Hip-replacement surgery

Hip-replacement surgery, also known as hip arthroplasty, is a medical procedure in which a diseased or damaged hip joint is replaced with an artificial joint or prosthesis. This surgery is typically performed to relieve arthritis pain or fix severe physical joint damage as part of hip fracture treatment. Hip-replacement surgery can be performed as a total replacement or a hemi (half) replacement.

Indications

Hip-replacement surgery is considered when pain and stiffness in the hip joint significantly affect the patient's ability to perform everyday activities and non-surgical treatments have not been effective. The most common reason for undergoing this surgery is osteoarthritis in the hip, but other conditions, such as rheumatoid arthritis, osteonecrosis, and injuries, can also lead to deterioration of the hip joint necessitating this surgery.

Procedure

The procedure involves removing the damaged head of the femur (thighbone) and replacing it with a metal or ceramic ball on a metal stem that is inserted into the femur. The damaged acetabular socket (part of the pelvis) is also removed and replaced with a metal socket. A plastic, ceramic, or metal spacer is placed between the new ball and the socket to allow for a smooth gliding surface.

There are several surgical approaches to hip replacement, including the posterior (most common), anterior, and lateral approaches, each with its advantages and considerations.

Recovery

Post-surgery, patients typically begin physical therapy immediately to aid recovery. The focus is on preventing clot formation, improving joint motion, and strengthening the muscles around the hip joint. Most patients can return to their normal activities within three to six months following surgery, although high-impact activities may be restricted.

Risks and Complications

As with any major surgical procedure, hip-replacement surgery carries risks, including blood clots, infection, fracture, dislocation, and wear or loosening of the prosthesis over time. Advances in surgical techniques and postoperative care have significantly reduced these risks.

Outcomes

The majority of individuals who undergo hip-replacement surgery experience a dramatic reduction in hip pain and a significant improvement in their ability to perform common activities. However, the longevity of the prosthesis is influenced by the patient's activity level, weight, and other factors. On average, hip replacements can last 15 to 20 years.

Future Directions

Research in hip-replacement surgery focuses on developing materials that last longer and are more resistant to wear and tear, as well as minimally invasive surgical techniques that reduce recovery time and complications.