to avoid lung congestion and the collapse of tiny airways in the lungs
  • Physical therapy is extremely important in the overall outcome

 
There are many things you can do to protect your hip replacement and extend the life of your hip implant.
 

  • Participate in a regular light exercise program to maintain proper strength and mobility of your new hip.
  • Take special precautions to avoid falls and injuries. If you break a bone in your leg, you may require more surgery.
  • Make sure your dentist knows that you have a hip replacement. Talk with your orthopaedic surgeon about whether you need to take antibiotics prior to dental procedures.
  • See your orthopaedic surgeon periodically for routine follow-up examinations and x-rays, even if your hip replacement seems to be doing fine.
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