Talking with Your Doctor About Hip Replacement
A hip replacement removes a diseased or damaged hip joint and replaces it with an artificial joint. The goal of the surgery is restore full function of the hip and eliminate chronic pain. If you are considering this surgery, prepare for hip replacement by talking with your doctor. If you aren’t sure what to ask before hip replacement surgery, here are some frequently asked hip replacement questions.
Your doctor will want to know how your hip problems are affecting your life and activities. When pain and stiffness limit your activities, it may be time for a hip replacement. It may also be the right option if your pain happens even at rest or makes sleep difficult. Eventually, this kind of pain can reduce your quality of life. Before recommending a hip replacement, your doctor will want to exhaust other treatment options. This includes medication and physical therapy treatments.
Traditional hip replacement surgery involves a large (10- to 12-inch) incision. Newer, minimally invasive techniques allow doctors to use smaller incisions. One approach uses a 3- to 6-inch incision on the outer hip. Another uses two incisions: a 2- to 3-inch incision in the groin and a 1- to 2-inch one in the buttock. This is an anterior approach to hip replacement. The doctor uses special surgical instruments to prepare and implant the new hip. This does not affect the type of implant your doctor can use. The implants are the same as with traditional surgery.
There are several advantages to minimally invasive surgery. It probably won’t shorten your hospital stay. But you will likely recover quicker and have less pain than traditional open hip replacement surgery. So this is an important question to ask.
In general, candidates for minimally invasive hip replacement are young, healthy, and relatively thin. You also have to be very motivated to complete rehabilitation—or rehab. People who are overweight or very muscular are probably not ideal candidates. It’s also not the best choice for people who have already had hip surgery, have hip deformities, or have medical problems that interfere with healing.
There are basically two types of hip replacement—total hip replacement and hip resurfacing. Total hip replacement removes the entire joint. The hip joint is a ball and socket joint. In a total hip replacement, doctors remove both the ball, or head of the thigh bone (femur) and the socket in the pelvic bone.
Hip resurfacing is basically a partial hip replacement. It does not remove the ball of the femur. Instead, it trims the bone and caps it with a metal covering. It also places a metal shell in the socket after cleaning out damaged cartilage and bone.
Hip resurfacing has several advantages including a more normal walking pattern and a decreased risk of hip dislocation. This type of hip replacement is also easier to revise should future problems occur. But there is a small risk of fracturing the top of the thigh bone. Should this happen, it would require a total hip replacement.
In general, candidates for hip resurfacing are younger than 60 and have a strong, healthy thigh bone. This usually means people with larger frames, especially men, are good candidates. Women, older people, and people with smaller frames may not have strong enough bones for this option.
Most hip replacements are successful and heal without complications. However, there are potential risks with any surgery. This includes bleeding, infection, and blood clots. With hip replacement, it is also possible to end up with uneven leg lengths, persistent hip pain, or hip dislocation.
The good news is there are strategies for preventing these complications. Your doctor may prescribe a blood thinner for several weeks after surgery to prevent blood clots. Your care team will also teach you how to protect your hip during recovery. This may include not crossing your legs, sleeping with a pillow between your legs, and not bending your hip past 90 degrees. Ask your doctor about other ways to safeguard your new hip joint.
After any type of hip replacement, you will spend time in an acute post-surgical rehab facility where you will receive skilled nursing care. In general, your stay will last from 1 to 4 days. You will need the assistance of a walker, cane or crutches until you are steady on your feet. Everyone progresses differently, so this may last a few days or a few weeks.
Your recovery will involve rehab with physical therapy, which can last for several weeks. Physical therapy is the key to regaining pain-free mobility and hip function. Sometimes, people need a short stay in a rehab center before they can safely live at home.
Most people can return to a normal daily routine in 6 to 7 weeks. Full recovery and return to physical activities can take 5 to 6 months or little longer.
Hip implants are mechanical and will wear out or loosen over time. This means you will likely need another surgery at some point. But today’s hip implants typically last 15 to 20 years. Like anything mechanical, there are steps you can take to prolong the life of your hip implant. This includes:
Getting regular exercise to keep supporting and stabilizing muscles strong
Maintaining a healthy weight. The implant is more likely to fail in people who are overweight.
Taking care to avoid trips and falls