Hip Replacement Surgery

Hip replacement surgery is performed on about 200,000 per year in the US alone. That is approximatively 1 in every 2,000 people. Of those people needing surgery, there are probably ten times more questions that will want to be answered prior to the replacement. Topics about complications and risks tend to come up the most, but there are other aspects that you the patient should be concerned about.

Why would I need a hip replacement?

There are a number of reasons why a person would need a hip replacement, but the most common causes are certain forms of arthritis and traumatic injuries.

Osteoarthritis, or degenerative joint disease, is a condition where the cartilage between the bones in your hip simply just wear away. The cartilage will settle underneath the bone, causing bone on bone contact. Cartilage can be thought of as a shock absorber between bones. If the cartilage wears away, it will make the bones grind on one another, causing severe pain and immobility.

Another cause is Rheumatiod arthritis. This is an autoimmune condition where inflammation of tissues around joints (most commonly shoulders, hips and neck) occur. This condition will make joint swollen and worn, leading to a breakdown in cartilage and the need for a joint replacement.

Hip replacement surgery will be needed when a condition called AVN, or also know as Avascular Necrosis, sets in. This condition is where the femoral head of the hip will lose blood supply over the course of time and eventually die. AVN can occur without reason, but is found prevalent in patients who have injured their hip. Other patients who have a history of alcohol or steroid use are at risk.

Other patients who have had severe injuries to their hip may need a complete replacement, although not very common. Most of the time a partial hip replacement can fix a fracture to the hip.

Can I prevent a hip replacement?

With the conditions stated above as the causes, there are a few things that you can do to prevent the onset of hip surgery.

1. Exercise regularly - Staying fit will keep good blood flow to your joints and sheds extra pounds that will put stress on your joints.

2. Protecting your joints - By keeping good posture, sleeping on firm mattresses and keeping them warm in cold winter conditions.

3. Relaxation - Tense muscles will again put stress on joints. Try to work out then jump in a hot tub to relax your muscles.

These tips are great, but some things can't be avoided. Family history and genetics come into effect and cannot be dodged. Accidents happen to everyone, but are never intended. If you can follow the steps, you better your chances of not needing a hip replacement.

Are there alternatives to hip replacement surgery?

In simple, yes there are alternatives, but your doctor will know what is best for you. If you are still unsure about your doctor's prognosis, get a second opinion.

Some common alternatives to hip replacement include injections and medications. The majority of these cases only stall the inevitable hip replacement. Cortisone shots can only be injected every so often and medications will only temporarily numb the pain. Again, your doctor will know what is the best case scenario.

Other procedures as in hip resurfacing, are becoming more popular. This procedure is where a small amount of bone in surgically removed from the femoral head and pelvic socket. The removed bone is then replaced by a metal cap and socket, which is cemented into the proper location. Hip resurfacing will remove much less bone than in a typical hip replacement.

In rare instances, the only other options could be to realign bones, remove excess cartilage or fuse the hip bones together. These instances are rare and the surgeon or doctor will advise you on your options.

What are the steps taken prior to hip replacement surgery?

Generally, after your primary care doctor informs you of a needed hip replacement, there are a few steps to be taken. These are general steps and can include extra and exclude various steps, depending upon your personal situation.

1. Select a surgeon - Find a surgeon that is located within a reasonable amount of time from your home. You may have to travel there a few times before surgery for routine check ups. Find a surgeon that you can relate to and have trust in. No one wants a surgeon who only cares about themselves and not you.

2. Get a second opinion - This time would also be wise to get a second opinion from another doctor. Even if you're certain that a hip replacement is definitely for you, a second opinion will reiterate the need for your case. It never hurts either.

3. Understanding your hip replacement - You will meet with your surgeon at least once before the surgery. At that meeting, you will be able to ask the surgeon any questions or concerns related to the surgery. Usually, a packet of information is given to the patient that will answer many common questions. Depending upon the hospital or surgical center, they may place you in a seminar or class that will inform you about the hip replacement surgery and rehabilitation.

4. Primary care physician visit - Another appointment will be set with your primary care physician just before your scheduled date for hip replacement. During this appointment, your doctor will ask about your overall health and conduct tests to be sure you are healthy enough for your operation. These tests may include blood tests, x-rays, EKG / ECG (test that records your heart's electrical activity) and an echocardiogram (basically an ultrasound of your heart). These tests are designed to ensure stability of health and eliminate any risks that may come up during surgery.

5. Day of surgery - The patient should bring enough belongings with them for their required stay at the hospital. They should also shower to eliminate any risk of infection during surgery. The surgeon will also notify you prior to this day with a list of things to do including to not wear jewelry, make up, etc.

Are there any risks involved with hip replacement surgery?

As with any surgery, there are always risks. Hip replacements are a very common procedure and there is a high success rate of improvement after surgery (about 97%). Although seldom, there are risks that should be mentioned.

• Infections - As with most incisions or lacerations to your body, theres always a risk of infection. If after your surgery there is a clear liquid seeping from your wound, it might lead to an infection. Doctors will perform blood tests, nuclear scans and aspirations to confirm is there is an infection.
• Blood clots - Sometimes clots can occur during hip replacement surgery. Most noticabley a DVT, or deep vein thrombosis. DVT is a clot that will form on the inner leg of the patient. It will cause dizziness, shortness of breath, chest pains and nausea. If problems persist, seek medical attention immediately.
• Metal Debris - New technology is using aluminum and other metal components to replace what was once bone. Studies and researching have found that metal debris from hip implants are getting into the patients blood stream. Since the findings, the implants have been recalled and are being replaced with safer technology.
• Vascular injury - There are two main arteries that run through the hip replacement area. Every surgeon is aware of these arteries and avoid them at all costs. Although rare, there are instances where the arteries have been cut.
• Numbness and pain - After having a hip replacement, there will be pain and numbness around the incision area. Most of the time feelings of numbness will go away with the passing of time. Although there are instances of reported nerve damage, but very unlikely.

How much recovery time will I need after hip replacement surgery?

Depending upon the type of surgery, your observation stay at the hospital will vary from 1-5 days. This time the hospital will keep close watch on you and conduct a few tests to make sure the surgery went as planned. After your hospital stay you will be sent home with specific instructions from your surgeon.

Post surgery recovery time will take anywhere from 3-6 weeks. The first two weeks after surgery is the most critical time. During this time the staples from your surgery will need to be kept dry until there are removed (usually two weeks after surgery). You must also report any irregularities to your surgeon (severe pain, clear liquid discharge from the wound, dizziness, etc.).

During the first couple weeks, exercises are required for a quick recovery. A therapist or nurse will inform you of exercises that can be done to improve mobility and strengthen muscles back to original form.

Most patients will be recovered, working and driving again within 3-6 weeks of the operation. Again, depending on circumstances and pain threshold of the patient, recovery times will vary.

Are there any complications after my hip replacement surgery?

Most patients report less pain, better mobility and a better overall life after their hip implant. There are instances where few patients have experienced discomfort or problems after surgery. These problems can be related back to the patient or surgeon.

Some cases have been cited where the implant itself became dislodged or separated due to a defect in the implant or surgical procedure. This can be a cause to a bad placement or lack of cement in the replacement.

Other cases have been caused by the patient being involved in physical activities or extreme bending of the hip (causing the implant to separate from repaired position).

In either case, the complications after hip replacement surgery are rare. Although, the patient should always abide by their surgeons guidelines.

For more information about hip replacement surgery, visit http://www.surgery-hipreplacment.com