joint . The "ball part of the joint is the top part of the thigh bone. The "socket" is a part of the pelvic bone. The "ball " � fits into a groove in the pelvic bone called the acetabulum. This gives the name "ball and socket " �. Tough tissue that is flexible, called cartilage, covers the parts of the joint in a normal hip. The cartilage lets the hip glide easily. The cartilage can become worn and cause bone to rub on other bone. This rubbing often leads to pain, stiffness, and trouble walking. Sometimes, drugs and exercises can help you with the pain. When a hip joint stops working, you may need hip joint replacement (arthroplasty) surgery. � �
Hip replacement surgery may be done in more than one way: � �
- Traditional Surgery:
- Both joint surfaces of the thigh bone and pelvic bone are replaced.
- The joints are cemented to the bone.
- Bipolar Hip Replacement:
- A plastic cup is fitted into the socket of the pelvic bone.
- It is not cemented in place.
- The thigh bone has the bipolar prosthesis.
- This prosthesis swivels and is designed to lessen the wear and tear on the cartilage.
- Bipolar hip replacement is most often is done in older patients with a certain type of break at the top of the thigh bone.
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What will the results be?
- Less pain
- More movement in your hip
- Easier to walk and do other daily activities
What happens before the procedure?
- A few weeks or days before the surgery, your doctor may have you:
- Get some tests to make sure you are healthy enough for surgery.
- Meet with a physical therapist. You may learn exercises for after surgery. You may also learn how to use crutches or a walker.
- Get some exercises from your doctor so you can start before the surgery.
- Donate blood in case you need a blood transfusion.
- Stop smoking if you are a smoker.
- Avoid beer, wine, and mixed drinks (alcohol) at least 48 hours before the surgery.
- Stop taking some drugs. Be sure to tell your doctor about all the drugs you are taking including herbals and supplements.
- The night before your surgery, you will need to stop eating and drinking at midnight.
What happens during the procedure?
- Once you are in the operating room, the staff will put an I.V. in your arm to give you fluids and drugs. You will be given a drug to make you sleepy. It will also help you stay pain free during the surgery.
- Your doctor will make a cut in your outer hip/upper thigh. Your doctor will then push aside the muscles without cutting them to get to the joint.
- Your doctor will next remove all the damaged parts of the joints and replace them with man-made parts. These are the implants or prostheses.
- Your doctor may put in a drain to get rid of some fluid at the site.
- Your doctor will close your cut with stitches or staples and cover it with clean bandages.
- The procedure will take about 2 hours.
What happens after the procedure?
- You will go to the Recovery Room and the staff will watch you closely. You may have to stay in the hospital for 1 to 2 days.
- Within a day or two, you will get out of bed to a chair. The staff will help you start to walk around. Doing coughing and deep breathing exercises will help keep your lungs clear. You will get drugs to help with your pain.
- The staff will look at your wound and may need to clean the site.
- You will have long, tight socks to put on or a cuff put on your leg that is hooked up to a machine. Either of these will keep the blood flowing to avoid blood clots.
- Most of the time, you will start physical therapy (PT) the same day. Sometimes, you start the day after surgery. Your doctor will let you know how much weight you can put on your operated leg. You will need to use a walker or crutches to help you walk.
- Most people stay in the hospital for 1 to 2 days.
What drugs may be needed?
The doctor may order drugs to: � �
- Help with pain
- Prevent blood clots
- Prevent infection
- Help with other problems you may have like trouble sleeping or hard stools
What problems could happen?
- Dislocation � � � it is important to keep from doing some movements. These can cause the hip joint to move out of the socket. This is less common than with a traditional approach. Ask your doctor what movements are safe for you. Your doctor may suggest you follow these hip precautions:
- Keep your legs from turning in or out.
- Avoid moving your operated leg backwards and out to the side.
- Avoid crossing your legs or ankles.
- Avoid taking long steps when walking.
- Avoid kneeling on your operated leg. If you have to kneel, then kneel on both knees so the operated hip is not pushed back.
- Avoid the straddling position.
- Blood clot or DVT (deep vein thrombosis) � � � To avoid these, your doctor may ask you to do ankle pumping exercises. Your doctor also may order blood thinning drugs or compression stockings.
- Lung infection � � � Taking deep breaths can help keep you from getting a lung infection. Take at least 10 deep breaths each hour while you are awake.
- Infection � � � Be sure to take all drugs as ordered.
- Other problems during or after surgery may include broken bones, nerve or blood vessel damage, bleeding, the chance of the leg not being the same length as the other leg, or loosening of the prosthesis.
Where can I learn more?
American Association of Hip and Knee Surgeons � �
http://www.aahks.org/patients/resources/MIS_Patients.pdf � �
National Institute of Arthritis and Musculoskeletal and Skin Diseases � �
http://www.niams.nih.gov/Health_Info/Hip_Replacement/default.asp � �
Consumer Information Use and Disclaimer
This information is not specific medical advice and does not replace information you receive from your health care provider. This is only a brief summary of general information. It does NOT include all information about conditions, illnesses, injuries, tests, procedures, treatments, therapies, discharge instructions or life-style choices that may apply to you. You must talk with your health care provider for complete information about your health and treatment options. This information should not be used to decide whether or not to accept your health care providers advice, instructions or recommendations. Only your health care provider has the knowledge and training to provide advice that is right for you. � �
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