In the hip joint there is a layer of smooth cartilage on the ball of the upper end of the thigh bone (femur) and another layer within your hip socket. This cartilage serves as a cushion and allows for smooth motion of the hip. Arthritis is a wearing away of this cartilage. Eventually it wears down and causes pain, discomfort, swelling and stiffness.
A total hip replacement is an operation that removes the arthritic ball of the upper thigh bone as well as damaged cartilage from the hip socket. The ball is replaced with a metal ball (such as cobalt chromium and titanium) that is fixed solidly inside the thigh bone. The socket is replaced with a plastic liner that is usually fixed inside a metal shell. This creates a smoothly functioning joint that does not hurt.
The average hip replacement lasts 10-20 years. If you are overweight, or extremely active, this time may be shortened. A second replacement may be necessary.
The most common reason for failure is loosening of the artificial ball where it is secured in the thigh bone, or loosening of the socket. Wearing of the plastic spacer may also result in the need for revision.
Most surgeries go well without complications. During your hospital stay, pneumonia and urinary tract infections are possibilities. Infections and blood clots in the leg can be serious problems. To avoid these complications, we use antibiotics and blood thinners. Dislocation of the hip after surgery is a risk. Your Southern Joint Replacement Institute orthopaedist and physical therapist will discuss ways to reduce that risk.
Yes. You should discuss preoperative physical therapy/exercise options with your Southern Joint Replacement Institute orthopaedic surgeon. Exercises should begin as soon as possible.
You may need blood after the surgery. You may:
  • Donate your own blood, if possible
  • Use the community blood bank supply
Your surgeon may request that you get out of bed the day of your surgery. The next morning you will get up, sit in a chair and walk with a walker helped by the staff.
Most hip patients will be hospitalized for three to four days after their surgery. This time varies according to an individual’s general health and any complications that may occur. If you need more time for rehabilitation, other options might be available to you. Make arrangements before your surgery to have someone stay with you when you are discharged.
Many individuals lack the appropriate support of a healthy spouse or close family member to allow them to go home immediately from the hospital. For those unable to depend upon family or close friends, an excellent alternative is a skilled nursing facility for one to three weeks. The aim is to regain adequate independence in order to reduce home-care needs to a level which friends or family can easily manage.
We reserve approximately two to two-and-one-half hours for surgery. Some of this time is taken by the operating room staff to prepare for the surgery.
You may have either a general anesthetic or a spinal anesthetic. You can discuss the options with the anesthesiologist to determine which is best.
Total hip replacement causes pain, but sophisticated pain management techniques are available. You will receive pain medications through an epidural catheter injection and you can expect the pain to diminish over time.
Yes. Until your muscle strength returns after surgery, you will need a walker, a cane or crutches. In most cases, the patient will be on a walker the first 2-3 weeks following surgery. You will then transition to a cane as determined by the physical therapist.
After hip replacement surgery, you will need a high toilet seat for about three months. If needed, you will also be taught by the occupational therapist to use adaptive equipment to help you with lower body dressing and bathing. You might also benefit from a bath seat or grab bars in the bathroom. Your home equipment needs will be arranged while you are in the hospital.
Yes. The first several days or weeks, depending on your progress, you will need someone to assist you with meal preparation, housekeeping, etc. Family members or friends need to help. Preparing ahead of time, before your surgery, can minimize the amount of help required. Having the laundry done, house cleaned, yard work completed, clean linens put on the bed and single portion frozen meals will reduce the need for extra help.
Yes. After you go home, you will have therapy at the Southern Joint Replacement Institute physical therapy facility or another outpatient facility. The length of time required for this type of therapy varies with each patient. We will help you make these arrangements before you go home.
The ability to drive depends on whether the surgery was on your right hip or your left hip and the type of car you have. If the surgery was on your left hip and you have an automatic transmission, you could be driving at two weeks. If the surgery was on your right hip, your driving could be restricted as long as six weeks. Getting “back to normal” will depend on your progress. Consult with your Southern Joint Replacement Institute orthopaedic surgeon for advice regarding activity. You should not drive if you are taking narcotic pain medicine.
We recommend that most people take at least one month off from work, even if your job allows you to sit frequently. More strenuous jobs will require a longer work absence.
Six weeks after discharge, you will be seen for your first post-operative office visit. The frequency of follow-up visits will depend on your progress. Patients usually return for a 3 month, 6 month, and yearly checkup. However, if the patient is experiencing discomfort or has concerns, they may contact Southern Joint Replacement Institute at any time and schedule an appointment.
Yes. High-impact activities such as contact sports, running, singles tennis and basketball are not recommended. Injury-prone sports such as downhill skiing are also dangerous for your new joint. Hip patients will be restricted from crossing their legs. Your surgeon and therapist will discuss further limitation with you following surgery.
You are encouraged to participate in low impact activities such as walking, dancing, golfing, hiking, swimming, bowling and gardening.
In many cases, patients with hip replacements think that the new joint feels completely natural. However, we recommend always avoiding extreme position or high impact physical activity. The leg with the new hip may be longer than it was before, either because of previous shortening due to the hip disease, or because of a need to lengthen the hip to avoid dislocation. Most patients get used to this feeling in time or can use a small lift in the other shoe. Some patients have aching in the thigh on weight bearing for a few months after surgery.