Hip pain results from damage to the hip joint, either through injury, osteoarthritis or rheumatoid arthritis. There are a variety of treatment options available, ranging from rehabilitation to total hip replacement surgery.
Hip replacement has become an increasingly common and successful procedure, with 95 to 97 percent of new hip joints lasting over 20 years. Hip replacements make it possible for patients to engage light activities without pain, such as walking, doubles tennis and golf.
The Anatomy of a Healthy Hip
The hip is one of the largest weight-bearing joints in the body. When it's working properly, it lets you walk, sit, bend, and turn without pain. To keep it moving smoothly, a complex network of bones, cartilage, muscles, ligaments, and tendons must all work in harmony.
The hip joint forms where the top of the thighbone (femur) meets the socket of the pelvic bone. The top of the femur is ball-shaped and fits snugly in the socket.
The bones of the hip joint are covered by cartilage that protects the bones while allowing easy motion. Surrounding the hip joint is the synovial lining, which produces a lubricant.
Tough fibers, called ligaments, connect the bones of the joint and hold them in place, while adding strength and elasticity for movement. Muscles and tendons also play an important role in keeping the hip joint stable.
A layer of smooth tissue called cartilage cushions the surface of the bones, helping the ball to rotate easily in the socket. Fluid-filled sacs (bursae) cushion the area where muscles or tendons glide across bone. The capsule surrounding the joint also has a lining (synovium) that secretes a clear liquid called synovial fluid. This fluid lubricates the joint, further reducing friction and making movement easier.
What is a Hip Replacement?
In a healthy hip joint, the surfaces of the bones where the ball and socket rub together are very smooth and covered with a tough protective tissue called cartilage. Arthritis causes damage to the bone surfaces and cartilage. These damaged surfaces eventually become painful as they wear.
In a total hip replacement surgery, the painful parts of the damaged hip are replaced with artificial hip parts called a prosthesis, a device that substitutes or supplements a joint. The prosthesis consists of steel components: a socket, ball, and stem. The outer shell of the socket is usually made of metal and the inner shell consists of plastic, or the entire socket may be plastic. When the metal ball is joined with the socket, the new hip can allow for smooth, nearly frictionless movement.
Anterior Hip Replacement
Anterior hip replacement is getting patients back on their feet sooner than traditional hip replacement surgery.† While the long term results are similar to a traditional hip replacement surgery, this approach is minimally invasive. An incision is made in the front of the hip, and in turn, fewer muscles are cut and disturbed. This provides the potential for less pain, faster recovery and improved mobility.
Anterior hip replacement developed out of a need for quicker recovery times and has become very attractive for more active patients. This approach has the potential for fewer restrictions during recovery. Patients are often more freely able to bend their hip and bear weight soon after surgery.
Hear Robert Lenahan, anterior hip replacement patient, and Dr. Kurt Morrison, Orthopedic Surgeon, discuss the surgery in this video:
Frequently Asked Questions
How long is too long to wait for total hip replacement?
Early diagnosis and treatment of osteoarthritis are important for your long-term mobility. In fact, having hip replacement surgery earlier in the course of the disease may be linked with better outcomes. If your doctor has recommended that you undergo a knee replacement, donít delay. Delaying surgery can lower your quality of life, both before and after surgery.
Am I going to have much pain after surgery?
Many patients find that the pain after traditional surgery is tolerable, treatable, and subsides gradually over a few months. Sacred Heart has a variety of options to manage pain and keep patients comfortable after surgery, such as numbing injections, IV pain medication, patient-controlled anesthesia, injections, pain pills and anti-inflammatory medications.
While most patients find that pain after anterior hip replacement is also tolerable and treatable, it usually subsides more quickly than pain associated traditional hip replacement surgery.
How long will I be in the hospital?
The typical hospital stay after traditional hip replacement surgery†is†one to three†days.
What kind of anesthesia will I have?
There are two common types of anesthesia used during hip replacement surgery: general anesthesia where the patient is put to sleep, and regional anesthesia, where the patient is numbed below the waist, typically with an epidural. Which type of anesthesia you will receive depends on your situation as the patient, as well as your surgeon's and anesthesiologist's recommendations. Please speak with your surgeon or anesthesiologist if you have any concerns regarding the anesthesia that will be used during surgery.
How soon can I return to normal activities after surgery?
Within six weeks after traditional hip replacement surgery, most patients are able to walk with a cane. You will probably feel well enough to drive a car within seven to eight weeks after surgery. Anterior hip replacement surgery usually results in a much quicker return to normal activities. Some patients are able to walk unassisted within two weeks.
In most cases, successful joint replacement surgery will relieve your pain and stiffness, and will allow you to resume many of your normal daily activities. But even after you have fully recovered from your surgery, you will still have some restrictions, including refraining from contact sports or activities that put excessive strain on your joints.
Will an implant set off a metal detector?
Since knee implants are made of metal, there is a chance they could set off metal detectors.† After your surgery, you will be provided with a special card to keep in your wallet explaining that you have a knee implant.
How long will the implant last?
The life of a knee joint implant is unique to each patient, depending on your physical condition, activity level, and weight, as well as the accuracy of implant placement during surgery. It is useful to keep in mind that prosthetic joints are not as strong or durable as a natural, healthy joint, and there is no guarantee that a prosthetic joint will last the rest of a patient's life. Most hip joints will last over 20 years.