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Patients with arthritis of the hip may have to undergo a hip replacement surgery if their arthritis is non-responsive to medication. This article outlines 6 things you should know about undergoing hip replacement surgery.

Arthritis, a disease characterized by the inflammation of joints, is not curable. However, there are several different treatments to reduce symptoms and improve joint functioning. One such treatment is surgery. In particular, some people with arthritis of the hip choose to undergo hip replacement surgery, which is a procedure in which an orthopedic surgeon removes a painful arthritic joint of the hip and replaces it with an artificial joint that is made from metal and plastic. However, surgery is often the last resort and is only recommended when all other treatments aimed at providing pain relief have failed.

A hip replacement surgery serves a dual purpose — relieving hip pain and enabling the patient to walk more easily. These are six things you should know if you are considering hip replacement surgery.

1. There are two different methods two carry out a hip replacement

There are two different ways in which surgeons can conduct a hip replacement surgery — a standard or traditional hip replacement surgery or the minimally-invasive technique. (Don't read if you get squeamish about the semi-graphic details of surgery!)

  • Standard hip replacement surgery. This takes place under general anesthesia. Your surgeon makes a cut on the side of the hip, and then moves the relevant muscles to the top of the thighbone to free the hip joint up. Next, the surgeon will take out the "ball" of the joint by cutting it with a saw. When it is gone, your surgeon replaces this with an artificial joint. This is attached to the thighbone with special materials that aim to make sure your new hip lasts a long time. Finally, the doctor will reattach the muscles and close the incision.
  • The minimally invasive technique. In this type of surgery, surgeons make one to two cuts that are between two to five inches long. The surgery then takes place using the same methods employed in a standard hip replacement, but through these small cuts. The use of this minimally invasive technique is associated with reduced blood loss, reduced pain after surgery, a shortened hospital, fewer scars and increased healing.

While the minimally invasive technique is, in theory, better, it is actually associated with more complications if done by a surgeon who is not experienced. Therefore, if you are contemplating undergoing a hip replacement, look into how often your surgeon does either technique.

2. You will be hospitalized for a few days after the surgery

After you undergo a hip replacement surgery, you will likely be hospitalized for four to six days and will have to be bedridden with a wedge-shaped cushion that is placed between your legs in order to keep the new hip joint in place. As you will be bedridden, you will require a catheter.

3. You will undergo physical therapy after the surgery

Usually, you will begin physical therapy the day after your surgery. You should be able to walk within days of the surgery using a walker, crutches, or a cane. Furthermore, you will continue physical therapy for weeks to months after the surgery.

4. You will have to avoid some activities after your surgery

Generally, for six to 12 months after your surgery, you should avoid doing any pivoting or twisting of the leg that is associated with the arthritic hip. Furthermore, you should not cross the arthritic leg past the midline of the body or turn the leg inward. You should not bend forward or squat. Your physical therapist will instruct you on how to perform daily activities and tell you what should be avoided.

If you don’t follow instructions, you may require another surgery. Even after your joint has healed, you should avoid certain sports or heavy activities.

Additionally, you should follow simple measures at home that can make your life easier. This includes keeping stair climbing to a minimum as you should only be climbing stairs once or twice a day. You should also:

  • Sit in a chair with a firm, straight-back and no recliners.
  • Remove all the rugs in your house and get rid of clutter to avoid any potential falls.
  • Use an elevated toilet so you don’t have to bend your legs too far.

5. While safe, hip replacement surgeries do come with a risk

Hip replacement surgery is fairly common and is performed very routinely all the time. Furthermore, as with any surgical procedure, it is constantly being improved. However, there are always risks. One of the risks is the development of a blood clot since you won’t be able to move around much at first. One of the ways to circumvent this issue is if the doctor gives you blood thinners. You can also get an infection or bleeding from the surgery. There are also other, smaller risks. You should always talk to your doctor about the risks before embarking on any surgeries.

6. Your artificial joint will likely last at least 20 years

As the techniques are constantly being improved, so are the types of artificial joints available. The original artificial joints were thought to last an average of 10 years but now, it is known that 85 percent of hip joint implants will last 20 years. Even if the joint does become damaged, surgeons are able to successfully repair the joint.

  • Kirwan, J. R., et al. "Overall long-term impact of total hip and knee joint replacement surgery on patients with osteoarthritis and rheumatoid arthritis." Rheumatology 33.4 (1994): 357-360.
  • Witt, J. D., M. Swann, and B. M. Ansell. "Total hip replacement for juvenile chronic arthritis." The Journal of bone and joint surgery. British volume 73.5 (1991): 770-773.
  • Poss, R. O. B. E. R. T., et al. "Complications of total hip-replacement arthorplasty in patients with rheumatoid arthritis." The Journal of bone and joint surgery. American volume 58.8 (1976): 1130-1133.
  • Photo courtesy of SteadyHealth

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