The hip is one of the main weight-bearing joints in your body. It consists of two main parts:
Ligaments, which are bands of tissue, connect the ball to the socket and help keep the ball and socket steady. A smooth, tough material called articular cartilage, which cushions the bones and lets them move easily, covers the surfaces of the ball and socket.
All the rest of the surfaces of the hip joint are covered by a thin, smooth tissue liner called synovial membrane, which makes a small amount of fluid that acts as a lubricant so that the bones in the hip joint will not rub against each other.
Pain in your hip can be debilitating, making it difficult for you to walk, climb stairs, or even pick up an object from the floor. It can limit your freedom of movement and ability to function independently.
While hip pain can be caused by deformity or by direct injury, like trauma or a sports injury, the most common cause of hip pain is osteoarthritis (OA) also known as degenerative joint disease (DJD). Depending on factors like age, weight, joint function, and activity, people with arthritis find their hip’s cartilage lining wears away over time. At that point, your bones begin to rub against each other, resulting in friction, swelling, pain, stiffness, and instability.
Experiencing joint pain day after day without relief can lead to “staying off” the joint — which often weakens the muscles around it so it becomes even more difficult to move.
You don’t have to live with severe joint pain and the functional limitations it causes. If you have not experienced adequate results with medication and other conservative treatments, total joint replacement may provide the pain relief you long for, in addition to allowing you to return to the lifestyle and activities you enjoy. Your orthopaedic specialist can tell you whether you might benefit from joint replacement and explain the reasons why it may, or may not, be right for you.
Of course, even if your orthopaedic specialist determines that joint replacement is a good medical option for you, it is still up to you to make the final decision. The ultimate goal is for you to be as comfortable as possible, and that always means making the best decision for you based on your own individual needs.
Hip replacement surgery involves replacing the femur (head of the thighbone) and the acetabulum (hip socket). Typically, the artificial ball with its stem is made of a strong metal or ceramic, and the artificial socket is made of polyethylene (a durable, wear-resistant plastic) or metal backed with a plastic liner. The artificial joint may be cemented in position or held securely in the bone without cement.
Hip replacement involves the removal of arthritic bone ends and damaged cartilage and replaces them with prosthetic implants that replicate the hip joint. Hip replacement can help relieve pain and get you back to enjoying normal, everyday activities.
Total hip replacement is often reserved for patients who:
In a total hip replacement operation, the surgeon replaces the worn surfaces of the hip joint with an artificial hip joint. The worn head of the femur (thighbone) is replaced with a metal or ceramic ball mounted on a stem; the stem is placed firmly into the canal of the thighbone at its upper end. The acetabulum (hip socket) is prepared and implanted with a metal cup and plastic or ceramic insert. The ball and insert glide together to replicate the hip joint.
Hip replacement surgery may be considered when arthritis limits your everyday activities such as walking and bending, when pain continues while resting, or stiffness in your hip limits your ability to move or lift your leg. Hip replacement may be recommended only after careful diagnosis of your joint problem. It may be time to consider surgery if you have little pain relief from anti-inflammatory drugs, or if other treatments, such as physical therapy, do not relieve hip pain.
After hip replacement surgery, you will probably spend no more than three to five days in the hospital. Most hip replacement patients begin standing and walking with the help of a walker and a physical therapist the day after surgery. However, everyone is different, and you should discuss what you can expect with your doctor.
Recovery varies with each person. It is essential that you follow your orthopaedic surgeon’s instructions regarding home care during the first few weeks after surgery; especially concerning the exercise program you are prescribed. You should be able to resume most normal light activities of daily living within three to six weeks following surgery. Some discomfort during activity and at night is common for several weeks. Complete recovery can take from about three to six months.
While most people will gradually increase their activities and return to doing things like playing golf, doubles tennis, shuffleboard, or bowling, you will be advised to avoid more active sports, such as jogging, singles tennis, and other high-impact activities.
As with any surgery, there is a risk of complications after hip replacement surgery. However, they are relatively rare. Blood clots are the most common complication after surgery. Your orthopaedic surgeon may prescribe one or more measures to prevent a clot from forming in your leg veins. These measures may include a special support hose, inflatable leg coverings, and blood thinners.
Hip replacement is one of the most important surgical advances of this century. This surgery helps more than 300,000 Americans each year to relieve their pain, and get back to enjoying normal, everyday activities.1
The conventional arrangement of a metal ball into a special plastic (polyethylene) cup has been shown to have positive results over the years. How long it will last depends not only on age, but also a patient’s activity level. Newer hip replacement materials using more durable alumina ceramic and titanium have made major advances in hip replacement technology. Demand and activity levels are generally considered when the surgeon works with you to decide which type of hip replacement materials are best for you.
1. http://www.aaos.org/wordhtml/research/stats/hip_recent.htm#patients – January 2006
Here are some exercises that your doctor may recommend:
Low Impact Aerobic Exercise – Swimming and riding a stationary bike are great low impact exercises that help build strength. Stop any exercise that causes increasing pain.
Short-Arc Knee Extensions – Roll up several towels in a roll 6-8 inches thick. Lay in bed with the towels under one knee. Bend the other knee. Keeping your knee on the towels, lift your foot to straighten the knee. Hold for a few seconds and lower the foot.
Ankle Pumps – While lying in bed, point your toes downward and then bring your toes back up towards your head, tightening your calf.
Heel Slides – Slide your heel along the bed pulling your foot towards you as your knee bends.
Straight Leg Raise – Start by tightening your quadriceps, the muscles in the front of your thigh. Then with toes toward the ceiling, lift your leg 6-12 inches from the bed.
Quadriceps Sets – Lie on your back, legs straight. Tighten the muscle in the front of your thigh as you press the back of your knee toward the bed. Hold for a few seconds, then relax the leg.
Standing Knee Bends – Stand while holding onto a steady surface, such as a table. Bend your knee as far as it will go comfortably. Hold for a few seconds and lower the leg.
Increasing upper body strength is also important because of the need to use a walker or crutches after surgery.
Bicep Curls – In a sitting position, keep you elbow close to your body and your wrist straight. Bend you arm, moving your hand up to your shoulder, then lower slowly.
Triceps Extensions – Sit, leaning forward from the waist. Bend your elbow so that your forearm is parallel to the floor. Then straighten your elbow as you extend your arm behind you.
Seated Press Ups – Sit in a sturdy chair with armrests. With palms on the armrests, press down to lift yourself from the chair. Hold for 3-5 seconds. Bend your elbows slowly to ease back down.
Talk to your doctor before starting any exercise program and remember to call your doctor if you experience increased pain or swelling after exercise.