Hip Replacement Surgery: Unlocking Insights, Latest Advancements, and Recovery Tips

19 March,2024

Conditions like arthritis and hip fractures make it difficult to perform even the easiest tasks, like getting in and out of bed. The initial course of treatment involves medications, the use of walking aids, a change in lifestyle, and physical therapy. When these fail, an orthopedic surgeon will recommend hip replacement surgery. 

Ever since the first attempt at hip replacement surgery in 1891, the procedure has witnessed significant improvements. With minimally invasive and computer-assisted technology, hip replacements today have a success rate of over 95%.

Whether you have already decided to undergo hip replacement surgery or are just exploring the procedure, this blog will give you all the necessary insights. You will learn about the surgical procedure, how it is performed, the risks involved, and the latest advancements in hip replacement techniques.

What is Hip Replacement Surgery?

Hip replacement/arthroplasty is a surgical technique for replacing the damaged and pain-causing hip joint with prosthetics. The hip joint is amongst the largest ball-and-socket type of joints in the human body. It consists of a ball at the top of the femur (thigh bone) and a socket (in the acetabulum, a part of the pelvis bone). Hip replacement surgery may involve replacing both or one part of the joint. 

Two types of hip replacement surgery are – 

• Partial Hip Replacement: In a hip hemiarthroplasty (partial hip replacement), the surgeon replaces only the head of the femur. The orthopedic surgeon recommends partial hip replacement to remove certain tumors and, in some cases, fractures. 
• Total Hip Replacement: THR, or total hip replacement surgery, is the most widely performed hip arthroplasty. The procedure involves replacing both the femoral head and the socket (acetabulum). The hip joint is completely recreated using artificial parts. 

Is Hip Replacement Surgery Right for You?

Certain conditions like arthritis cause severe pain, making it hard to do simple activities like standing, walking, and doing everyday chores. When medicines, physical therapy, and the use of cranes/walkers do not help elevate pain, the orthopedic specialist will recommend a hip replacement surgery. 

The hip replacement surgery will be the right option if you have any of the following conditions.

• Arthritis is the most common condition that warrants joint replacement surgery. It affects the hip joint in several ways and causes excruciating pain. Osteoarthritis and rheumatoid arthritis are the major reasons people seek hip replacement surgery for pain relief. Juvenile arthritis affects children, making them undergo the procedure at a young age. 
• Osteonecrosis: Avascular necrosis or osteonecrosis of the hip joint is a medical condition in which the blood supply to the joint is reduced. The joint receives a deficit of essential nutrients required for maintaining bone health, ultimately leading to its death. Over time, the entire joint deteriorates, and the patient requires hip replacement surgery. 
• Other Conditions: Certain conditions such as car accidents, falls, hip dysplasia, Perthes disease, bone cancer, femoroacetabular impingement syndrome, etc., are also a reason for hip replacement surgery.

A person might be a suitable candidate for a hip replacement if the pain – 

• Does not get resolved with anti-inflammatory medications, walking support, physiotherapy
• Constantly present even while resting
• Worsens with walking, sitting, standing
• Interferes with sleep
• Affects the ability to climb stairs

What are the Risks Involved in Hip Replacement Surgery?

A hip replacement surgery is a major orthopedic procedure. Although generally considered safe, it has a few risks. 

• Blood Clots: Deep vein thrombosis (blood clot formation in the veins of lower limbs) is a common complication of hip replacement. Blood-thinning medications help reduce the chances of blood clots.
• Fracture: There is a possibility of healthy bones getting fractured during the replacement surgery. Most of these fractures are minor and heal on their own without requiring intervention. 
• Infection is one of the most common risks associated with surgery. Having a sterile environment in the hospital and the OT significantly reduces the chances of infection. Taking antibiotics per the surgeon's advice is highly recommended for infection prevention. 
• Dislocation: Certain movements and positions can cause the dislocation of the new hip, in which the ball comes out of the socket. This occurs mainly during the first few months when the body is still recovering and the muscles are not strong enough.
• Change in Leg Length: In most cases, leg length shortening is corrected with hip replacement surgery. However, there is a chance that there might be a discrepancy in leg length. This is caused by muscle contracture and can be corrected by strengthening and stretching hip muscles. 
• Nerve Damage: On rare occasions, the nerves around the implant get damaged, leading to numbness, weakness, and pain. 
• Loosening: This is another rare complication in which the new implants loosen, causing pain. Revision surgery is advisable in such cases.  

What to Expect Before Hip Replacement Surgery?

A hip replacement surgery is a big event in a patient's life. It would help if you are mentally prepared before undergoing the surgery. A positive mindset and complete trust in the surgeon are necessary for successful outcomes. 

