Total Hip Replacement
Hip replacement, also called hip arthroplasty, is a surgical procedure to replace a worn-out or damaged part of your hip joint. The surgeon replaces them with an artificial joint surface (prosthesis), which are made of metal, ceramic or highly durable polyethylene.
Why is a total hip replacement needed?
- To relieve severe pain caused by osteoarthritis, rheumatoid arthritis and arthritis that results from a hip injury
- If nonsurgical treatments like medications are no longer helpful
- If pain worsens with walking, even with a cane or walker
- If you have severe hip pain that limits everyday activities
- Hip fractures
- Failure to substantially improve with other treatments such as anti-inflammatory medications, cortisone injections or physical therapy
What is the preparation for total hip replacement?
You will undergo different tests beforehand to ensure you are healthy enough for the procedure. These will include:
- Blood tests
- A review of your medical history
- A physical examination. This will assess the hip, paying attention to the range of motion, stability, strength, and overall leg alignment
- X-rays – these images help to determine the extent of damage and deformity in your hip
- Other tests, like occasionally blood tests, or advanced imaging such as a magnetic resonance imaging (MRI) scan, may be needed to determine the condition of the bone and soft tissues of your hip
Our team will provide you with a complete set of instructions about preparing yourself for surgery. These can include:
- Not eating or drinking anything before the surgery for 8 hours or more
- Having someone to stay with you immediately after surgery
- Your doctor might ask you to stop taking certain medications and supplements
- Arrange for a ride home
Before the procedure
Our nurse inserts an IV line for injecting medication and fluids through your vein. You will be given an intravenous antibiotic before, during, and after the procedure to help prevent post-surgical infection.
Your surgeon might also give you a nerve block by injecting an anaesthetic in and around the joint to help block pain after your surgery. You may be put under general anaesthesia, which means you will not be conscious before and during the surgery or under spinal anaesthesia, which leaves you awake but unable to feel pain from your waist down.
During the procedure
- Exposure: Your surgeon makes an incision over the front or side of your hip and retracts the layers of tissue to expose the hip The diseased and damaged bone and cartilage are removed, leaving healthy bone intact
- Socket preparation: The damaged socket in the pelvic bone is prepared to receive a new prosthetic socket fixed by pressfit and/or screws
- Thighbone preparation: The round spherical head of your femur will be removed then the thighbone canal will be prepared to fit a stem in the correct position to which a prosthetic ball is attached
- Closure: The prosthetic joint parts are reduced and the wound is closed after final cleaning
After the procedure:
- You are brought to the recovery room until you recover from anaesthesia
- Your vital signs are closely monitored the entire time
- You will be encouraged to move your foot and ankle, which increases blood flow to your leg muscles and helps prevent swelling and blood clots
- You will likely receive blood thinners and wear support hose or compression boots to further protect against swelling and clotting
- You will be asked to do frequent breathing exercises and gradually increase your activity level
- The day after surgery, you will walk full weight bearing on your operated limb with your physical therapist who will recommend strengthening and mobility exercises and will help you learn how to use a walking aid, such as a walker, a cane, or crutches
- After you leave the hospital, you will continue physical therapy at home or a centre. You will be asked to keep a pillow between your legs when sleeping and to sit on a toilet seat elevator for 6 weeks after surgery
- The report of the procedure, discharge medications, and follow up appointment details will be provided to you at the time of discharge
Do your exercises regularly, for the best recovery, follow all your care team’s instructions concerning wound care, diet and exercise.