Show references Hip replacement. Accessed Dec. Erens GA, et al. Total hip arthroplasty. Total hip replacement. American Academy of Orthopaedic Surgeons. Hip replacement.
Mayo Clinic; Complications of total hip arthroplasty. Evans JT, et al. How long does a hip replacement last? A systematic review and meta-analysis of case series and national registry reports with more than 15 years of follow-up. The Lancet. Deep vein thrombosis. Guay J, et al. Nerve blocks or no nerve blocks for pain control after elective hip replacement arthroplasty surgery in adults Review.
Cochrane Database of Systematic Reviews. Office of Patient Education Center. Some surgeons and therapists suggest avoiding extreme hip movements and activities with a high risk of falling, such as skiing.
Others may advise against running on hard surfaces, jumping, or sports that involve sudden turns or impacts, such as squash or tennis. If in doubt, ask your surgeon or physiotherapist for advice. Learn about risks and side-effects. Many thousands of hip replacements are carried out each year without any complications at all.
However, hip replacement is a big operation and, as with all major surgery, there are some risks. The chance of complications varies according to your general health. Your surgeon will discuss the risks with you.
Most complications are fairly minor and can be successfully treated. After surgery, some people develop blood clots in the deep veins of the leg deep vein thrombosis, or DVT , causing pain or swelling in the leg.
You should seek medical advice straight away if this happens. There are a number of ways to reduce the risk of this happening, including special stockings, pumps to exercise the feet, and drugs that are given by injection into the skin, such as heparin or fondaparinux. Rivaroxaban, dabigatran and apixaban are tablets that can help prevent DVT. A blood clot can sometimes move to the lungs, leading to breathlessness and chest pains. This needs urgent treatment.
In extreme cases a pulmonary embolism can be fatal. However, it can usually be successfully treated with blood-thinning medicines and oxygen therapy. Sometimes an artificial hip may dislocate. If this happens, it will need to be put back in place under anaesthetic.
If the hip keeps dislocating, you may need further surgery or a brace to make it stable. Continuing with a programme of muscle-strengthening exercise will still help to improve stability.
To reduce the risk of infection, special operating theatres are often used, which have clean air pumped through them. And most people will be given a short course of antibiotics at the time of the operation. Despite these precautions, a deep infection can occur in about 1 in cases. The infection can be treated but the new hip joint usually has to be removed until the infection clears up.
A new hip replacement will then be given six to 12 weeks later. All hip implants will wear to some extent over time, although ceramic components generally wear less than metal or plastic ones. New, harder-wearing plastics are being developed that may help to reduce this problem. When a joint replacement starts to wear, tiny bits of metal or plastic may come away from the replacement.
These are usually absorbed into the bloodstream, then filtered by the kidneys and passed out of the body in the urine.
But in some people, the particles can cause a reaction in the soft tissues around the hip that could lead to tissue damage and other health problems although this is rare. This was found to be a problem in particular with metal-on-metal hip implants.
As a result, a number of implants were taken off the market. The most common reason for a hip replacement to fail is when the artificial hip loosens. This usually causes pain, and your hip may become unstable. Loosening is most common after 10—15 years, although it could happen earlier. A fracture around the implant usually needs to be fixed surgically and the implant may need to be replaced. A wound haematoma is when blood collects in a wound.
Usually this stops within a couple of days. But occasionally blood may collect under the skin, causing a swelling. This blood may go by itself, causing a larger, but temporary, leakage from the wound usually a week or so after surgery. But sometimes it may require a smaller second operation to remove the build-up of blood. Drugs like aspirin and antibiotics, which reduce the risk of blood clots and infection, can sometimes increase the risk of haematoma after surgery.
Your new hip should allow you almost normal, pain-free activity for many years. Most hip replacements last for at least 15 years, although there are some differences between different brands and types of joint replacement. Repeat hip replacements called revisions are possible and are becoming increasingly successful. Many hospitals now have surgeons who specialise in this type of surgery.
Revision surgery is usually more complicated than the original operation, and the results may not be quite as good.
In this case you may need a bone graft, where a piece of bone is taken from another part of your body or from a donor. However, the end result is usually good. This involves removing the original implant and inserting a temporary spacer, usually for at least six weeks. It may still be possible to get about during this time if your other hip and leg are alright. The spacer contains antibiotics to help fight the infection.
