Specialty:
Knee & Hip Replacement Surgeries, Joint Surgery
Hip Replacement Surgery
Total Hip Arthroplasty (THA), or Total Hip Replacement (THR), is a surgical procedure used to replace a damaged hip joint due to severe osteoarthritis or injury. It has been in practice for around 70 years, and with the advancements in surgical techniques and materials, it has become a more modern procedure with better results.
In Which Diseases is Total Hip Replacement Used?
THA is usually performed after middle age, but there is no upper age limit. It is a pain-relieving procedure with excellent outcomes, particularly for those with osteoarthritis or blood supply problems of the femoral head (developmental hip dysplasia or avascular necrosis). THA is also recommended for the following groups of people:
- Those with childhood disease sequelae such as calcification, hip dislocation, and growth plate slippage
- Patients with rheumatic diseases or inflammation sequelae
- Those with tumors, advanced age hip fractures, and bone necrosis due to blood supply problems
How is Hip Replacement Surgery Performed?
The following are the steps involved in hip replacement surgery:
- Pre-operative blood tests are taken, and an anesthesiologist is consulted if there are no active infections like urinary tract, throat, or dental infections.
- The patient is admitted to the hospital one day before the operation or on the day of the surgery.
- Diabetes and blood pressure diseases are not a contraindication for this surgery, but they must be under control.
- Smoking is not recommended, as it increases the risk of infection.
- The operation can be performed under general anesthesia or with a local anesthetic agent.
- A 10-20 cm incision is made from the hip based on the surgeon’s preference.
- After removing the damaged bones, the surgeon replaces them with prostheses, sutures the capsule, muscle, fascia, subcutaneous tissues, and skin.
- The patient is then moved to the ward after the operation.
- After an average of 4-6 hours, patients are allowed to eat normally.
- Patients are assisted to walk immediately after the operation or the following day, using a walker and compression stockings.
- Wound dressing is done once every two days.
Is Hip Replacement Surgery for You?
Hip replacement surgery is considered when:
- Pain and stiffness limit everyday activities such as walking or bending.
- Hip pain continues while resting, either day or night.
- Stiffness in the hip limits the ability to move or lift the leg.
- Non-surgical treatments like medications, physical therapy, or walking supports are no longer helpful.
When Surgery Is Recommended?
Surgery is typically recommended when:
- The hip joint is severely damaged by arthritis, injury, or other conditions.
- The patient experiences chronic pain that affects their quality of life.
- There’s significant loss of function and mobility.
Candidates for Surgery
Ideal candidates for hip replacement surgery are:
- Individuals with chronic hip pain and stiffness that affects daily living.
- Those who have not found relief from pain medications, physical therapy, or walking supports.
- Individuals in good health without conditions that could interfere with surgery or recovery.
Risks
Some potential risks of hip replacement surgery include:
- Infection at the surgical site.
- Blood clots in the leg vein or lungs.
- Hip dislocation.
- Fracture of the bone during surgery.
- Differences in leg length.
- Wear and loosening of the implant over time.
However, thanks to advanced robotic hip replacement surgery, these risks can be significantly reduced.
What are the different types of hip replacement surgery?
Total Hip Replacement (THR): The damaged bone and cartilage are removed and replaced with prosthetic components.
Partial Hip Replacement: Only the head of the femur is replaced with a prosthetic implant, and the hip socket remains intact.Hip Resurfacing: Instead of removing the head of the femur, it’s trimmed and capped with a smooth metal covering. The damaged bone and cartilage within the socket are removed and replaced with a metal shell.
Frequently Asked Questions about Hip Replacement Surgery
Severe pain, which is initially felt while walking, is the most common symptom of patients who need hip replacement surgery. The pain gradually occurs at rest and even at night while sleeping. Other common symptoms include limited mobility, limping, and short legs.
While non-operative treatments such as medication, physical therapy, or intra-articular injections like PRP or stem cells may provide relief for some patients, delaying surgery can cause the healthy knees, other hip, waist, and back regions to suffer from serious calcification and deterioration. When these areas are overloaded, there is an increased risk of them requiring surgery in the future.
Stem cell therapy cannot replace the need for hip replacement surgery in patients who require a definitive hip replacement. However, it can be applied in selected cases by discussing the treatment’s objective results with the patient.
There is no upper age limit for hip replacement surgery, although it is mainly performed after middle age. The procedure is indicated for those who have completed bone development or are about to complete it.
Individuals with dementia, mental illness, active hip infection, advanced artery or vein failure, and muscle paralysis due to neurological diseases around the hips are not suitable candidates for this surgery.
Recovery after hip replacement surgery
The recovery time after hip replacement surgery varies depending on the individual patient and the type of surgery performed. Generally, patients can expect to stay in the hospital for 4-5 days after surgery. During this time, physical therapy sessions will begin to help the patient regain strength and mobility.
After leaving the hospital, patients will need to continue physical therapy and exercise regularly to maintain their hip’s strength and flexibility. Full recovery can take several weeks or months, and patients may need to avoid certain activities or movements during this time.
It is also important for patients to follow their surgeon’s post-operative instructions carefully, including taking any prescribed medications and attending follow-up appointments to monitor their progress.
Benefits of Hip Replacement
Hip replacement surgery offers many benefits to patients who suffer from severe hip pain and limited mobility. Some of the main benefits of hip replacement surgery include:
Reduced pain: Hip replacement surgery can significantly reduce or eliminate the chronic pain and discomfort associated with a damaged hip joint.
Improved mobility: The new artificial joint can restore mobility and range of motion, allowing patients to move more freely and perform daily activities with ease.
Better quality of life: Hip replacement surgery can improve the overall quality of life for patients by reducing pain and improving mobility, which can lead to a more active and fulfilling lifestyle.
Risks and complications of hip replacement surgery
As with any surgical procedure, there are risks and complications associated with hip replacement surgery. These can include:
- Infection
- Blood clots
- Dislocation of the new joint
- Nerve or blood vessel damage
- Implant failure or loosening
- Allergic reaction to anesthesia or the implant materials
Fortunately, the risk of these complications is low, and most patients have a successful outcome from their hip replacement surgery.
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Olcay Güler, MD, Prof.
Orthopaedics and Traumatology
Specialty:
Knee & Hip Replacement Surgeries, Joint Surgery
Mehmet Halis Çerçi – MD.
Orthopaedics and Traumatology
Specialty
Knee & Hip Replacement Surgeries, Arthroscopic Surgery