Hip Replacement


Hip replacement is a surgical procedure in which a surgeon removes the damaged and painful sections of the hip joint and replaces it with an artificial one that is usually made from metal, ceramic, and High density  plastic components. This procedure is undertaken to reduce pain and improve one’s joint movement and function. The artificial joint is known as a prosthesis.

Hip replacement is usually done when other, less invasive methods have failed to provide relief to the patient. Also known as Hip Arthroplasty, hip replacement is also considered if the hip pain interferes with one’s daily activities. Damage caused due to Arthritis is one of the most common reasons for Hip Replacement Surgery. Some conditions that may require hip replacement surgery to treat it are:

Osteoarthritis: Also known as wear-and-tear arthritis, this condition damages the protective cartilage that cushions the ends of your bones which helps the joints move smoothly.

Rheumatoid Arthritis: This is an autoimmune disease in which there is inflammation in the joints, which in turn leads to bone erosion and joint deformity.

Osteonecrosis: Osteonecrosis occurs when there is no adequate blood supply to the ball portion of the hip joint, which might occur due to dislocation of the hip bone or hip fracture.

Does an artificial hip work better after a hip replacement?

Hip replacement offers the greatest benefit of pain relief. Along with that, there is an improvement in movement, strength, and coordination of the lower body. It also helps you to get back to your active life. But, despite being highly effective, an artificial hip is associated with certain limitations.

1. Durability: Though majority the of the artificial hip implants last for 15 to 20 years, one cannot guarantee smooth functioning in every case of certain situations such as infections or trauma, an artificial hip can get worn out quickly, making it necessary for a second replacement. Normally, an artificial hip can work for up to 15 – 20 years, without any major trouble.

2. Susceptibility to allergy: Though these problems are rarely seen, they can occur. The patient may display signs of metal allergy after the surgery. This is characterized by skin rash, itching sensation, and discoloration in the area where the artificial joint has been fixed. 

3. Weather problems: In some patients, the natural bones surrounding the hip implant take more time to adapt to the metallic nature of the hip, leading to increased weather sensitivity in the patient. Due to this phenomenon, a patient may feel increased pain and stiffness in the artificial hip in certain seasons like monsoon or winter.

4. Caution in future dental visits: You need to take care while visiting your dentist after your hip replacement as you could catch an infection. Preferably, you should take a prophylactic antibiotic.

What type of permanent restrictions will one have after a hip replacement surgery?

Every patient’s experience with Hip Replacement Surgery is not the same. Hence, it is not possible to predict whether a particular patient will have permanent movement restrictions after hip replacement or not. Most of the patients can return to a normal daily routine without any permanent restrictions, albeit with less pain and discomfort. However, a risk always prevails regarding an implant getting worn out, in which case the patient might need a second replacement. Though there are no permanent restrictions in most cases, there are certain activities one has to avoid for a certain period. These restrictions are also known as posterior hip precautions. They are:

  1. Cross your legs: One should not cross their legs past the midline of the body after a hip replacement surgery. To avoid crossing your legs, the surgeon may also advise sleeping on your side or keeping a pillow between the legs.
  2. Forward bending: It is also important to ensure that you do not bend your hip beyond 90 degrees after a hip replacement. Your knee must be below your hip joint. You can utilize cushions and pillows to elevate your seat, to ensure that your knees are positioned lower than your hips.
  3. Positioning your feet: Ensure that you keep your feet and your knees pointed straight ahead, in the front. Do not try turning them in or out. Also, avoid sitting in the same position for more than 30 40 minutes.
  4. Seating arrangement: Make sure that you are using a firm chair with a straight back and armrests. Avoid chairs that are too soft, rocking chairs, recliners, and stools.
  5. Climbing the stairs: Avoid climbing the stairs very frequently, as it will put a strain on the artificial joint.

