What Is a Hip Replacement?

Hip replacement, also known as hip arthroplasty, is a surgical procedure in which the damaged or diseased parts of the hip joint are removed and replaced with artificial components, referred to as the prosthesis. The primary goals of hip replacement surgery are to:

• Increase mobility
• Improve hip joint function
• Relieve pain

Hip replacement is commonly recommended for people with severe hip joint damage due to conditions such as osteoarthritis, rheumatoid arthritis, or other diseases that impair joint function.

Who Should Have Hip Replacement Surgery?

Candidates for hip replacement surgery typically have significant hip joint damage that causes persistent pain and interferes with daily activities, even after other treatments have been tried. Common conditions that may require hip replacement include:

• Osteoarthritis (the most common cause of hip joint damage)
• Rheumatoid arthritis (an inflammatory disease affecting the joints)
• Osteonecrosis (avascular necrosis) (bone death due to inadequate blood supply)
• Injury or fractures to the hip joint
• Bone tumours affecting the hip

While hip replacement surgery was once reserved for older adults, advancements in surgical techniques and prosthetic technology have made this procedure successful for younger, active individuals as well. A person’s overall health and activity level are now more important than age in determining the success of the surgery.

In some cases, people with chronic conditions, such as Parkinson’s disease or severe muscle weakness, may not be suitable candidates for surgery due to higher risks of complications.

Why Do People Have Hip Replacement Surgery?

For most patients, hip replacement surgery results in significant improvements, including:

• Pain relief: A reduction in pain, especially during normal activities like walking or sitting.
• Increased mobility: Improved range of motion and the ability to move freely.
• Improved activities of daily living: Easier ability to perform daily tasks without discomfort.
• Better quality of life: Enhanced independence and overall well-being.

What Are Alternatives to Hip Replacement Surgery?

Before considering hip replacement surgery, other conservative treatments may be explored, including:

• Exercise programs: Strengthening the muscles around the hip joint can help alleviate some symptoms.
• Walking aids: Canes, walkers, or crutches may help reduce stress on the affected hip joint.
• Medication: Pain relievers or anti-inflammatory drugs may offer relief, especially for less severe cases.

If these methods do not provide sufficient relief, or if the pain and dysfunction significantly interfere with daily life, then hip replacement surgery may be the most effective option.

What Are Possible Complications of Hip Replacement Surgery?

Though modern surgical techniques have greatly reduced the risks, hip replacement surgery can still involve complications. The most common risks include:

• Hip dislocation: The artificial ball and socket can become dislodged, especially if the hip is positioned incorrectly (e.g., bending the knee toward the chest). This is most likely to occur during activities such as sitting in low chairs or twisting the leg.
• Inflammatory reactions: Over time, tiny particles from the artificial joint can wear off and cause inflammation, which may trigger the breakdown of bone around the implant, leading to loosening. This may require revision surgery.

Other complications, though rare, include:

• Infection: As with any surgery, there is a risk of infection. Keep the surgical site clean and contact your doctor if you notice signs of infection, such as fever, redness, or swelling.
• Blood clots: Deep vein thrombosis (DVT) can occur post-surgery. Warning signs include swelling, redness, or tenderness in the leg.
• Heterotopic bone formation: Abnormal bone growth around the hip joint can lead to limited mobility or pain.

It’s important to follow post-surgical instructions to reduce the risk of complications. If you notice signs of a blood clot or infection, contact your doctor immediately.

When Is Revision Surgery Necessary?

Over time, wear and tear on the artificial joint may require revision surgery. This is typically needed after 15 to 20 years when the implant begins to degrade or loosen. Revision surgery is more complex than the original procedure and may not yield the same outcomes.

Revision surgery may be necessary if:

• Pain or disability persists despite medication or lifestyle changes.
• X-rays show signs of bone damage around the implant.
• Fractures, dislocations, or infections occur in the artificial joint.

It’s essential to discuss all options with your doctor before considering revision surgery to ensure the best outcome.

What Types of Exercise Are Most Suitable for Someone With a Total Hip Replacement?

Exercise is an important part of recovery, helping to reduce stiffness and improve muscle strength. When you have a total hip replacement, exercise programs should be tailored to your needs, and your doctor or physical therapist can help you develop a plan. Initially, the focus will be on:

• Range-of-motion exercises: These will help restore flexibility and prevent stiffness.
• Strengthening exercises: Focus on building the muscles around the hip to improve support and stability.

As you progress in recovery, many doctors recommend avoiding high-impact activities or high contact sports as these can place excessive stress on the artificial joint. Instead, consider activities like:

• Walking: A low-impact exercise that improves mobility.
• Cycling: Both stationary and outdoor cycling are excellent ways to increase strength and endurance.
• Swimming: Provides a full-body workout without stressing the hip joint.

With proper exercise and care, you can enjoy an active lifestyle post-surgery while preserving the health of your new hip joint.