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What Happens During Hip Replacement Surgery

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After A Hip Replacement

Hip replacement recovery starts right away. You will be encouraged to get up and move around as soon as possible after surgery. Patients who dont have other health conditions can go home as soon as they demonstrate that they can walk, climb stairs, and get in and out of a car.

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.

While you recover, be sure to:

  • Keep the surgical area clean and dry. Your doctor will give you specific bathing instructions.
  • Take all medications as directed.
  • Keep all the follow-up appointments with your surgeon.
  • Attend physical therapy and complete home exercises.
  • Resume your normal diet unless otherwise instructed.
  • Elevate the leg and use ice to control swelling.
  • Do not drive until your doctor says it is safe to do so.

Planning For Your Recovery After Surgery

You may not be able to walk unaided for at least 4 weeks after surgery, and other types of movement such as stretching or picking things up may also be severely restricted.

You may want to consider making some changes to your home to make life easier while you recover from the operation, such as:

  • adding a shower seat to your bathroom
  • placing any useful objects at hand level so you do not have to bend down to pick them up
  • stocking up on food that is easy to prepare, such as frozen ready meals, or prepare and freeze your own dishes to reheat during your recovery

Many people find it useful to buy a “reacher grabber” a handheld device that allows you to pick up objects that are slightly out of reach. These devices are easily available through the internet as well as from shops that sell mobility products.

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What To Expect During Hip Replacement Surgery

During hip replacement:

  • You will receive anesthesia. Depending on your health and current medications, your past experiences with anesthesia, and the type of hip replacement you are having, you may have:
  • Regional anesthesia, which blocks nerves to a certain area of your body. Most people who have regional anesthesia are awake, so you may receive a light sedative to help you relax.
  • General anesthesia, which acts on the brain and nervous system and puts your whole body to sleep.
  • Your surgeon will make an incision over the hip. The size of the incision will vary depending on many factors, including your size and your surgeons preferences.
  • Your surgeon will remove the diseased bone tissue and cartilage from the hip joint.
  • Your surgeon will replace the ball and the surface of the socket with new, artificial parts.
  • You will be moved to the recovery room after surgery.
  • How Do I Safely Sit Down And Stand Up After A Hip Replacement

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    There are three steps to sitting down after a hip replacement:

  • Back up to the bed/chair until the backs of your knees are touching it.
  • Reach your hands back for the armrests. Hold your weight still.
  • Lower your body slowly into a seated position. Avoid bending forward at your trunk.
  • Keep the following tips in mind while youre sitting:

    • Sit on a firm chair with a straight back and armrests. Keep your hips and knees at 90 degrees .
    • Dont sit on low, soft or overstuffed furniture that may cause excessive bending of your hip.
    • Follow the precautions and weight-bearing status as instructed by your healthcare provider or physical therapist.

    To stand, follow these two steps:

  • Scoot to the edge of the bed/chair. Avoid bending forward at your trunk.
  • With your hands on the bed or chair, push up to the standing position. Bring one hand at a time up to your walker.
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    Types Of Socket Implant Attachment

    • Uncemented prosthesis attaches with a porous surface, which allows bone to grow over time and hold it in place.
    • Cemented prosthesis attaches with bone cement.

    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.

    Will I Need Another New Hip

    Nowadays, most hip implants last for 15 years or more. If you are older, your new hip may last your lifetime. If you are younger, you may need another new hip at some point.

    Revision surgery is more complicated and time-consuming for the surgeon to perform than a first hip replacement and complication rates are usually higher. It cannot be performed in every patient. However, it is much more successful than it used to be and most people who can have it report success for 10 years or more.

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    How Long Do Hip Implants Last

    Generally speaking, a hip replacement prosthesis should remain effective for between 10 and 20 years, and some can last even longer.

    Results vary according to the type of implant and the age of the patient. In a 2008 study of more than 50,000 patients who had THR surgery at age 55 or older, between 71% and 94% still had well-working implants after 15 years.

    When a hip implant does need to be replaced because it has loosened or worn out over time, this requires what is called .

    How Should I Prepare For Hip Replacement Surgery

    Hip replacement surgery: What to expect

    There are certain steps patients can take both before and after surgery to improve recovery time and results. It is important to follow the instructions and guidance provided by your orthopedic surgeon, medical team and rehabilitation therapist. Visit to get information on preoperative hip replacement classes and patient education materials about joint replacement surgery.

