In total hip replacement, metal and plastic components replace the ball-and-socket of the hip. The head of the thighbone (femur) is replaced with a high strength metal stem that is connected to a smooth metal or ceramic ball. The ball articulates with a highly durable plastic insert placed in a metal cup that is surgically implanted into the pelvis.
Performed regularly since the 1960’s, total joint replacement surgery is one of the most important surgical advances of this century. Since then, improvements in joint replacement surgical techniques and implant technology have greatly increased the effectiveness of this surgery. Today, more than 300,000 total hip replacements are performed each year in the United States.
Once you and your doctor agree that you are a good candidate for total hip replacement, a date will be scheduled for your surgery. Take the time prior to your surgery to learn as much as possible about all aspects of the process, from the procedure, anesthesia, your hospital stay, recovery, and life after joint replacement. The following is a list of the activities that both you and your surgeon may do prior to surgery:
General physical examination;
Donate one to two units of your blood in the event that a transfusion is required;
Discuss general preparation for surgery with your surgeon;
Discontinue use of non-steroidal anti-inflammatory drugs, which may prevent your blood’s ability to clot;
Set up your house to accommodate your needs after surgery.
In the presurgical area, a member of the anesthesia team will evaluate you. The most common types of anesthesia for total joint replacement surgery are general anesthesia (which puts you to sleep throughout the procedure), epidural (which can relieve surgical and post-surgical pain) and spinal anesthesia (which allows you to be awake but anesthetizes your body from the waist down). The anesthesia team will discuss these choices and help you decide your best option.
You will remain in the presurgical area until the operating room is ready. The operating room is a highly controlled area, where a very strict protocol is followed to ensure a highly sterile environment. In the operating room, you will be transferred from your gurney to the operating room table. The anesthesia team will prepare you for the anesthesia option chosen before surgery.
The surgical procedure will usually last 1-2 hours. For specific details on the surgical procedure, refer to the total hip replacement section. After your surgery, you will be taken to the Post-Anesthesia Care Unit (PACU) until the anesthesia wears off. Nurses in this area will closely monitor your vital signs to ensure you properly recover from the anesthesia.
You will typically spend three day in the hospital. During your stay, you will be asked to perform several basic functions from standing to walking, based on your condition. Depending on your progress, your recovery may include a special rehabilitation facility prior to returning home.
Your surgeon will place you on a rehabilitation program to speed recovery. A physical therapist will recommend a series of exercises. The quicker you get moving, the quicker you will regain your independence. Pain medication may be prescribed to reduce the discomfort of initial activity.
The goal of joint replacement is to restore function of the joint and eliminate pain. Slowly, you will be able to resume most daily activities. However, these activities may need to be altered to ensure a successful outcome.