Overview
Hip replacement, also called total hip replacement, is a surgical procedure in which damaged parts of the hip joint are replaced with artificial parts (prosthesis). The goals of total hip replacement are to relieve pain, improve function of the hip joint, and increase mobility.
The hip joint is one of the largest weight-bearing joints in the body. It is a ball-and-socket joint in which the thighbone (femur) fits into a rounded socket (acetabulum) in the pelvis. The top of the thighbone (femoral head) is connected to the socket with bands of connective tissue (ligaments), which help to make the hip joint stable. A thin layer of smooth, elastic tissue (articular cartilage) cushions the ends of the bones within the hip joint.
The most common cause for hip damage is osteoarthritis . Other conditions that can damage the hip joint include the following:
- Bone tumor
- Injury
- Osteonecrosis (death of bone tissue caused by inadequate blood supply to the bone)
- Rheumatoid arthritis
Damage to the hip joint can cause pain and interfere with daily life. Treatment may include physical therapy , exercises to strengthen the muscles surrounding the hip joint, walking aids (e.g., canes, walkers), and medications (e.g., acetaminophen, nonsteroidal anti-inflammatory drugs [NSAIDs]). In some cases, stronger medications, topical pain relievers (analgesics), corticosteroids (e.g., prednisone, cortisone), and joint lubricants may be used.
When these treatment methods are ineffective, a procedure called an osteotomy may be performed. In an osteotomy, bones in the hip are realigned to shift pressure and weight to a healthy bone surface. If hip function worsens and pain continues, total hip replacement may be necessary.
Surgical Procedure
Total hip replacement can be performed using traditional surgery or a minimally invasive method. The procedure, which usually takes a few hours, may be performed under general or regional anesthesia. Sedation may also be given before the patient is taken into the operating room.
General anesthesia, which renders the patient completely unconscious, is given intravenously or inhaled through a breathing mask. Once the anesthesia has taken effect, patients need assistance breathing (e.g. oral airway, endotracheal tube). Regional anesthesia (e.g., spinal, epidural) may be used to numb the hip area. Some patients feel pressure or tugging during surgery when regional anesthesia is used.
Patients are closely monitored by the anesthesiologist throughout the surgery. Heart rate, blood pressure, and blood oxygen levels are continuously recorded. The amount of anesthesia received is carefully controlled and adjusted for the duration of the hip replacement surgery.
In traditional open surgery, an incision (usually 6 to 8 inches in length) is made in the hip and the damaged tissue is removed and replaced with artificial parts (prosthesis). The healthy portions of the hip joint are left i...
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