What to Expect from Total Hip Replacement Surgery - dummies

What to Expect from Total Hip Replacement Surgery

By Sarah Densmore

Maybe you’ve been battling arthritis for years, or your hip has slowly deteriorated since you were in that car accident a few years ago. Pain killers, canes, and walkers aren’t relieving your pain or making movement any easier. Now your doctor is telling you to consider total hip replacement surgery.

The prospect of replacing an entire body part can be daunting. However, doctors have been replacing hips for nearly 50 years and more than 193,000 Americans undergo the surgery each year with few serious complications. In nearly 90 percent of cases, the replaced hip lasts for the remainder of the person’s life.

Replacing worn-out hip ball and socket with body-friendly materials

An orthopaedic surgeon, a doctor who specializes in treating bone and muscle problems, will replace your hip. She’ll perform a preoperative evaluation which will include taking your medical history, making note of any medications you’re taking, giving you a brief physical, conducting blood tests, and examining your hip both palpably and with an X-ray or MRI.

After your preoperative visit, your doctor will give you specific surgery-prep instructions. These may include performing exercises to strengthen your muscles and improve flexibility and taking antibiotics and blood thinners to guard against infections and blood clots after surgery.

You probably won’t have to arrive at the hospital until the day of your operation, but you’ll have to stay there for a few days of recuperation afterwards. When you arrive in the operating room, you’ll either be put to sleep using general anesthesia or you’ll be given spinal or epidural anesthesia which numbs you from your waist down. Your surgical team will decide which type of anesthesia would be best for you.

On average, it takes about two or three hours to replace a hip. During the operation, your surgeon will make a 6- to 8-inch incision in the side of your hip, through the muscle. She’ll remove the diseased bone and tissue and leave the healthy bone and tissue.

First, she’ll secure the socket portion of your new hip into your pelvic bone with bone cement. Then she’ll insert the ball and ball stem, attaching the stem to your thigh bone with bone cement. (Sometimes hip replacement is done without bone cement. In these cases, your natural bone eventually grows and attaches itself to your new hip. Typically, uncemented replacements are reserved for patients younger than 50.)

Artificial hip designs and materials can vary; however, all of them are comprised of a ball and a socket. The ball is made of either a strong metal or ceramic. The socket is formed from a strong plastic, metal, or ceramic. These materials allow your hip ball to glide smoothly in the socket so you regain mobility.

When your surgery is over, you’ll be taken to recovery where you’ll be monitored for a couple hours until you’re fully awake.

After your hip’s replaced: recovery, yes; rest, no

Although you’ll stay in the hospital for a few days after your hip’s been replaced, don’t count on spending all of that time in bed. Once you’re out of recovery, you’ll be asked to breathe deeply and cough a lot so your lungs don’t become congested.

Because blood clots are the most common complication of hip replacement, your doctor may also require you to take blood thinners and wear compression stockings or a pressure sleeve (sort of like a blood pressure cup) on your lower legs. You might also be fitted with a positioning split to protect your new hip from dislocation for the first few days.

The day after your operation, you’ll be asked to sit up and a physical therapist will show you how to begin walking with the aid of a walker. Within a day or two, the physical therapist will show how to perform exercises specifically designed to regain your hip strength and mobility. You’ll need to perform these exercises regularly so that in the near future you’ll be able to walk unassisted and put your full body weight on your leg.

Life with your new hip

It will take three to six months for you to fully recover from hip replacement surgery. During your first few weeks home after surgery, you’ll need to focus on following your doctor’s exercise and incision-care regimen so you regain hip strength and mobility and protect yourself from blood clots and infection.

You’re at high risk for dislocating your new hip until it’s completely healed. To protect yourself during the initial weeks of recovery don’t cross your legs, bend your hips more than 90 degrees, or turn your feet inward or outward at extreme angles.

Follow the rules your doctor and physical therapist lay out and you’ll be able to resume most normal, light activities within three to six weeks.

Once you’re fully recovered, you should notice a great reduction in hip pain and a substantial increase in mobility. You’ll most likely be able to participate in as many of life’s low-impact activities as you desire. What you won’t be able to do is jog, run, play basketball, or participate in any other activity that requires you to jump up and down.

Your new hip should be with you for the rest of your life if you protect it from injury and keep the surrounding bone and muscle strong with proper exercise.

Don’t forget to tell your dentist about your new hip. If you need dental surgery, you’ll have to take antibiotics before the procedure to guard against infectious bacteria inflaming your hip.