Total hip replacement surgery is usually done when hip pain and loss of function become severe and treatment no longer relieves the pain. Hip replacement is sometimes done after a hip fracture.
How is hip replacement surgery performed?
The surgery can use general anesthesia or regional anesthesia. In traditional hip replacement surgery, an incision is made on the side or back of your hip. Other soft tissues, such as some muscles and ligaments, are cut so the doctor can reach the hip joint. A hip replacement can also be done with one or two small incisions. This is called minimally invasive surgery. It may cause less blood loss and leave a smaller scar. A newer type of surgery is done with a small incision in the front of the hip. Anterior hip surgery causes less muscle and other soft tissue damage than entering the hip joint from the side or from the back. It can help you recover faster and return to activity sooner.
What to expect after surgery?
Immediately after the surgery, your pain will be controlled with medication. You will likely have medications to prevent infection, blood clots, and nausea. If you’ve had regional anesthesia, you may have little or no feeling below your waist for a while.
There may be a cushion between your legs. It helps your new hip stay in the correct position. You may also have a catheter. It allows you to empty your bladder without standing up. You may be wearing compression stockings to help prevent blood clots. Your legs may have compression sleeves. These compress and release your lower legs to help move blood.
You will get out of bed with assistance on the day of surgery or the next day. You will learn to walk with a walker or crutches. When you leave the hospital, you can safely sit and stand, dress yourself, use the toilet, take a bath and use the stairs.
You will begin physiotherapy as soon as possible. You will learn exercises that will help you become stronger. You will also be taught how to move your body without moving your hips.
What should be considered?
Avoid bending at the hips. Keep your shoulders, hips, knees and feet facing forward. Do not bend your hips more than 90 degrees. This means not leaning forward and bending to tie your shoes while sitting. Do not allow your affected leg to cross from the middle of your body to the other leg.
Avoid crossing your legs or feet and be very careful when getting in or out of bed or car. Make sure your leg does not cross the imaginary line in the middle of your body. While lying down, put a pillow between your knees (careful for the first month and a half).
Your doctor will let you know if you can stay in the hospital or go home on the day of surgery. When you get home, you will need someone to help you for the next few weeks or more until you have energy and can move better.
You may need a walker, crutches, or cane for a few weeks. As you regain your energy, try to take short walks a few times each day.
Living with a hip replacement
Exercise (such as swimming and walking) is important for improving your muscle strength. It helps you feel better overall. Discuss with your doctor which type of exercise is best for you. You will likely be able to return to most of the activities you did before the surgery, such as cycling, swimming or dancing. You may be asked to avoid running, playing tennis, and doing other things that put too much stress on the joint.
Surgery usually gives good results. You will likely have much less pain and be able to do most of your daily activities more easily, but recovery takes time and patience.
Most artificial hip joints last 20 years or more. This depends on your age, how much pressure you put on your joint, and how well your new joint and bones heal. Your weight can make a big difference. Every extra kilogram of body weight adds 3 kilograms of stress to your new hip joint. Controlling your weight will help your new hip joint last longer.