Total Hip Replacement Surgery

If you and your surgeon have exhausted all non-surgical measures for treating your hip problems, you may be a candidate for total hip replacement surgery. This procedure is often the only option for restoring an active, pain-free life. If your doctor decides that this is right for you, the following information will give you an understanding about what to expect.

The purpose of hip replacement surgery is to remove the two damaged and worn parts of the hip joint - the hip socket (acetabulum) and the ball (femoral head) - and replace them with smooth, artificial implants called prostheses, which will help make the hip strong, stable, and flexible again.

Hip Implant Components

At surgery, the hip implant selected by your doctor to fit your hip will be affixed to the thigh bone (femur) and the pelvis. In total hip replacement surgery, the prosthesis is made up of three components - the femoral stem, femoral head (ball), and acetabular component (socket). The femoral stem, made out of a metal such as titanium, is implanted down the shaft of the thigh bone. The femoral head (ball), which is attached to this stem, is designed to replace the arthritic femoral head. The new socket is a metal shell with a plastic inner socket liner.

These components are implanted into the pelvis and thigh bone, and are designed to closely approximate the mobility of the natural hip joint.

The Procedure

Before you are taken to the operating room, the anesthesiologist will talk with you about the medications that will be used during the procedure. Usually a general anesthetic is used or a spinal with sedation. The anesthesiologist will also administer medication to help you relax.

Next, the surgeon will make an incision in your upper thigh to access the hip joint. Your surgeon will select the appropriate incision length and approach that is best for your case. After the incision is made and exposure is adequate, the ligaments and muscles are separated to allow access to the bones of the hip joint.

Once the ball that fits into the socket is removed, the socket is prepared forming a hemispherical shape where the metal shell (socket) will be positioned. Your surgeon initially places trial hip implant pieces of different shapes and sizes in the reamed socket to determine the optimal size for your body prior to implanting the actual component into the socket.

The next step involves preparing the inside of the thigh bone to accept the stem of the artificial hip. Special instruments are used to prepare the inner surface of the thigh bone so it matches the shape of the femoral implant.

For some patients, a special type of acrylic cement, which is well tolerated by the body, is used to affix the components to the underlying bone. For other patients, the implants are affixed to the bone without cement. In these cases, the implants may be coated with a special porous surface that allows the living bone tissue to adhere to the implant.

Finally, the wound is closed, and a dressing is applied to the incision. You are then taken to the recovery room where staff will monitor your vital signs until you are transferred to your hospital room.