Frequently Asked Questions
How does the hip work?
The hip is a ball-and-socket joint. It is highly stable, connecting to the femur bone by way of the femoral head. This attaches to the pelvis inside a socket known called the acetabulum. The joint itself is surrounded by a fibrous sleeve called the capsule. This capsule is lined by a highly slippery fluid called synovium. This fluid serves to increased mobility, maintain cartilage integrity, and provide joint lubrication. Hyaline cartilage lines the acetabulum and femur head, providing stability, shock absorption and smooth mobility. Ligaments and muscles also surround the hip joint increasing stability and range of motion.
Who qualifies for hip surgery?
There are several alternatives to hip replacement surgery including physical therapy, cortisone injections, non-prescribed medications such as ibuprofen and aspirin, cold compression in conjunction with rest, and activity management. However, in certain cases hip replacement may be the ideal treatment in order to restore pain free movement and mobility. Typically candidates fall between 50-80 years of age; however candidacy relies on the extent of injury rather than age. Chronic pain and discomfort of the joint, debilitating stiffness, and inadequate relief from symptoms following alternative methods of treatment often indicate the necessity for surgical intervention.
What is hip revision surgery used to treat?
Hip replacement surgery is considered common, however is a major procedure. It may be used to treat any of the following: osteoarthritis, bone tumors, rheumatoid arthritis, injury or bone fractures, and osteonecrosis (death of bone tissue).
What is involved in Total Hip Arthroplasty/Replacement/Revision?
During this procedure, damaged tissue (the femoral head) and the cartilage surface of the socket (acetabulum) is removed and replaced by a metal stem attached to a ceramic ball which serves to replace the hip joint. This ceramic ball is often lined with a plastic, ceramic, or meal spacer to restore pain free mobility and smooth range of motion.
Minimally Invasive/Arthroplasty Hip Replacement: This approach requires several tiny incisions to the surgical area, through which the surgeon will insert a small camera in tandem with surgical equipment. This allows the surgeon to view the hip on screen and perform surgery without damaging any of the surrounding anatomy. Advantages to this approach include decreased recovery time, pain and risk.
Open Hip replacement Surgery: This type of surgery is considered more invasive as surrounding anatomy such as muscle must sometimes be cut in addition to a larger incision. This approach allows for increased visibility, enabling the surgeon to perform more dramatic repairs. Recovery time is often longer, and the procedure may require general anesthesia.
What type of anesthesia will be used?
Hip Replacement/Revision Surgery typically requires one of three types of anesthesia, which are sometimes used in combination with each other:
Local Anesthesia: This type of anesthesia is administered directly to the surgical site. This area is numbed using topical or injection based anesthesia. It does not require sedation and consciousness is maintained throughout the procedure. For major surgeries such as total hip replacement, this method may be used in tandem with other kinds of anesthesia, and is used only during minimally invasive procedures.
Regional Anesthesia: Often referred to as a nerve block, this type of anesthesia is injected into nerves surrounding the surgical site. Sedation is often used in combination with regional anesthesia in order to ensure relaxation and comfort. Regional anesthesia is often used during arthroscopic procedures.
General Anesthesia: This type of anesthesia requires the intravenous administration of anesthesia in conjunction with inhaled gases resulting in a state of total unconsciousness. This prevents any pain or discomfort during the procedure. An anesthesiologist will be present to determine the correct dosage and types of anesthesia based on your physicality and medical history, as well as monitor your vital functions.
What will recovery be like?
The typical hospital stay following Hip Replacement surgery is approximately 3-5 days. Full recovery can range from-6 months, and may require physical therapy. Blood clotting and pain medication will be prescribed by your doctor. Activities such as driving will not be permitted immediately following surgery, and activities such as bathing, cooking, and household chores may require assistance. Crutches or a walker are often necessary.
Hip replacement often results in a dramatic decrease in pain. Return to normal activities such as golf, swimming, hiking and driving are realistic, however some high impact sports may need to be avoided.
What should I expect prior to surgery?
Prior to surgery, you will be asked to abstain from any food or drink after midnight before surgery. Your doctor will also discuss your medical history and any medications or supplements you may be taking.