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    What Can I Expect After Hip Replacement Surgery

    How long you stay in the hospital or surgical center after your surgery depends on many factors, including your overall health. Some people may go home the same day, while others stay in the hospital. These are some common steps in recovery.

    • If you need extra time and therapy to recover, your health care team may recommend that you spend some time in a rehabilitation or skilled nursing care facility.
    • Everyone who has hip replacement surgery learns exercises to strengthen the hip and how to move around safely.
    • Whether you stay at the hospital, go home the same day, or transfer to another facility, your health care team will give you instructions to follow once you are home.

    How quickly and how fully you recover from hip replacement surgery varies from person to person. This depends on many factors, such as your overall health and fitness level before surgery. For many people, much of their recovery happens in the first 2 months after surgery. However, it is important to know that full recovery continues as you get stronger and more active over the next year after surgery.

    Your health care team can provide advice on when you can start to participate in more demanding activities.

    Managing Your Recovery At Home

    You may feel quite tired when you get home, so get plenty of rest. Then its important to slowly increase your activity.

    Here are a few things you can do to strengthen your hip, avoid damaging it and help your wound heal:

    • Continue the exercises the physiotherapist showed you 3 or 4 times a day for 6 weeks
    • Try low-impact exercises like walking and gradually increase how far you walk
    • If moving around is uncomfortable, take any painkillers weve prescribed until youre pain free
    • Dont lift anything heavy or do any strenuous exercise
    • Avoid bending your hip beyond 90 degrees
    • Avoid rolling your leg towards the other leg or crossing your legs
    • Avoid twisting on your hip when standing
    • Keep using your crutches or walking stick for as long as you feel you need to
    • Shower instead of taking a bath

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    Hip Replacement Surgery: Total Hip Precautions

    Hip replacement patients should wear total hip precautions for at least 12 weeks after the procedure. At this time, you should avoid turning your toes in or out, crossing your legs, and bending over 90 degrees. Dislocation and infection are two of the most common complications following hip replacement. The most important thing you can do in the days following surgery is to maintain a healthy balance of rest and physical therapy. Scar tissue can form after surgery and weaken the muscles, so do not move if you are not moving.

    Total Hip Replacement Step

    Total Hip Replacement Surgery

    The exact steps of the surgical procedure will depend on the patients needs and the orthopedic surgeons training and approach, but generally the steps are as follows:

    • The patients vital signs are checked to make sure blood pressure, heart rate, body temperature, and oxygenation levels are normal and surgery can proceed. A mark is made on the hip undergoing surgery.
    • Anesthesia is administered. A patient may receive general anesthesia or be given a regional/spinal anesthesia to block sensation from the waist down, along with a relaxant. The type of anesthesia a patient receives is decided well ahead of time.
    • The acetabular cup is placed into the reshaped socket. This cup is often made of porous titanium metal to allow the bone to grow into it over time, or it may be attached with special bone cement. The type of cup and how it is attached to the bone depends on the surgeons preference and the patients physiology.
    • The surgeon puts a rounded acetabular insert/liner inside the acetabular cup. The insert may be ceramic or plastic and will facilitate smooth movement within the new joint.
    • The surgeon prepares the femur bone and inserts the prosthetic femoral stem into it. The femoral stem is a narrow, tapered metal shaft that fits several inches down inside the femur. The top of the stem is designed to hold a prosthetic ball that will replace the femoral head.

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    How Long Does A Hip Replacement Surgery Take

    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.

    Why The Procedure Is Performed

    The most common reason to have this surgery is to relieve arthritis. Severe arthritis pain can limit your activities.

    Most of the time, hip joint replacement is done in people age 60 and older. Many people who have this surgery are younger. Younger people who have a hip replaced may put extra stress on the artificial hip. That extra stress can cause it to wear out earlier than in older people. Part or all of the joint may need to be replaced again if that happens.

    Your doctor may recommend a hip replacement for these problems:

    • You can’t sleep through the night because of hip pain.
    • Your hip pain has not gotten better with other treatments.
    • Hip pain limits or prevents you from doing your normal activities, such as bathing, preparing meals, doing household chores, and walking.
    • You have problems walking that require you to use a cane or walker.

