A total hip replacement is a surgery to replace a diseased or injured hip joint. An artificial ball-and-socket joint is inserted to make a new hip. It can be done by full open surgery or a minimally invasive technique. The minimally invasive technique only requires 1 or 2 tiny incisions and special instruments.
Left Total Hip Replacement
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This surgery is done when pain and stiffness limit your normal activities and rest, medication, and physical therapy are no longer working.
Other reasons for surgery may include a broken hip, severe rheumatoid arthritis, bone tumors, and loss of blood supply to the bones of the hip.
If you are planning to have a hip replacement, your doctor will review a list of possible complications, which may include:
Factors that may increase the risk of complications include:
Be sure to discuss these risks with your doctor before the surgery.
Your doctor will do a physical exam and may also do:
In the time leading up to the procedure:
An incision will be made along your joint. The muscles will be moved aside. The damaged bone and cartilage of the hip joint will be removed. The remaining bone will be prepared for the prosthesis. The new artificial joint will be placed in position. Depending on the type of prosthesis, bone cement may be used to hold one or both parts of the artificial hip firmly to your bone. Lastly, the incision will be closed with stitches or staples.
This surgery may be done with 1 or 2 small incisions, one over the groin and another over the buttock. Special tools are used that fit into these small incisions. In some cases, x-rays will be used to help guide the doctor.
For the one-incision surgery, an incision will be made over the outside of your hip. The muscles and tendons will be moved out of the way. Next, the damaged bone and cartilage of the hip joint will be removed. The remaining bone will be prepared for the prosthesis. The new artificial joint will then be placed in position. Depending on the type of prosthesis, bone cement may be used to hold the artificial hip in place. Lastly, the incision will be closed with staples or stitches.
You will have pain after the surgery. Pain medication will be given to help with discomfort.
This procedure is done in a hospital setting. The usual length of stay is:
Your doctor may choose to keep you longer, if complications occur. In some cases, you may need to stay in a rehabilitation unit. The focus will be on regaining function.
While you are recovering at the hospital, you may need to:
When you return home, do the following to help ensure a smooth recovery:
Antibiotics may be needed before certain dental procedures or surgeries now that you have an artificial joint. This will prevent possible infections from entering the bloodstream. Make sure to let the dentist or doctor know that you have an artificial joint.
Within 6 weeks, you should be able to resume normal, light activities. A replacement hip typically lasts 10-15 years.
Contact your doctor if your recovery is not progressing as expected or you develop complications such as:
In case of an emergency, call for emergency medical services right away.
American Academy of Physical Medicine and Rehabilitation
National Institute of Arthritis and Musculoskeletal and Skin Diseases
The Arthritis Society
Canadian Orthopaedic Association
Activities after hip replacement. Ortho Info—American Academy of Orthopaedic Surgeons website. Available at: http://orthoinfo.aaos.org/topic.cfm?topic=A00356. Updated July 2014. Accessed February 11, 2016
Al Muderis M, Bohling U, Grittner U, Gerdesmeyer L, Scholz J. Cementless total hip arthroplasty using the Spongiosa-I fully coated cancellous metal surface: a minimum twenty-year follow-up. J Bone Joint Surg Am. 2011 Jun 1;93(11):1039-1044.
Antibiotic prophylaxis for patients after total joint replacement. American Academy of Orthopaedic Surgeons website. Available at: http://orthodoc.aaos.org/davidgrimmmd/Antibiotic%20Prophylaxis%20for%20Patients%20after%20Total%20Joint%20Replacement.pdf. Published February 2009. Accessed February 11, 2016.
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Hip fracture. EBSCO DynaMed Plus website. Available at: http://www.dynamed.com/topics/dmp~AN~T116789/Hip-fracture. Updated May 13, 2016. Accessed October 10, 2016.
Lindström D, Azodi, Sadr O, et al. Effects of a perioperative smoking cessation intervention on postoperative complications: a randomized trial. AnnSurg. 2008;248:739-745.
Minimally invasive total hip replacement surgery. Ortho Info—American Academy of Orthopaedic Surgeons website. Available at: http://orthoinfo.aaos.org/topic.cfm?topic=A00404. Updated June 2014. Accessed February 11, 2016.
Pagnano MW, Trousdale RT, Meneghini RM, Hanssen AD. Slower recovery after two-incision than mini-posterior-incision total hip arthroplasty. Surgical technique. J Bone Joint Surg Am. 2009 Mar 1;91 Suppl 2 Pt 1:50-73.
Questions and answers about hip replacement. National Institute of Arthritis, Musculoskeletal, and Skin Diseases website. Available at: http://www.niams.nih.gov/Health_Info/Hip_Replacement/default.asp. Updated July 2013. Accessed February 11, 2016.
Who needs a hip replacement? NIH SeniorHealth website. Available at: http://nihseniorhealth.gov/hipreplacement/whoneeds/01.html. Accessed February 11, 2016.
6/14/2017 DynaMed Plus Systematic Literature Surveillance http://www.dynamed.com/topics/dmp~AN~T566765/Elective-total-hip-arthroplasty: Wilson SH, Wolf BJ, Algendy AA, Sealy C, Demos HA, McSwain JR. Comparison of lumbar epidurals and lumbar plexus nerve blocks for analgesia following primary total hip arthroplasty: a retrospective analysis. J Arthroplasty. 2017;32(2):635-640.
Last reviewed March 2017 by EBSCO Medical Review BoardWarren A. Bodine, DO, CAQSM
Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.
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