The thigh bone (femur) is a long bone running from the knee up to the hip with a head shaped like a ball to fit neatly into a socket on the hip (acetabulum) to form the hip joint. These bones are covered by a hard cartilage, which provides a cushion between the bones when you move your hip. If the hard cartilage wears away, the bones can rub against each other to cause pain and stiffness. This is called osteoarthritis. If arthritis is limiting your everyday activities and you have not been able to manage your pain with medications, cortisone injections, or physical therapy, then a hip replacement might be an option for you.
Total Hip Replacement
A hip replacement (arthroplasty) is where the entire joint is replaced with a metal insert and is typically done without cement if the bone is healthy enough. Each piece, both the replacement for the thigh bone and the hip socket are custom fit into the bone. This surgery can be done in an inpatient or outpatient setting depending upon your health, medical history, and insurance. This means you may or may not spend a night in the hospital. Depending on your overall health before surgery, insurance and available help at home, you may stay one to three days in the hospital. Some individuals may even go to a skilled nursing facility for short periods of time if additional assistance is needed or returning home is unsafe.
With either approach you can expect to attend physical therapy after surgery, sometimes even starting as early as the next day. Although it can take up to a year, the majority of patients who undergo total hip replacement surgery feel much better than they had prior to surgery. This is the most successful orthopaedic surgery done. You will find that you are able to move your hip with greater ease and without pain, making everyday tasks enjoyable again. Most people are able to get back to their daily activities in about three months. For the first six months after surgery while your hip heals, you will have precautions including no deep bending at the waist or over rotating the hip. Your surgeon will go over specific recommendations for you.
Here at the Klasinski Clinic, our surgeons are trained in two different hip replacement techniques. The most common is the posterior approach to hip replacements. In this surgery, an incision is made on the back and side of the affected hip. The total hip replacement surgery involves separating the muscles on the side of your hip, the gluteal and IT band, and then the smaller muscles that rotate the hip are detached in order to access the hip in a nerve-free location. Your surgeon will replace the ball of your thighbone with one made out of surgical metal and replace the damaged cartilage of the acetabular socket with a surgical metal cup.
An up and coming method of hip replacement is the anterior approach, which research has shown that some patients have decreased pain immediately after surgery and the surgeon has better visualization of the acetabular socket during surgery. Overall, there is not a difference in long-term outcomes versus a posterior approach. With an anterior approach there is a slightly increased risk of fracture and it will take more experience for doctors to become comfortable doing this type of procedure compared to the traditional posterior approach. Talking to your physician will help you determine which approach is right for you and your specific hip condition.