Once the infection has cleared up completely you will have the second operation to insert the new hip joint. Some surgeons offer a technique called minimally invasive surgery for total hip replacements. Before you go into hospital, find out as much as you can about what's involved in your operation. Your hospital should provide written information or videos. Stay as active as you can. Strengthening the muscles around your hip will help your recovery.
If you can, continue to do gentle exercise, such as walking and swimming, in the weeks and months before your operation. You may be referred to a physiotherapist, who will give you helpful exercises. Your hospital may offer an enhanced recovery programme. This rehabilitation programme aims to get you back to full health quickly after major surgery. Find out more about preparing for surgery , including information on travel arrangements, what to bring with you and attending a pre-operative assessment.
You'll usually be in hospital for 3 to 5 days, but recovery time can vary. Once you're ready to be discharged, your hospital will give you advice about looking after your hip at home. You'll need to use a frame or crutches at first and a physiotherapist will teach you exercises to help strengthen your hip muscles. An occupational therapist will check if you need any equipment to help you manage at home.
You may also be enrolled in an exercise programme that's designed to help you regain and then improve the use of your hip joint. It's usually possible to return to light activities or office-based work within around 6 weeks. However, everyone recovers differently and it's best to speak to your doctor or physiotherapist about when to return to normal activities.
Your age, weight, fitness level and other factors will help the surgeon decide if you are a good candidate. A traditional hip replacement includes a single, large incision that helps the surgeon gain access to the hip, usually through the side lateral approach or from the back posterior approach.
Recovery from a traditional hip replacement can take time, because the surgeon needs to cut through or detach some muscles and tendons to get to the joint. The muscles and tendons are repaired when the hip implants are in place.
The surgical approach your doctor will recommend depends on several factors, including how the surgeon will gain access to the hip, the type and style of the implant and how it will be attached, and your age and activity level, and the shape and health of the hip bones.
The likelihood of future surgery also figures into the decision, because some surgical approaches and types of implant attachment can make a revision surgery easier or more challenging. As part of the evaluation for surgery, your orthopaedic surgeon will discuss the options of minimally invasive surgery or traditional hip replacement, as well as how he plans to perform the surgery and what type of implant will be used.
The Johns Hopkins hip and knee replacement program features a team of orthopaedic specialist highly skilled in joint replacement procedures. Our team will guide you through every step, from pre-surgical education to post-surgical care and physical therapy.
Our goal is to return you to your desired level of activity as soon as possible. Both uncemented and cemented approaches can work well to secure the implant.
As hip replacement techniques have evolved over the years, the cement used has improved, as have methods to encourage natural bone re-growth. For some hip replacements, the surgeon will combine methods. He or she might prefer to use cement on the femoral stem while using an uncemented attachment on the socket piece that fits into the hip bone. Both left and right hips can be replaced during a single surgery. A double hip replacement is also called a bilateral hip replacement.
If you are having issues with both hips, your doctor might recommend a double hip replacement if you are in good health and can tolerate a longer surgery and a more challenging recovery.
Hip replacements are performed in a hospital or surgery center. They are often considered outpatient procedures, even though you might need to stay a night or two for observation or to resolve complications.
On average, hip replacement surgeries last about two hours. A partial hip replacement might require less time, and a double hip replacement may take longer. Complications during surgery might also extend the surgery time.
You may need imaging, such as an X-ray, immediately after the procedure and during recovery, to confirm that your surgery was successful and that your new hip is healing well. Hip replacement recovery starts right away. You will be encouraged to get up and move around as soon as possible after surgery. Some patients might spend time in an inpatient rehabilitation unit to prepare for independent living at home.
Whether you go home or to a rehabilitation unit after surgery, you will need physical therapy for several weeks until you regain muscle strength and good range of motion.
The surgeon, physical therapist or occupational therapist can advise you on when you are ready to walk with or without assistance, and how to manage your pain. The provider will discuss your rehabilitation needs, what to expect in the days and weeks ahead, and how to make the most of your recovery. Your motivation and cooperation in completing the physical therapy is critical for an effective recovery process and overall success of the surgery.
Some fluid might drain from your incision.
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