Total Hip Replacement

Hip replacement surgery, also called hip arthroplasty, is a surgical procedure in which the structures that make up the hip joint are replaced with an artificial joint (prosthesis). The hip joint consists of the pelvic acetabulum and the femoral head resembling a ball and socket-type anatomic joint. When only the femoral side of the joint is replaced this is called a hemiarthroplasty whereas when both acetabular and femoral joint components are replaced with prosthesis then the procedure is called a total hip replacement. 

Hip replacement surgery is often considered for relatively older patients with osteoarthritis for ease of pain and improved gait and mobility. Additionally, this surgical procedure may also be necessary for younger patients who have inflammatory joint arthritis, femoral head osteonecrosis, developmental hip dysplasia (congenital hip dislocation), and some types of hip fracture.

Hip replacement surgery is an open surgical procedure. It can be performed under general or regional anesthesia The choice of anesthesia depends fundamentally on your medical condition which will be investigated before the operation. However, if your medical status permits you can choose the anesthesia type for your operation. After the administration of anesthesia, a sterile area is created in the surgical area and draped. After a final time-out check an incision of 15-20 cm is made in the lateral thigh, the fascia and muscles are lifted in accordance with the surgical technique, and the joint capsule is reached. The joint capsule is excised and the femoral head is approached and removed from the acetabulum. The degenerated surface of the acetabulum is reamed to expose the healthy bone. The acetabular cup is then implanted in the reamed acetabulum. An acetabular artificial joint surface called a ‘liner’ is then impacted into the acetabular cup. The artificial joint surface of choice will be pre-discussed with you. Next, the femoral medulla is reamed and rasped for the implantation of the femoral component. After assembling the artificial femoral head the joint is reduced to its proper position and tested for motion, stability, and leg length. Finally, a suction drain is placed to drain the accumulated blood and the incision is closed. 

The patient usually stays in the hospital for 3 to 5 days. On the day after the surgery, the drain is removed and the patient starts to get mobilized with assistance. Appropriate anesthesia selection and postoperative proper pain medication suitable for your age and health status will be utilized to keep you in comfort as much as possible. Once everything is found stable and the patient can safely mobilize with crutches the patient is discharged. The patient is advised on how to exercise and physical conditions to refrain from. Generally, after the 5th day, the surgical wound should heal enough so that no serum or blood from the wound would be leaking. If this is the case you will need as little as 2 dressing changes until the wound is totally sealed and safe to be left open. You will be advised to use walking aids for 4 to 6 weeks after discharge. Most patients recover from these aids after six weeks. The exercises that your doctor or physiotherapist wants you to perform will determine your recovery time to normal living standards.

As with any surgical operation, this surgery also carries risks as well as benefits. Although complications from hip replacement surgery are rare they can be very challenging and even sometimes life-threatening. The common major complications from hip replacement surgery can be listed as deep-vein thrombosis, embolism, prosthetic infection, and endoprosthetic mechanical problems. Unfortunately, there are no known methods to totally prevent such complications. Yet, there are known and established approaches and methods to decrease the risk of these complications.  You can and you should always ask your doctor for more information on complications and strategies to prevent them. 

Please contact us for more information about total hip replacement.

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