Hip Replacement Frequently Asked Questions

The hip joint is a ball and socket joint. The acetabulum, or socket, is formed by three areas of the pelvic structure: the ilium, the ischium, and the pubis. The femoral head is the “ball”, which is located on the upper end of the femur. There is a high degree of fit and stability within this ball and socket joint. It is stabilized by strong ligaments in the front of the hip which prevent dislocation. Both the femoral head and the acetabulum are covered with a layer of cartilage which provides shock absorption and load distribution within the hip. This cartilage is also a source of nutrition for the joint. Numerous muscles play an important role in the stability of the hip, one of which is the gluteus medius. This is a deep muscle within the buttock, and its proper function is important in normal walking. Click here for more information.
Approximately 3 times the body weight is distributed through the hip with routine activities due to the muscle pull and joint forces that occur. Any degenerative condition within the hip will alter biomechanical relationships and can cause limping, leg length inequality and disability. The stability of the hip joint is maintained by the precise fit of the femoral head within the acetabulum. The hip allows rotation in many planes. These include: flexion/extension (used most commonly in sitting), internal and external rotation (used with twisting activities), and abduction and adduction (inward and outward motion of the hip in a scissoring action). Click here for more information.
Hip arthritis is any condition that leads to degeneration of the hip joint and its cartilage surfaces. Some of these conditions are osteoarthritis, rheumatoid arthritis, avascular necrosis and congenital dysplasia (dislocation) of the hip. Fractures and other injuries to the hip joint can also lead to hip degeneration. Hip arthritis is a degenerative condition that affects the hip joint, and often leads to a significant impairment in the quality of life. The ability to walk, work and live pain free can be adversely affected. Click here for more information.
Osteoarthritis is a degenerative condition that may affect many joints throughout the body. It causes changes in the mechanical structure of the cartilage, which lead to its breakdown. Over time complete loss of the articular cartilage can occur. Changes in the underlying bone and loss of cartilage can result in joint space narrowing, peripheral osteophytes (bone spurs), loss of motion, pain and disability. Click here for more information.
Rheumatoid arthritis is an inflammatory condition that affects the lining of all joints in the body. It causes an inflammatory response in the joint lining which destroys the articular cartilage and surrounding tissues. Click here for more information.
Osteonecrosis or avascular necrosis is a condition in which the bone within the femoral head dies. This eventually leads to the collapse of large segments of the bone supporting the cartilage of the hip joint. It ultimately causes the destruction of the hip. Click here for more information.

Most commonly, hip arthritis pain is described as increasing pain in the groin and anterior (front) thigh area. This usually begins with pain only during activities. It progresses to pain at rest and eventually disturbs sleep at night. With longstanding arthritis in the hip, motion in this area can be extremely limited, especially in flexion (bending) and internal rotation. 

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A diagnosis of hip arthritis is made after a physician will take the patient’s history and perform a physical examination including a joint mobility examination. Routine X-rays can reveal signs of arthritis. Occasionally an MRI will be ordered to detect other conditions. Click here for more information.

Total hip replacement surgery is very successful and has excellent short and long term outcomes. The surgeon removes the arthritis from the hip and inserts a metal and plastic prosthesis into the hip. This provides for hip function, limb length equality and restoration of motion. The procedure can be done with cement, which is a grout type of substance.

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Short term complications from hip replacement surgery include infection, dislocation, bleeding, never injury, and in some cases the limb length may not be totally equal. Long term complications include the loosening of the components. Overall the complication rate from first hip replacement surgery is less than 5%. Click here for more information.
Conservative measures, as described above, are used until they no longer provide adequate pain relief, and the functions of daily living become severely limited. Non-operative treatment usually results in some improvement in pain, endurance, and function. Very often non-operative treatment can not be indefinite. Click here for more information.

Following surgery the patient will keep sutures clean and dry for seven to fourteen days, followed by removal. For the first eight weeks care is given to prevent dislocation. A patient will use crutches or a walker for the first six to eight weeks. An exercise program begins there after. Improvement in mobility and pain relief may take six to nine months.

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Older age is not a strict criterion for hip replacement. Incapacitating pain, limited function, and poor quality of life due to degeneration of the joint are the indications for hip replacement. Click here for more information.
Dislocation of the artificial joint is the most frequent complication of THR. Relocation of the joint usually requires anesthesia and may need brace or cast treatment after the joint is reduced. Infection, limb length, inequality, and bleeding are other less frequent complications. Click here for more information.
Modern hip replacements have a 90-95% survival rate at 15 years. Click here for more information..

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