    Other reasons for replacing the hip joint are:

    • Fractures in the thigh bone. Older adults often have a hip replacement for this reason.
    • Hip joint tumors.

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    What Are The Different Types Of Hip Replacement Surgery

    The three major types of hip replacement are:

    • total hip replacement
    • partial hip replacement
    • hip resurfacing

    The most common type of hip replacement surgery is called a total hip replacement . In this surgery, worn-out or damaged sections of your hip are replaced with artificial implants. The socket is replaced with a durable plastic cup, which may or may not also include a titanium metal shell. Your femoral head will be removed and replaced with a ball made from ceramic or a metal alloy. The new ball is attached to a metal stem that is inserted into the top of your femur.

    Healthy hip

    Arthritic hip

    Replaced hip

    Two other types of hip replacement surgeries are each generally appropriate for patients of specific age groups and activity levels:

    • Partial hip replacement involves replacing only one side of the hip joint the femoral head instead of both sides as in total hip replacement. This procedure is most commonly done in older patients who have .
    • of the femoral head and socket is most commonly done in younger, active patients.

    X-ray of a total hip replacement showing the ball, socket and stem implants

    Hip replacement surgical methods

    There are two major surgical approach methods for performing a total hip replacement:

    • the posterior approach

    Total hip replacement animation: Posterior approach

    What Are Hip Implants Made Of

    What happens during a Hip Replacement? | HCA Healthcare UK

    There are three separate implants: the stem, the ball and the socket.

  • The stem, made out of metal is inserted into your natural thighbone.
  • The ball is usually made out of polished metal or ceramic, and fits on top of the stem.
  • The socket is usually a combination of a plastic liner and a cobalt-chrome or titanium backing.
  • Learn more about joint replacement prostheses by reading .

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    Different Approaches To Hip Replacement Surgery

    Depending on which hip surgery you choose, there are couple of different ways your surgeon may approach your hip replacement procedure:

    • During anterior hip replacement surgery, the surgeon operates through a single large incision on the front of your hip. The incision typically starts at the top of the pelvic bone and ends at the top of the thigh.
    • Posterior hip replacement surgery uses a large, curved incision on the back and side of the hip.
    • Minimally-invasive hip replacement surgery involves one or more smaller incisions instead of a single large one. In this type of procedure, the surgeon often uses the help of x-ray guidance to help position the implant. Minimally-invasive procedures can involve shorter healing times than open surgeries, but they often require specialized surgical skills and equipment.

    Looking After Your New Hip Joint

    You need to take care, especially during the first eight to 12 weeks after the operation, to avoid dislocating the hip. You may not be able to bend your leg towards your body as far as youd like to. Your therapist will advise you about any movements that you need to take special care with. Dont be tempted to test your new joint to see how far it will go.

    However, its important to continue with the programme of muscle-strengthening exercises recommended by your physiotherapist.

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    Why Is Hip Replacement Surgery Needed

    Hip replacement surgery is usually needed to repair damage to the hip joint from:

    • Injuries or fractures from trauma or disease.

    Your health care provider may recommend that you try other treatments before having hip replacement surgery, including:

    • Pain medications.
    • Physical therapy and exercise programs.
    • Activity changes to limit strain on your hip.
    • Assistive devices such as a cane, crutch, or walker.

    If after trying other therapies you are still having joint pain that limits your activities, your doctor may recommend hip replacement surgery. New technologies have improved artificial parts so that they handle more stress and last longer. This means that hip replacement surgery can also be successful in people of all ages.

    However, it is important to be aware that hip replacement surgery may not be recommended for people with certain health conditions. You and your doctor will determine the best treatment for you depending on your health history and the risks associated with the surgery.

    How Soon Will I Be Up And About

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    The staff will help you to get up and walk about as quickly as possible after surgery. Some patients are able to get up and walk the same day as their surgery.

    Initially, you will feel discomfort while walking and exercising, and your legs and feet may be swollen. You may be given an injection into your abdomen to help prevent blood clots forming in your legs, and possibly a short course of antibiotics to help prevent infection.

    A physiotherapist may teach you exercises to help strengthen the hip and explain what should and should not be done after the operation. They will teach you how to bend and sit to avoid damaging your new hip.

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