Your hip joint, which is formed where the thighbone meets the hipbone, is a ball-and-socket type joint. A smooth cushion of articular cartilage covers the end of each bone and is lubricated by fluid produced by the joint lining, allowing the bones to move against each other easily. When the joint does not work as it should, you experience decreased mobility and pain.
The causes for joint replacement are arthritis, avascular necrosis and hip fracture.
- Arthritis, the wearing away of the cartilage of a joint, can be caused by aging, injury or disease. As the bones rub together without the cushion of the cartilage, pain and further deterioration can occur.
- Avascular necrosis occurs when the blood supply for the ball part of the hip joint is blocked, due to an injury or a clogged artery. When the joint is no longer able to receive this blood, part of the femoral (thighbone) head will die, causing it to collapse. The result is a very painful joint.
- A hip fracture (or break) can result in the hip joint no longer working properly. Hip fractures are common in women who have osteoporosis, or thinning of the bones.
The surgery is performed under general anesthesia by an orthopedic surgeon. The surgery usually takes 1 1/2 to 3 hours. During this time, the surgeon places a metal socket with a strong plastic lining into your hipbone. The ball portion of your thighbone will be replaced with a metal prosthesis that exactly fits the metal socket. Following surgery, you will be in the recovery room for another hour or two, then taken to a room in the hospital.
Hip replacement is often scheduled weeks in advance, except in the case of a hip fracture, when surgery is usually done within a few days. If there is time prior to surgery, you should consider making changes that could maximize your recovery. Talk to your surgeon about your diet, exercise, weight and medicines. If you have any health changes, such as an infection, report them to your doctor as soon as possible. Finally, you should use this time to get plenty of rest.
You can also use the time prior to surgery to prepare for your return home. After surgery, any sitting areas you use should allow your hips to remain higher than your knees, because that will make it easier for you to get up. Before you have your surgery, check to make sure these areas allow you to use proper form. Examples of areas to "test" are your favorite chair, the side of the bed, the sofa, the toilet and the seats in your car. If any of these spots prevent proper form as described above, use a firm pillow to raise the level of your hips. Special aids can also be purchased, such as a raised toilet seat.
The average length of stay in the hospital is five days. During this recovery time, you will work with physical and occupational therapists to help you prepare for your return home. Before you go home, the hospital staff will teach you how to get in and out of bed and a chair, walk with crutches or a walker, get in and out of the shower and go up and down steps. All of these activities will be taught using hip precautions to protect your new joint. You will also be advised on the medicines you will be taking, special supplies you will need and how to use them, how to care for your incision and what exercises you should do during your recovery at home. Make sure to ask any questions you may have - your recovery is important!