During hip replacement surgery, a surgeon removes the damaged parts of the hip joint and replaces them with parts made of metal, ceramic, or very hard plastic. This artificial joint (prosthesis) aids in the reduction of pain and improvement of function. 

Hip replacement surgery, also known as total hip arthroplasty, may be an option if hip discomfort interferes with everyday activities and nonsurgical therapies haven't helped or are no longer effective. The most prevalent reason for hip replacement is arthritis deterioration.

Why is it done? 

Conditions that might harm the hip joint and necessitate hip replacement surgery include: 

Osteoarthritis: Osteoarthritis, also known as wear-and-tear arthritis, is a condition that causes damage to the slippery cartilage that covers the ends of bones and allows joints to move smoothly. 

Arthritis rheumatoid: Rheumatoid arthritis, which is caused by an overactive immune system, causes a kind of inflammation that can destroy cartilage and occasionally underlying bone, resulting in damaged and misshapen joints. 

Osteonecrosis: If there is insufficient blood supply to the ball component of the hip joint, which may occur as a result of a dislocation or fracture, the bone may collapse and distort.

If you are experiencing hip discomfort, hip replacement surgery may be a possibility: 

-> Continues despite pain medication 
-> Impairs walking, even with a cane or walker
-> Disrupts sleep
-> Impairs ability to go up or down stairs
-> Makes it harder to rise from a seated position

Risks 

Hip replacement surgery has the following risks: 

-> Clots of blood form: Clots in the leg veins can occur following surgery. This is risky because a clot fragment can break off and move to the lung, heart, or, in rare cases, the brain. Blood-thinning drugs can help to mitigate this risk. 

-> Infection: Infections can arise at the incision site as well as in the deeper tissue around the replacement hip. Most infections are managed with medicines, but a serious infection around the replacement hip may necessitate surgery to remove and replace the artificial components.

-> Fracture: Healthy parts of the hip joint may fracture during surgery. Small fractures may heal on their own, but bigger fractures may require stabilization with wires, screws, and maybe a metal plate or bone transplants. 

-> Dislocation: Certain situations, especially in the first few months following surgery, might cause the ball of the replacement joint to come out of the socket. If the hip dislocates, a brace can assist hold the hip in place. If the hip continues to dislocate, surgery may be required to stabilize it.

-> Leg length variation: Surgeons take precautions to avoid the issue, but sometimes a replacement hip causes one leg to be longer or shorter than the other. A contracture of the muscles around the hip can sometimes cause this. In some circumstances, gradually strengthening and extending certain muscles may be beneficial. Small variations in leg length are generally undetectable after a few months. 

-> Loosening: Although this issue is uncommon with modern implants, the new joint may not become securely attached to the bone or may loosen over time, producing hip discomfort. Surgery may be required to correct the condition. 

-> Damage to the nerves: Nerves in the region where the implant is put are seldom harmed. Numbness, weakness, and discomfort can result from nerve injury.

A second hip replacement may be required. 

The mechanical hip pieces may ultimately wear out, especially in persons who have hip replacement surgery when they are still young and active. If this occurs, you may require a second hip replacement. However, new materials are extending the life of implants.

How do you prepare? 

You will undergo an examination with the orthopedic surgeon before to the procedure. The surgeon could: 

- Request information about your medical history and current drugs. 
- Examine your hip, paying special attention to the joint's range of motion and the strength of the surrounding muscles. 
- Request blood work and an X-ray. An MRI is rarely required. 

Ask any questions you have regarding the surgery at this visit. Find out which drugs you should avoid or continue to take in the week leading up to surgery. 

Tobacco products should be avoided since they can interfere with recovery. Consult your doctor if you need assistance quitting.

What to anticipate ?

When you arrive for your operation, you will be asked to change out of your clothing and into a hospital gown. You'll be given either a spinal block to numb the bottom half of your body or a general anesthetic to put you to sleep. 

To assist block pain following surgery, your surgeon may also inject a numbing drug around nerves or in and around the joint.

Throughout the treatment 

The surgical process takes around two hours to complete. In order to execute a hip replacement, the surgeon must: 

- Makes an incision through the layers of tissue around the hip
- Removes sick and damaged bone and cartilage while keeping good bone intact 
- Inserts the new socket into the pelvic bone. 
- Inserts a metal stem into the top of the thighbone, followed by a new ball.

Following the surgery 

After surgery, you'll be transported to a recovery area for a few hours while your anaesthetic wears off. Medical personnel will check your blood pressure, pulse, awareness, pain or comfort level, and medication requirements. 

To assist keep fluid out of your lungs, you will be advised to breathe deeply, cough, or blow into a device. The length of your stay following surgery is determined by your specific needs. Many folks can return home that day.

Preventing blood clots 

You will be at an elevated risk of blood clots in your legs following hip replacement surgery. Possible precautions to avoid this problem include: 

-> Moving ahead of schedule: Soon after surgery, you will be urged to sit up and walk using crutches or a walker. 

-> Putting pressure on: You may be required to wear elastic compression stockings or inflated air sleeves on your lower legs both during and after surgery. Your legs will be squeezed and released by the air sleeves. This prevents blood from accumulating in the leg veins, lowering the likelihood of clot formation.

-> Blood-thinning drugs: Following surgery, your surgeon may prescribe an injectable or oral blood thinner. You may require blood thinners for many weeks following surgery, depending on how quickly you walk, how active you are, and your overall risk of blood clots.

Rehabilitation treatment 

Daily movement and exercise can help you restore joint and muscle function. A physical therapist may advise you on strengthening and mobility exercises, as well as teach you how to utilize a walking device such as a walker, cane, or crutches. You'll progressively increase the amount of weight you put on your leg as therapy advances until you're able to walk without assistance.

Home rehabilitation 

Before you leave the hospital, you and your carers will be given instructions on how to care for your new hip. To ensure a seamless transition: 

-> Have a friend or relative prepare some meals ahead of time
-> Keep everyday items at waist level so you don't have to bend down or reach up
-> Consider getting a raised toilet seat and a shower chair for your at-home recovery
-> Keep your phone, tissues, TV remote, medicine, and books near the area where you'll be spending the majority of your time during recovery

Results 

The time it takes for a person to fully recover after a hip replacement varies, but most individuals are doing well three months following the operation. Improvements usually continue for a year following surgery. 

The replacement hip joint can relieve discomfort and improve hip range of motion. But don't anticipate to be able to accomplish all you could before the hip injury. 

High-impact activities, such as jogging or basketball, may put too much strain on the artificial joint. However, most people may eventually participate in lower-impact sports such as swimming, golfing, and bicycle riding.

By Recmed Medical - Orthopeadics and Traumatology Doctors