Hip Replacement surgery or hip arthroplasty is the procedure to treat the damaged or diseased hip by replacing it with a prosthetic implant. The aim of the surgery is to restore the function of hip joints, relieve pain and enable movement. Hip replacement surgery is now a common and one of the most successful orthopedic procedure. Studies reveal that the long term satisfaction rate for hip arthroplasty is high, up to 90%. The prosthetic used can be made of metal, ceramic or plastic material and the modern implant can last for 15 years, at least.
The hip joint is a ball in socket structure which provides the flexibility to move the entire leg in different directions. Certain condition damages the cartilage over the joint, causing the ball to move less smoothly or freely in the socket. This leads to stiffness in the joint and pain which may affect the normal activities of everyday life.
Conditions which lead to the damaged hip joint:
- Osteoarthritis: most common reason for recommending hip replacement surgery
- Inflammatory conditions: rheumatoid arthritis, ankylosing spondylitis
- Septic arthritis
- Bone Dysplasia: disorders that cause unusual development of hip from childhood
- Avascular necrosis of the hip: insufficient blood supply leading to loss of bone
- Bone cancer
- Injury caused by trauma or accident
- After a hip fracture
It is important to keep in mind that if there is much delay in the surgery, the condition of the patient may worsen due to loss of strength and disability, which will make recovery harder and longer. The delay can lead to
Indications that you need Hip Replacement surgery include:
- Severe chronic hip pain – such that it affects normal activities, even sleeping and resting
- swelling and stiffness around hip joint
- lack of movement
- difficulty in performing a simple task, like getting out of the bed or shower or climbing up the stairs
- No improvement with physical therapy, medications, steroids
- X-ray shows significant joint damage
The surgeon usually examines the x-rays, and other tests before suggesting the surgery. The health status, age, gender, and other factors are also considered. The decision to go for hip replacement surgery should not be just based on occasional flares of pain but rather on the persistent pain.
Signs that suggest hip replacement surgery might not be needed:
- Pain is not that severe and doesn’t affect simple every day activities
- Haven’t tried non-surgical options like painkillers, anti-inflammatory medications, and therapy
- Therapies and medications are able to reduce pain
- Activities like walking, swimming, driving are not affected
- Walking aids like cane, a walker is helping
Arthritis has a tendency to remain the same and even get better or increase over time. The surgery is usually recommended when the pain can longer be managed by less invasive methods.
Alternative non-surgical methods include –
- Pain-relief medication: Painkillers are an effective way to manage pain on a daily basis
- Steroidal injections: In a few cases, corticosteroid injections can be given directly over the hip joint and can help relieve pain and inflammation.
- Physical therapy: This aims to strengthen the hip and thigh muscles, improving the motion around the hip. It can also help the person in managing lower back pain, which is common in the cases of the diseased hip.
Hip resurfacing is an alternative, more conservative surgical option of treatment, and is suggested by the surgeon based on the level of damage. It does not involve replacing the whole joint, like in total hip replacement, but only the damaged surface is shaved off and capped with metal bearings. This surgery has the advantage that less bone is removed and the person can return back to all physical activities. But the limitation is that it is less preferred in young women as the metal ions can affect the pregnancy and for older people (above the age of 65) as the bones become weak and fragile overage.
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