Hip replacements may be an option for people with damaged or worn out hip joints. The most common cause of this damage is degeneration of the joint from osteoarthritis causing chronic pain, impairment of daily functions such as bathing, walking, performing general household chores, preparing meals and an inability to sleep - all of these symptoms are considered life limiting.
The majority of the time, hip replacements are performed on people over 60 years of age but there are many who have them younger. The reluctance to replace a younger hip is because there will be extra stress placed on it which will cause it to wear out again. They can last for around 20 years.
The surgical procedure of replacing a hip is when the damaged or diseased part (the top of the upper thigh bone and the socket it fits into) is removed and replaced with a man-made or prosthetic implant. The aim is to improve walking and other movement, help the hip joint function better and relieve pain. The procedure is only really considered after pain relief and physical therapy have been exhausted and usually takes place under general anesthetic or regional anesthesia; most commonly epidural and takes up to three hours to perform.
Hips are made up from two major parts, one or both may be replaced: the hip socket (acetabulum) and/or the upper end of the thighbone (femoral head). The replacement socket is usually made from a strong metal. A full replacement is known as total hip arthroplasty consists of replacing the acetabulum and femoral head whereas a half or hemi replacement just replaces the femoral head.
A metal stem is inserted into the thigh bone (femur). At the neck of this stem is a small metal or ceramic hip ball which will replace the top of your thigh bone and fit into a plastic or ceramic liner which allows the hip to move smoothly. Together, these create a new joint. The liner is inserted into a metal shell which is anchored to your pelvis and a metal stem that is attached to the thigh bone makes the joint more stable.
Your surgeon will make the decision as to whether to anchor the new hip to the bone using cement or the more natural, bone ingrowth. Cement hardens to a durable polymer and holds the implant in place but the most popular method of fixation is bone ingrowth which uses porous-coated implant technology and revolutionized hip replacements. A fiber mesh simulates the bone with a special, granular surface into which the bone grows and in turn locks the implant into place.
Although no two patients are the same, the recovery time for a hip replacement will take time; generally between three and six months when you will be able to resume normal activities. Your surgeon will assure you that you will get out of your recovery what you put in - in other words, a positive mental attitude, a strong support network and becoming a diligent and active participant will help speed up your recovery and give you a more successful outcome.
Short-term recovery involves the ability to eat and drink normally, climb up and down a short flight of stairs, use the bathroom, be able to perform the prescribed home exercises and get in and out of your hospital bed, you will normally be discharged with a walker (Zimmer frame) crutches or a cane between one and four days later.
Soon after your discharge, you should be able to give up major pain relief, perhaps exchanging it for over-the-counter painkillers and manage a full-night of sleep. When you no longer need a walking aid, you can start to walk around the house and if you’re feeling adventurous, outdoors for a couple of blocks without resting and hopefully pain-free. Exercise will reduce stiffness of joints, make the muscles stronger and improve range of motion.
Long-term recovery involves the healing of all surgical wounds and internal soft tissue and a gradual return to normal activities. You should also be starting to feel ‘normal’ again. It’s recommended that you allow around 3-6 months for this but as with all medical procedures, this may vary.
You are considered ‘healed’ when you are in a better physical state with greater mobility and less pain that you were prior to your operation.