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Total Hip Replacement
Total hip replacement 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 a 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, and 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.
Symptoms
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.
Post-operative care
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
Risks
As with any major surgical procedure, there are certain potential risks and complications involved with total hip replacement surgery. The possible complications after total hip replacement include:
- Infection
- Dislocation
- Fracture of the femur or pelvis
- Injury to nerves or blood vessels
- Formation of blood clots in the leg veins
- Leg length inequality
- Hip prosthesis may wear out
- Failure to relieve pain
- Scar formation
- Pressure sores
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.
Total Hip Replacement
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I would like to thank Dr. Toman and his staff for the excellent service I received before and after my rotator cuff surgery. It has been six months since the surgery and I am able to do everything I did before the injury and with no pain.
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As a retired state trooper, and active sports official, I was experiencing severe pain in my shoulder joint that was interrupting my sleep and causing major discomfort. On the recommendation of another doctor I was seeing, I set up a consultation with Dr. Toman. It was agreed that a total shoulder replacement was necessary due […]
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Dr.Charles Toman replaced my left knee in October of 2010. In 5 days I was walking, doing my outpatient rehabilitation and exercising. My 90 year old Aunt also had her knee replaced and she was walking, after just one week, to my house (which is about a block away) I can’t thank Doctor Toman enough, […]
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Dr. Toman did a complete knee replacement on me in November of 2010. I was only in the hospital 3 days and at the end of 2 weeks I was in out patient therapy. Dr. Toman’s outstanding skill as a surgeon and advance technology had me up and moving well within 6 weeks. His professional […]
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On Feb. 8, 2011 Dr. Toman performed a right total shoulder replacement and muscle re-attachment on me. I was 70/1/2 at the time. His skill was obvious by my recovery time. Ten weeks after surgery I was released from physical therapy. After my surgery Dr. Toman took my wife and son from the waiting room […]
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It is one of the best decisions I have made. My shoulder was bothering me to the point that I had trouble sleeping and raising my arm. My wife kept after me to see a doctor. From my first visit with D.Toman, I knew that I had made the correct decision. He lets you know […]
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Dr. Toman replaced my left shoulder at Fawcett Memorial Hospital at the beginning of April. I highly recommend Dr. Toman. There has been no pain throughout the procedure and my recovery. Home health care was arranged including physical therapy. Outpatient PT was started after 4 weeks and will be continued during my stay up north. […]
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