Hip joint replacement, or arthroplasty, is the surgical procedure in which damaged joint surfaces are replaced by metal and plastic components. This procedure has been widely used for about 25 years, and the results have generally been excellent.

Hip joint replacement is most often performed when arthritis has severely damaged the joint. The wearing away of cartilage, the smooth, hard material that protects the ends of the bones, occurs in both rheumatoid, arthritis and osteoarthritis (degenerative joint disease).

When this damaged is extensive, cartilage erosion can cause severe or constant pain, stiffness, loss of function, and deformity. Walking may become difficult or even impossible.

What happens during Hip Joint Replacement?

Hip joint replacement surgery requires hospitalization and anaesthesia. The length of the operation is normally at least an hour, while the hospital stay depends upon the person’s overall health. the procedure is performed by an orthopaedic surgeon with special training and experience in joint replacement.

This operation is one of the most dramatic success stories in orthopaedic surgery.  More than 90% of hip joint replacements are termed successful, and the majority of people who undergo them report remarkable relief of pain and improvement in mobility. One or both hips may be replaced.

Hip replacement may be carried out in later life following childhood problem such as Perthe’s disease (a condition in which the blood supply to the head of the femur or thigh bone is impaired leading to degeneration). In rare cases the hip may be dislocated at birth and therefore does not develop properly. This may lead to arthritis in later years.

In deciding whether to perform a hip replacement, the surgeon will consider both the condition of the bones and the patient’s age. Until recently, hip replacement was only performed on people over the age of 60 because of the likelihood that the artificial joint would loosen with ageing, requiring another replacement during the patient’s lifetime.

Advances both in the design of the synthetic joint and in surgical techniques have made hip replacement increasingly possible in younger people. Although some still have to undergo a second or third replacement.

The cement now used for anchoring an artificial hip can be expected to stay intact for many years, although loosening can still sometimes be a problem. The development of new joint designs that do not rely on cement to hold them in place continues to go on.

The operation involves the removal of the diseased portion of the head of the femur and replacing it with a metal component which is pushed down the shaft of the bone. In most cases this is secured in position using a special type of cement.

The socket of the joint is cleared of damaged cartilage and replace with a plastic cup into which the head of the femoral component is placed. The muscles are stitched back into place over the artificial joint and the skin is closed over the muscles. High dose antibiotics are usually prescribed to prevent infection.

Hip resurfacing is a less drastic procedure that is an alternative to total joint replacement. Here, the diseased part of the top of the thigh bone is cleaned away and capped with a metal covering. At the same time, the hip socket is cleaned and lined with plastic. It is seldom performed, however, since most specialists feel that it will not last as long or be as effective as a total joint replacement.

After the Hip Joint Replacement Operation

- A drain may be placed in the wound to prevent a build-up of fluid.
- A blood transfusion may be required.
- It will be possible to start getting mobile once the surgeon is happy with your post-operative x-rays, which are taken one to two days after the operation. This will be followed by a rehabilitation programme. You should avoid crossing your legs for several months, to prevent any risk of dis-location, and you should also sleep on your back with a pillow between your thighs. Make sure you find out how to get in and out of the bath without disturbing the joint.
- You will need to walk with crutches for approximately six weeks after the operation, and then to use a walking stick. You should be able to resume normal activities after about six months.
Warning

Infection after joint replacement can be very serious, especially if it invades the bones or spreads through the bloodstream. Call your doctor immediately if you experience symptoms such as fever, deep joint pain or inflammation of overlying skin.