Total Hip Arthroplasty
How Your Hip Works
Your hip joint is like a ball and socket formed by the “ball” or femoral head at the upper end of your thighbone and a rounded “socket” or acetabulum in the pelvis. The ends of the bone are covered with smooth cartilage for frictionless movement. A thin, smooth tissue lining called the synovium surrounds the joint space. The synovium produces fluid that acts as a lubricant to reduce friction and wear inside the joint. When all parts of the joint work together, your hip moves easily without pain. When your joint becomes diseased or injured, however, the cartilage can break down and cause escalating pain that severely limits your ability to move and work.
Most patients considering a hip replacement are experiencing considerable pain and limited movement. The erosion of cartilage and damage to bone surfaces caused by arthritis and other debilitating joint conditions can interfere with just about every aspect of your life – from walking, exercising and working to enjoying time with family or friends and getting a full night of sleep.
During total hip replacement, your surgeon will remove parts of your damaged hip joint and replace them with an implant designed to function like a normal, healthy hip. Specifically, the surgery involves replacing your femoral head or thighbone and your acetabulum or hip socket.
What to Expect Immediately After Surgery
Most hip replacement surgeries take between one to two hours and patients spend one to two nights in the hospital following surgery. You’ll spend a great deal of time exercising your new joint. The proper use of pain relievers before, during, and after your surgery is an extremely important aspect of your treatment. The goals of postoperative pain management are to minimize pain and stress, and to enable you to participate fully in physical therapy. Most patients have very little pain after hip replacement surgery. Your weight-bearing status will be determined by your surgeon, but most patients will be encouraged to bear full weight on their hip as soon as they can tolerate it. Patients typically start with a walker or crutches, and then progress to a cane.
You will be evaluated by a physical therapist and occupational therapist, who will go over exercises and precautions. You may be surprised at how soon after hip replacement patients are encouraged to get up and start moving – usually as early as the day of surgery.
The majority of hip replacement patients can safely return home following their hospital stay. Total hip replacement patients will need help at home for the first few weeks, including assistance with bathing, dressing, preparing meals, running errands and with transportation. It is best for someone to be with you for the first 24-72 hours after discharge. A small number of patients may require a short stay in a rehabilitation facility before returning home.
While total hip replacement may allow you to resume many daily activities, don’t push your hip to do more than you could before your problem developed. Give yourself at least six weeks following surgery to heal and recover from muscle stiffness, swelling and other discomfort. Some people continue to experience discomfort for 6-12 weeks or longer following joint replacement.
Watch for infection. If you have any sign of infection anywhere in your body, call your doctor. Also you are at risk for blood clots for the first several weeks after your surgery. Be sure you take the medication prescribed by your surgeon to prevent blood clots for the entire length of time recommended. Moving and walking as much as possible will also decrease your risk of blood clots.
When you get home, keep up the exercise program you learned in the hospital. We will arrange for a physical therapist to visit you in your home for several initial treatments. This is to ensure you are safe in and about your home. Expect to regain strength and endurance as you begin to take on more of your normal daily routine.
Finally, be encouraged and focus on the high rate of success for total joint procedures.
Excerpted from “A Patient’s Step-by-Step Guide to Hip Replacement Surgery and Recovery”, North Shore Medical Center.