A hip replacement is an orthopedic reconstruction procedure that replaces damaged parts of the hip with artificial joints.
The hip is one of the body’s largest joints, so when it’s painful or limited in function, it can greatly impact your day-to-day living. At The Ohio State Wexner Medical Center in Columbus, Ohio, our expert joint replacement surgeons understand the importance of helping you alleviate hip pain and restore mobility so you can get back to enjoying life.
The orthopedic reconstruction specialists at the Ohio State Wexner Medical Center use various surgical techniques for hip replacement surgery. The approach is specifically selected for you depending on factors including condition, anatomy and activity level. This type of individualized care sets Ohio State apart from other medical centers in the region.
We’re constantly innovating how we treat debilitating hip pain, including using 3D models to precisely tailor each person’s surgery and performing minimally invasive procedures as well as muscle-sparing hip replacements. Our hip replacement experts will take you through each step to improving your quality of life.
What is hip replacement surgery?
A hip replacement, which is also called hip arthroplasty or orthopedic adult hip reconstruction, is a procedure to remove damaged parts of the hip joint and replace them with artificial parts, usually made of metal, plastic and ceramic. This involves rebuilding the joint by placing a prosthetic socket in the acetabulum, or pelvic bone, and a prosthetic stem in the femur (thigh bone).
The goal of surgery is to reduce or eliminate pain and improve mobility, and hip replacements can have a high success rate of achieving these goals.
Typically, hip replacement surgery is not the first line of treatment for hip pain, and it’s only recommended when other nonsurgical methods such as physical therapy and injections do not have the desired results.
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Types of hip replacement surgery
At the Ohio State Wexner Medical Center, joint replacement experts offer types of hip replacement surgery not always available elsewhere, including minimally invasive procedures. The breadth of our hip replacement options is unmatched in the Columbus area.
Types of hip replacement surgery includes:
- Total hip replacement – Your surgeon will replace all of the hip joint, including the top of your femur (thigh bone) and the acetabulum (socket). Most hip replacements are total replacements.
- Partial hip replacement – Also called hemiarthroplasty, this procedure replaces only one damaged area. This can repair certain types of bone fractures or be done after a tumor is removed.
The approach we take to each replacement can be different, too. Types of approach include:
- Posterior hip replacement, meaning you lie on your uninjured hip, and your surgeon accesses the hip by splitting muscles near the buttocks
- Direct anterior hip replacement, meaning you lie on your back, and your surgeon accesses the hip through an incision in the upper thigh
- Direct lateral hip replacement, meaning you lie on your uninjured hip, and your surgeon accesses the hip through a cut directly near your hip
Why do people need a hip replacement?
People may need hip replacement surgery when their hip joints develop severe damage from injury or disease, such as arthritis of the hip. When the pain becomes persistent and limits your mobility to the point where it impacts daily life, you might be a candidate for a hip replacement.
Conditions treated by a hip replacement include:
- Osteoarthritis (wear-and-tear arthritis)
- Rheumatoid arthritis and other inflammatory conditions
- Arthritis caused by trauma, such as a fracture
- Avascular necrosis (osteonecrosis), when blood flow to the ball portion of the hip joint is cut off, causing the bone to deform
- Hip dysplasia from childhood
Before recommending surgery, our expert orthopedic and sports medicine specialists will try a variety of less-invasive methods to preserve the joint, including:
- Physical therapy
- Injected steroids
- Injected visco-supplementation, also called hyaluronic “gel" injections
- Medications
- Less-invasive surgical procedures
When is it time to have a joint replacement?
Jeffrey Reeves, MD, orthopedic surgeon, says there's no perfect time, but when arthritis is affecting your quality of life and conservative options have failed, it might be time to explore surgery.
What to expect before, during and after hip replacement
While each person’s experience with hip replacement surgery will vary, here are some guidelines on what to expect.
Preparing for a hip replacement
You’ll meet with your physician to discuss your medical history, the medicines you take and any questions you have.
Your physician may also schedule routine pre-surgical blood tests and imaging. Because the risk of infection could cause serious problems with your replaced hip, you need to have a dental clearance visit. If you don’t have a dentist, check with the surgeon’s office to see if they can help you find a dentist.
You’ll be given instructions to follow before the hip surgery, such as fasting and when to stop taking medications. You may need some help to move around safely when you first leave the hospital. You’ll receive information on how to plan for help, prepare your home and buy adaptive equipment. Specific exercises will be recommended by your surgeon to strengthen your muscles and lungs before surgery.
During surgery
During surgery you’ll be under general anesthesia or a spinal anesthetic, meaning you won’t feel pain. The surgery lasts one to two hours. When you arrive at the hospital, here’s what will happen:
- An IV is inserted to administer the general anesthetics to make you fall asleep.
- Potentially, we’ll give a spinal anesthetic to minimize the pain from the surgery and limit the amount of medication that is needed to control pain after the surgery.
- The surgeon makes an incision to access the hip joint. Where the incision is made depends on the type of hip replacement you’re having.
- The damaged cartilage and bone are removed to make room for the artificial joint.
- Once the implant is placed and a spacer (or liner) is inserted, the surgeon will close the incision to prepare you for recovery.
Recovering from hip replacement surgery
After surgery, your surgeon, nurses and physical therapists will set goals with you to get you back to your favorite activities, as recovery times and time in the hospital vary from person to person.
Your care team will closely monitor your condition and progress as you get back on the move. You can enhance your joint replacement care plan using Care Companion in your MyChart account, where you'll receive notifications for tasks such as taking your medication, reviewing educational content and answering questions about how you're progressing.
Adhering to recovery guidelines and setting realistic expectations will give you the best chance for success. It will be important to focus on wound care, diet, rest and activity level throughout your recovery journey.
Benefits of a hip replacement
Though full recovery from a hip replacement takes time and effort with rehabilitation, there are advantages to having this procedure. Most people who have a hip replacement have their pain significantly decreased or eliminated altogether. They also experience improved range of motion and strength and can return to activities including walking, hiking and biking.
Preventing complications from hip replacement
Most people who have hip replacement surgery do well, but complications can happen, as they can with any other medical procedure.
Potential risks of a hip replacement include:
- Blood clots
- Infections
- Nerve damage
- Fractures or dislocations
- Leg-length discrepancy
- Implant loosening or wearing down over time
Though rare, the surgery may fail to fix the hip issue, making another surgery necessary.
We take every precaution to minimize these risks, but there are steps you can take to help prevent complications, too. These include:
- Have a caregiver help you with daily tasks in the first few weeks following surgery
- Follow any activity restrictions
- Use a cane, crutches, walker or other assistive device to move around
- Begin physical therapy right away and complete assigned exercises at home
- Eat a well-balanced diet as your appetite increases
- Get plenty of rest
- Avoid getting your incision wet until it’s dried and healed