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(Hip Arthroplasty; Total Hip Replacement; Minimally Invasive Total Hip Replacement; Mini-incision Hip Replacement)

Definition

A total hip replacement is surgery to replace a diseased or injured hip joint. An artificial ball-and-socket joint is inserted to make a new hip.

Left Total Hip Replacement
Hip Replacement
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Reasons for Procedure

This surgery is done on people who are not helped by other methods. It is also done when the pain and stiffness limit normal activities.

It may also be done to treat a broken hip, severe arthritis, bone tumors, and loss of blood supply to the bones of the hip.

Possible Complications

Problems are rare, but all procedures have some risk. The doctor will go over some problems that could happen, such as:

  • Excess bleeding
  • Problems from anesthesia, such as wheezing or sore throat
  • Infection
  • Blood clots
  • Hip dislocation —happens when the ball portion of the artificial joint comes out of its normal position in the hip
  • Injury to nearby nerves or blood vessels
  • Noisy or squeaky hip after surgery

Things that may raise the risk of problems are:

What to Expect

Prior to Procedure

The surgical team may meet with you to talk about:

  • Anesthesia options
  • Any allergies you may have
  • Current medicines, herbs, and supplements that you take and whether you need to stop taking them before surgery
  • Fasting before surgery, such as avoiding food or drink after midnight the night before
  • Arranging a ride to and from surgery
  • Tests that will need to be done before surgery

Anesthesia

The doctor may give:

Description of the Procedure

This can be done using open surgery or using a minimally invasive technique.

Open Surgery

An incision will be made along the joint. The muscles will be moved aside. The damaged bone and cartilage of the hip joint will be removed. The remaining bone will be prepared for the artificial joint. The artificial joint will be put in place. Bone cement may be used to hold one or both parts of the artificial hip to the bone. The incision will be closed with stitches or staples.

Minimally Invasive Technique

A few small incisions will be made. Tools will be passed through these incisions. Images may be taken to help guide surgery. The muscles will be moved aside. The damaged bone and cartilage of the hip joint will be removed. The remaining bone will be prepared for the artificial joint. The artificial joint will be put in place. Bone cement may be used to hold one or both parts of the artificial hip to the bone. The incision will be closed with stitches or staples.

How Long Will It Take?

  • Total hip replacement: 1 to 1.5 hours
  • Minimally invasive total hip replacement: 1 or more hours

Will It Hurt?

Pain and swelling are common in the first few weeks. Medicine and home care can manage pain.

Average Hospital Stay

The usual length of stay is 1 to 3 days. If you have problems, you may need to stay longer.

Post-procedure Care

At the Hospital

After the procedure, the staff may:

  • Give you pain medicine or medicine to prevent blood clots
  • Put compression boots or stockings on your legs
  • Ask you to get up and walk using a walker

During your stay, staff will take steps to lower your chance of infection, such as:

  • Washing their hands
  • Wearing gloves or masks
  • Keeping your incisions covered

You can also lower your chance of infection by:

  • Washing your hands often and reminding visitors and staff to do the same
  • Reminding staff to wear gloves or masks
  • Not letting others touch your incisions
At Home

Physical activity will be limited during recovery. You may need to ask for help with daily activities and delay your return to work for a few weeks. It will take about 6 weeks before you can begin light activities.

Call Your Doctor

Call your doctor if you are not getting better or you have:

  • Cough, shortness of breath, chest pain
  • Redness, swelling, more pain, a lot of bleeding, or leaking from the incision
  • Signs of infection, such as fever and chills
  • Severe nausea or vomiting
  • Pain or swelling in the feet, calves, or legs
  • Pain that you cannot control with medicine
  • Numbness, tingling, or loss of feeling in your leg, knee, or foot

If you think you have an emergency, call for medical help right away.

RESOURCES

American Academy of Physical Medicine and Rehabilitation  http://www.aapmr.org 

National Institute of Arthritis and Musculoskeletal and Skin Diseases  http://www.niams.nih.gov 

CANADIAN RESOURCES

The Arthritis Society  http://www.arthritis.ca 

Canadian Orthopaedic Association  http://www.coa-aco.org 

References

Elective total hip arthroplasty. EBSCO DynaMed website. Available at:  https://www.dynamed.com/procedure/elective-total-hip-arthroplasty#MANAGEMENT . Updated May 5, 2020. Accessed July 15, 2020.

Minimally invasive total hip replacement surgery. Ortho Info—American Academy of Orthopaedic Surgeons website. Available at: http://orthoinfo.aaos.org/topic.cfm?topic=A00404. Updated June 2014. Accessed July 15, 2020.

Ninomiya JT, Dean JC, et al. What's New in Hip Replacement. J Bone Joint Surg Am. 2015 Sep 16;97(18):1543-1551.

6/14/2017 DynaMed Plus Systematic Literature Surveillance  https://www.dynamed.com/topics/dmp~AN~T566765/Elective-total-hip-arthroplasty  : Wilson SH, Wolf BJ, et al. Comparison of lumbar epidurals and lumbar plexus nerve blocks for analgesia following primary total hip arthroplasty: a retrospective analysis. J Arthroplasty. 2017;32(2):635-640.

Revision Information