Definition of Hip joint replacement:

Hip joint replacement is surgery to replace all or part of the hip joint with an artificial device (a prosthesis).

Description:

The hip is a ball and socket joint, linking the "ball" at the head of the thigh bone (femur) with the cup-shaped "socket" in the pelvic bone. A total hip prosthesis is surgically implanted to replace the damaged bone within the hip joint.

The total hip prosthesis consists of three parts:

• A cup that replaces your hip socket. The cup is usually plastic, although some centers are trying other materials like ceramic and metal.
• A metal or ceramic ball that will replace the fractured head of the thigh bone.
• A metal stem that is attached to the shaft of the bone to add stability to the prosthesis.

If the surgery is a "hemi-arthroplasty," the only bone replaced with a prosthetic device is the head of the femur.

You will receive an extensive preoperative evaluation of your hip to determine if you are a candidate for a hip replacement procedure. Your health care provider will assess the degree of disability, impact on your lifestyle, and pre-existing medical conditions. The health care provider will also evaluate your heart and lung function.

The surgery will be performed using general or spinal anesthesia. The orthopedic surgeon makes an surgical cut, often over the buttocks, to expose the hip joint. The head of the thigh bone is removed and removed. Then, the hip socket is cleaned out and a tool called a reamer removes all of the remaining cartilage and arthritic bone.

The new socket is implanted, after which the metal stem is inserted into the thigh bone. The artificial components are fixed in place, sometimes with a special cement. The muscles and tendons are then replaced against the bones and the surgical cut is closed.

You will return from surgery with a large dressing on the hip area. A small drainage tube will be placed during surgery to help drain excess fluids from the joint area. Many surgeons also place a knee immobilizer or special pillow between the legs in the operating room to prevent the hip from dislocating.

You will have moderate to severe pain after surgery. However, you will receive painkillers for the first day or more after surgery. Painkillers may be given through a vein ( intravenously, or IV) through the spinal cord (an epidural), or by way of a special patient-controlled analgesia (PCA) device.

The pain should gradually decrease, and by the third day after surgery, painkillersk, taken by mouth, may be sufficient to control your pain. Try to schedule your pain medications about 30 minutes before walking or changing position.

You will also return from surgery with several IV lines in place to provide fluids and nutrition. The IV will remain in place until you are drinking adequate amounts of fluids.

If the procedure is elective (planned in advance rather than in response to an injury), you can donate blood several weeks prior to surgery to replace any blood lost during the procedure.

Sometimes, the blood that is drained from the wound during surgery is collected in a special sterile container to be reinfused through an IV after surgery.

You will also return from surgery wearing special stockings or inflatable compression stockings, which are used to reduce your risk of developing blood clots . Blood clots are more common after leg surgery.

Start moving and walking early after surgery. On the first day after surgery, you should get out of bed to a chair. When in bed, perform ankle exercises frequently to prevent development of blood clots.

You may be instructed on how to use a device called a spirometer, which shows how much air you breathe in at one time. You'll be shown how to gradually increase the depth of each breath you take, and to perform deep breathing and cough procedures to prevent pneumonia.

A Foley catheter may be inserted during surgery to monitor your kidney function and fluid level. It will be removed after surgery. You will be encouraged to try to walk to the bathroom with assistance.

Indications:

Hip joint replacement is primarily done in people age 60 and older. The operation is usually not recommended for younger people because of the strain they can put on the artificial hip, causing it to fail prematurely.

The reasons for replacing the hip joint include:

• Fractures in the elderly of the neck of the femur (usually requires a hemi-arthroplasty)
• Hip joint tumors
• Severe arthritis pain that limits a person's ability to do the things they want to do

This surgery is usually not recommended for:

• Current hip infection
• Extreme obesity (weight over 300 pounds)
• Nerve disease affecting the hip
• Paralyzed quadriceps muscles
• People with poor skin coverage around the hip
• Serious physical disease (terminal disease, such as metastatic cancer)
• Those with severely limiting mental dysfunction
• Very young patients