Before your hip replacement surgery, you will have a prior consultation with the treating surgeon. A few things you can expect during initial consultations are –

• The surgeon will ask about your past medical and family history. They will also require information regarding your medications (if any).
• They will do a physical examination, examining your hip, the joint's range of motion, and the muscles' strengths.
• A few blood tests and X-rays will be done to know the hip's condition.

By taking a few steps, you can have excellent post-surgery results. These actions include – 

• Quit smoking or at least cut back. The use of tobacco products interferes with the healing process.
• Doing the exercises the doctor advises will help strengthen muscles before the surgery.
• Loose weight if you are obese. Follow the doctor's advice to do so.
• Ask the operating team for special arrangements to be made at home, such as raised toilet seats and grab handles in the bathroom.
• You might need to stop some medications, such as blood thinners, a few days/weeks before the surgery. The doctor will tell you the exact way to do so. 
• Arrange for blood transfusions in advance as there are chances of blood loss during the surgery.

How is Hip Replacement Surgery Done?

• The first step involves giving general anesthesia so that you go into deep sleep. An anesthesiologist will be present throughout the surgery to make sure you do not feel any pain during the procedure.
• The next step is cleaning the incision site and making a cut. The size of the cut depends on the surgical technique the surgeon chooses for you. The surgeon will then move the muscles and soft tissues aside to access the hip joint.
• The surgeon will cut the upper part of the femur bone and remove the ball. A metal stem will be inserted in the thigh bone.
• Next, the surgeon will remove the diseased bone and cartilage from the hip bone and implant the replacement socket. The new prosthetic ball at the femur is then inserted into the socket.
• The final step involves stitching back the major muscles and closing the incision with sutures or staples.

What Happens After a Hip Replacement?

• You will stay at the hospital for a few days post-surgery. You will be under the surgeon’s supervision to check how well you are recovering from the hip replacement surgery.
• You will notice a remarkable reduction in pain immediately after the surgery. Experiencing surgical pain is natural and will be resolved within a few weeks. Anti-inflammatory medications and pain medications will help manage surgical pain.
• Antibiotics will be prescribed to prevent infections, and stockings will prevent deep vein thrombosis (blood clot formation in the lower limbs).
• Physical therapists will help you strengthen your muscles and improve your range of motion post-surgery.
• By diligently following the advice of the physical therapists and surgeon, you can recover quickly and safely.
• Within 6 to 12 weeks, you will have no restrictions in movement, and after 3 months, you can go back to doing all your everyday tasks. Complete recovery from hip replacement surgery can take 6 to 12 months.
• Avoid high-impact activities like basketball or running, as they put stress on the artificial joint. However, you can take part in lower-impact activities such as golfing, swimming, and bicycle riding.

What’s the Latest in Hip Replacement Surgery?

Continuous research and development is going on in the field of orthopedics. The recent advancements in hip replacement surgery are – 

• Minimally Invasive Hip Replacement Surgery (MIHR): Traditional hip replacement surgery involves making a 10-15-inch incision. This damaged the surrounding muscles, making the recovery period longer. But now, specialized surgeons use a minimally invasive technique in which an incision of only 4-6 inches is made. This technique has reduced the chances of postoperative complications. The recovery after the surgery is quick as less damage is done to the muscles and surrounding tissues. 
• Robotic and Computer-Assisted Hip Replacement Surgery: Advanced orthopedic hospitals are equipped with the newest technologies, including robotic systems, to perform joint replacement surgery. Robotic surgery does not mean a robot performs the surgery without the requirement of a surgeon. In contrast, the orthopedic surgeon uses robotic arms to perform the joint replacement procedure. It helps in improving the precision of cuts and implant placement. By using computerized techniques, the surgeon can plan the surgery in advance by creating a 3D model similar to the patient’s hip joint, which will be replaced. 
• Hip Resurfacing: Hip resurfacing can be a potential alternative to total hip replacement surgery. It is advisable for younger patients who might require multiple replacement surgeries. The procedure involves fitting a hollow cap over the head of the femur rather than completely removing the head and replacing it with a prosthetic. Researchers are trying to use ceramic materials instead of metal ones to improve the surgery outcomes. 
• Mini Hip Replacement: A bone-conserving hip replacement is available through clinical trials, as it is still under research. In a mini hip replacement, the stem of the ball is shorter, and the surgeon removes less bone during the surgery. Since less bone and tissues are affected during a mini hip, the recovery time is quick. However, the long-term benefits of the surgery are still being studied. 

Key Takeaway

Hip replacement surgery addresses hip pain and stiffness for people with avascular necrosis, arthritis, trauma, or other forms of hip joint damage. An orthopedic surgeon will replace the damaged hip joint with a prosthesis (artificial joints) during the surgery. Various surgical approaches exist to hip replacement surgery, including minimally invasive and robot-assisted options that may be appropriate for you. Following the doctor’s advice is necessary for a quick recovery. It will help you return to everyday activities with fewer complications and less pain.