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Total Hip Replacement

Hip replacement surgery, also called total hip arthroplasty, involves removing a diseased hip joint and replacing it with an artificial joint, called a prosthesis. Hip prostheses consist of a ball component, made of metal or ceramic, and a socket, which has an insert or liner made of plastic, ceramic or metal. The implants used in hip replacement are biocompatible — meaning they’re designed to be accepted by your body — and they’re made to resist corrosion, degradation and wear.

Hip replacement is typically used for people with hip joint damage from arthritis, osteoarthritis, avascular necrosis or an injury.

Osteoarthritis - This is an age-related “wear and tear” type of arthritis. It usually occurs in people 50 years of age and older and often in individuals with a family history of arthritis. The cartilage cushioning the bones of the hip wears away. The bones then rub against each other, causing hip pain and stiffness.

Rheumatoid arthritis - This is an autoimmune disease in which the synovial membrane becomes inflamed and thickened. This chronic inflammation can damage the cartilage, leading to pain and stiffness.

Post-traumatic arthritis – This can follow a serious hip injury or fracture. The cartilage may become damaged and lead to hip pain and stiffness over time.

Avascular necrosis – An injury to the hip, such as a dislocation or fracture, may limit the blood supply to the femoral head. This is called avascular necrosis. The lack of blood may cause the surface of the bone to collapse, and arthritis will result. Some diseases can also cause avascular necrosis.

Childhood hip disease – Some infants and children have hip problems. Even though the problems are successfully treated during childhood, they may still cause arthritis later on in life. This happens because the hip may not grow normally, and the joint surfaces are affected.

In a total hip replacement, the damaged bone and cartilage is removed and replaced with prosthetic components.

  • Surgeons replace both the ball (femoral head) and socket (acetabulum) during total hip replacement surgery.
  • The damaged femoral head is removed and replaced with a metal stem that is placed into the hollow center of the femur. The femoral stem may be either cemented or “press fit” into the bone.
  • A metal or ceramic ball is placed on the upper part of the stem. This ball replaces the damaged femoral head that was removed.
  • The damaged cartilage surface of the socket (acetabulum) is removed and replaced with a metal socket. Screws or cement are sometimes used to hold the socket in place.

A plastic, ceramic, or metal spacer is inserted between the new ball and the socket to allow for a smooth gliding surface.

Many different types of designs and materials are currently used in artificial hip joints. All of them consist of two basic components: the ball component (made of highly polished strong metal or ceramic material) and the socket component (a durable cup of plastic, ceramic or metal, which may have an outer metal shell).

The prosthetic components may be “press fit” into the bone to allow your bone to grow onto the components or they may be cemented into place. The decision to press fit or to cement the components is based on a number of factors, such as the quality and strength of your bone. A combination of a cemented stem and a non-cemented socket may also be used.

Your orthopaedic surgeon will choose the type of prosthesis that best meets your needs.

The success of your surgery will depend in large measure on how well you follow your orthopaedic surgeon’s instructions regarding home care during the first few weeks after surgery. Hip replacement surgery is successful more than 90 percent of the time.

Expect your new hip joint to reduce the pain you felt before your surgery and increase the range of motion in your joint. But don’t expect to do anything you couldn’t do before surgery. High-impact activities — such as running or playing basketball — may never get your doctor’s approval. But in time, you may be able to swim, play golf, walk or ride a bike comfortably.