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Hip joint replacement - Overview

Alternative Names

Hip arthroplasty; Total hip replacement; Hip hemiarthroplasty

Definition of Hip joint replacement:

Hip joint replacement is surgery to replace all or part of the hip joint with an artificial joint. The artificial joint is called a prosthesis.

Description:

The artificial hip joint has four parts:

  • A socket that replaces your old hip socket. The socket is usually made of metal.
  • The liner, which fits inside the socket. It is usually plastic, but some surgeons are now trying other materials, like ceramic and metal. The liner allows the hip to move smoothly.
  • A metal or ceramic ball that will replace the round head (top) of your thigh bone.
  • A metal stem that is attached to the shaft of the thigh bone to make the joint more stable.

You may receive general anesthesia before this surgery. This means you will be unconscious and unable to feel pain. You may have a spinal or epidural anesthesia. In this kind of anesthesia, medicine is put into your back to make you numb below your waist.

After you receive anesthesia, your surgeon will make a surgical cut to open up your hip joint. Often this cut is over the buttocks. Then your surgeon will:

  • Remove the head of your thigh bone.
  • Clean out your hip socket and remove the remaining cartilage and damaged or arthritic bone.
  • Put the new hip socket in place, then insert the metal stem into your thigh bone.
  • Secure all the new parts in place, sometimes with a special cement.
  • Place a liner and ball that fit your body in the artificial joint.
  • Repair the muscles and tendons around the new joint.
  • Close the surgical cut.

This surgery usually takes 1 to 3 hours.

Why the Procedure Is Performed:

The most common reason to have a hip joint replaced is to relieve severe arthritis pain that is limiting your activities.

Hip joint replacement is usually done in people age 60 and older. Younger people who have a hip replaced may put extra stress on the artificial hip. That extra stress can cause it to wear out. Part or all of the joint may need to be replaced again if that happens.

Your doctor may recommend a hip replacement for these problems:

  • You can't sleep through the night because of hip pain
  • Your hip pain has not gotten better with other treatments
  • Hip pain limits or prevents you from doing your normal activities, such as bathing, preparing meals, doing household chores, and walking

Other reasons for replacing the hip joint are:

  • Fractures in the thigh bone. Older adults often have hip replacement for this reason.
  • Hip joint tumors

Even when you need a hip replacement, some medical problems may lead your doctor to recommend that you not have it done. Some of these problems are:

  • History of infection, which can spread to the replaced joint
  • Morbid obesity (weighing over 300 pounds)
  • Severe mental dysfunction
  • Unhealthy skin around the hip
  • Very weak quadriceps, the muscles in the front of your thigh. Weak quadriceps could make it very hard for you to walk and use your hip.
  • Reviewed last on: 10/31/2010
  • C. Benjamin Ma, MD, Assistant Professor, Chief, Sports Medicine and Shoulder Service, UCSF Dept of Orthopaedic Surgery. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.

References

Eikelboom JW, Karthikeyan G, Fagel N, Hirsh J. American Association of Orthopaedic Surgeons and American College of Chest Physicians guidelines for venous thromboembolism prevention in hip and knee arthroplasty differ: what are the implications for clinicians and patients? Chest. 2009;135:513-520.

Harkess JW. Arthroplasty of the hip. In: Canale ST, Beatty JH, eds. Campbell's Operative Orthopaedics. 11th ed. Philadelphia, Pa: Mosby Elsevier; 2007:chap 7.

Jones CA. Total joint arthroplasties: current concepts of patient outcomes after surgery. Rheum Dis Clin North Am. 2007;33(1):71-86.

St Clair SF. Hip and knee arthroplasty in the geriatric population. Clin Geriatr Med. 2006;22(3): 515-533.

Schmalzried TP. Metal-metal bearing surfaces in hip arthroplasty. Orthopedics. 2009;32.

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