Hip joint replacement

Definition

Hip joint replacement is surgery to replace all or part of the hip joint with an artificial joint. The artificial joint is called a prosthesis.

Alternative Names

Hip arthroplasty; Total hip replacement; Hip hemiarthroplasty

Description

The artificial hip joint has 4 parts:

• A socket that replaces your old hip socket. The socket is usually made of metal.
• The liner fits inside the socket. It is usually plastic, but some surgeons are now trying other materials, like ceramic and metal. The liner allows the hip to move smoothly.
• A metal or ceramic ball that will replace the round head (top) of your thigh bone.
• A metal stem that is attached to the shaft of the bone to add stability to the joint.

You may receive general anesthesia before this surgery. This means you will be unconscious and unable to feel pain. You may have a spinal or epidural anesthesia. In this kind of anesthesia, medicine is put into your back to make you numb below your waist.

After you receive anesthesia, your surgeon will make an incision (cut) to open up your hip joint. Often this incision is over the buttocks. Then your surgeon will:

• Remove the head of your thigh bone.
• Clean out your hip socket and remove the remaining cartilage and damaged or arthritic bone.
• Put the new hip socket in place, then insert the metal stem into your thigh bone.
• Fix all the new parts in place, sometimes with a special cement.
• Repair the muscles and tendons around the new joint.
• Close the incision.

This surgery usually takes 1 to 3 hours.

Risks

Risks for any anesthesia are:

• Allergic reactions to medicines
• Breathing problems

Risks for any surgery are:

• Blood clots in the legs that may travel to the lungs
• Infection, including in the lungs, urinary tract, and chest
• Bleeding
• Heart attack or stroke during surgery

Some risks of this surgery are:

• Dislocation of the artificial joint
• Infection that requires removing the joint
• Loosening of the artificial joint over time
• Pneumonia
• Extra bone growth that can cause stiffness
• Allergic reaction to the artificial joint
• Injury to nerves or blood vessels
• Mental confusion (dementia): Many people who fracture a hip already have some problems thinking clearly. Sometimes, having a fracture and surgery can make this worse.
• Pressure sores (also called pressure ulcers or bed sores) from being in bed or a chair for long periods of time.

People who have a prosthesis, such as an artificial joint, need to carefully protect themselves against infection. You should carry a medical identification card in your wallet that says you have a prosthesis. You may need to take antibiotics before any dental work or invasive medical procedures.