Total hip replacement (THR) is a surgical procedure in which the damaged cartilage and bone is removed from the hip joint and replaced with artificial components. The hip joint is one of the body’s largest weight-bearing joints, located between the thigh bone (femur) and the pelvis (acetabulum). It is a ball and socket joint in which the head of the femur is the ball and the pelvic acetabulum forms the socket. The joint surface is covered by smooth articular cartilage which acts as a cushion and enables smooth movements of the joint.
A number of diseases and conditions can cause damage to the articular cartilage. Total hip replacement surgery is an option to relieve severe arthritis pain that limits your daily activities.
Disease Overview
Arthritis is inflammation of the joints resulting in pain, swelling, stiffness and limited movement. Hip arthritis is a common cause of chronic hip pain and disability. The three most common types of arthritis that affect the hip are:Total hip replacement (THR) is a surgical procedure in which the damaged cartilage and bone is removed from the hip joint and replaced with artificial components. The hip joint is one of the body’s largest weight-bearing joints, located between the thigh bone (femur) and the pelvis (acetabulum). It is a ball and socket joint in which the head of the femur is the ball and the pelvic acetabulum forms the socket. The joint surface is covered by smooth articular cartilage which acts as a cushion and enables smooth movements of the joint.
A number of diseases and conditions can cause damage to the articular cartilage. Total hip replacement surgery is an option to relieve severe arthritis pain that limits your daily activities.
Disease Overview
Arthritis is inflammation of the joints resulting in pain, swelling, stiffness and limited movement. Hip arthritis is a common cause of chronic hip pain and disability. The three most common types of arthritis that affect the hip are:
- Osteoarthritis: It is characterized by progressive wearing away of the cartilage of the joint. As the protective cartilage wears down, the bone ends rub against each other and cause pain in the hip. Rheumatoid arthritis: This is an autoimmune disease in which the tissue lining the joint (synovium) becomes inflamed, resulting in the production of excessive joint fluid (synovial fluid). This leads to loss of cartilage causing pain and stiffness.
- Traumatic arthritis: This is a type of arthritis resulting from a hip injury or fracture. Such injuries can damage the cartilage and cause hip pain and stiffness over a period of time.
The most common symptom of hip arthritis is joint pain and stiffness resulting in limited range of motion. Vigorous activity can increase the pain and stiffness which may cause limping while walking.
Diagnosis
Diagnosis is made by evaluating medical history, physical examination and X-rays.
Surgical Procedure
Surgery may be recommended, if conservative treatment options such as anti-inflammatory medications and physical therapy do not relieve the symptoms.
The surgery is performed under general anesthesia. During the procedure a surgical cut is made over the hip to expose the hip joint and the femur is dislocated from the acetabulum. The surface of the socket is cleaned and the damaged or arthritic bone is removed using a reamer. The acetabular component is inserted into the socket using screws or occasionally bone cement. A liner made of plastic, ceramic or metal is placed inside the acetabular component. The femur or thigh bone is then prepared by removing the arthritic bone using special instruments, to exactly fit the new metal femoral component. The femoral component is then inserted to the femur either by a press fit or using bone cement. Then the femoral head component made of metal or ceramic is placed on the femoral stem. All the new parts are secured in place using special cement. The muscles and tendons around the new joint are repaired and the incision is closed.
Advantages of posterior approach in Hip Replacement
The potential advantages of minimally invasive Posterior approach for total hip replacement as compared with traditional total hip replacement Approaches may include:
- Early mobilization 24 hrs after the surgery with no gait alteration or limping
- Smaller incisions
- Shorter hospital stay
- Less Violation of the hip muscles
- Quicker recovery
- Faster rehabilitation
- Minimal post-operative pain
Post-operative care
Most patients need 2-5 nights in hospital. The incisions take 14 days to heal.
Most patients improve dramatically in the first 6 weeks. Occasionally, there are periods where the hip may become sore and then settle again. This is part of the normal healing process.
It takes three months for your hip to fully recover from hip replacement. Continued improvements may be gained up to 1 year post-surgery.
After undergoing total hip replacement, you must take special care to prevent the new joint from dislocating and to ensure proper healing. Some of the common precautions to be taken include:
- Avoid combined movement of bending your hip and turning your foot inwards
- Keep a pillow between your legs while sleeping for 6 weeks
- Never cross your legs and bend your hips past a right angle (90)
- Avoid sitting on low chairs
- Avoid bending down to pick up things, instead a grabber can be used to do so
- Use an elevated toilet seat
Return To Work After Hip Replacement Surgery
Return to work will vary depending on the procedure performed and type of work you are engaged in. Most people can return to office work within 2-3 weeks. Labour intensive work however, may require you to take 5-6 weeks before returning to full duties.
During these period patients are not fit to perform work duties that involve:
- Prolonged standing,
- Heavy lifting,
- Bending or
- Excessive stair climbing
Return To Sport
Low impact activities, such as cycling and swimming, can be commenced from week 4. High impact activities, such as running and jumping, are best avoided for 8-12 weeks post-surgery.
Total hip replacement is one of the most successful orthopaedic procedures performed for patients with hip arthritis. This procedure can relieve pain, restore function, improve your movements at work and play, and provide you with a better quality of life.
Video
Hip Replacement Surgery
Cases ( Before and After )
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