Even after the joint has completely healed strenuous physical activities like sports must be avoided. It is important to keep in mind that the prosthetic joint has only been designed to withstand day-to-day physical activities. You can work with a physical therapist to learn various techniques and guidelines while performing various activities. If you do not follow the above-mentioned restrictions, you may run the risk of dislocating your joint, leading to second replacement surgery. Hence, you must be well-informed and take precautions with utmost care as suggested by your surgeon.

Today, the healthcare industry is simmering with innovation and new ideas. Transformation is happening at an astonishing pace and redefining the way in which patients are treated for any health-related issues. New-age technologies have boosted the success rate and are also turning out to be less invasive as compared to older methods. Especially, when it comes to treating hip pain and improving patient’s quality of life, hip replacement surgery is one of the most advanced and successful procedures in today’s medical space. Traditionally, Orthopaedic surgeons use to prefer a total hip replacement surgery by incising back or on the side of your hip. However, in recent times, surgeons prefer incising a cut in the upper part of the front thigh. This approach is called an anterior approach or anterior hip replacement. These surgeries may likewise be called small mini, modified, minimally invasive, or muscle-saving surgeries. The procedure involves replacing a damaged hip joint with an artificial hip that can be of metal or ceramic.

Though there are various approaches to the hip that can provide an exemplary outcome, over the past several years, the anterior approach has become more popular because of its minimally-invasive technique. Also, it lowers the risk of complexity before, amid and after the surgery. However, adopting this technique is highly preferred in patients with arthritis, but can also be used for patients undergoing THR due to any other reason like hip fracture, disorders that cause unusual bone growth (bone dysplasias), etc. A lateral or posterior hip replacement surgery and anterior hip replacement approach vary in certain ways but both the approaches share the same objective. Both the approaches are devised to provide adequate pain relief from the hip joint and allowing the patient to perform their normal chores with great comfort. Now let’s take a look at some benefits of Anterior Total Hip Replacement.

Benefits of anterior Total Hip Replacement

  • Compared to ancient science, after anterior THR, a patient suffers from less pain without causing much damage to surrounding tendons and muscles, which leads to a rapid and smooth recovery.
  • The patient will no longer need to be kept under observation post-surgery and can be allowed to go home immediately as per doctor’s advice.
  • Once the surgery is completed, it allows an option for the patient to walk out of their bed and cover small distances independently using any walking aid as soon as it’s comfortable.
  • The patient can also navigate through stairs with ease and comfort. While pursuing the stairs, lifting the stronger leg first onto the steps and starting with the weaker leg when coming back down through the stairs helps in preventing dislocation of the new implant. It is common for the patients to use cane, walker or any other equipment for walking assistance immediately after the surgery.
  • With the lateral or posterior approach, patients have to avoid bending and even sitting with their legs crossed for 6 – 8 weeks as this could result in hip dislocation. But with anterior approach patients are not restricted from any of these activities.

Life after anterior Total Hip Replacement

After implementing a successful anterior THR surgery, patients are able to bear weight on their new hip and can walk easily using any walking aid as per their support. The only thing that patients need to make sure is that their home stairs have a guardrail or banister installed, as to avoid any temptation of walking up or down the stairs unsupported. However, patients will need a personal trainer to restore the strength and movement in their joints and surrounding muscles. Mostly it will take up to 4-6 weeks to gain ample strength for the movement and performance of the daily routine activities. One can resume work after anterior THR, as it allows the majority of patients to start working after a month but we would recommend waiting for up to 3 months if it involves physical labour. Patients can expect their lifestyle to be a lot like how it was before having surgery but without the pain.

Summing up, anterior hip replacement by far is less painful and leads to a faster recovery of mobility and strength compared to a lateral or posterior approach. However, the recovery process still involves distinct phases to ensure the tissue is healing properly which will allow optimum functionality. It is important for every patient to know that every case is unique and the progression will completely depend on their unique set of circumstances. But, an anterior hip replacement approach is mostly likely to add more quality to a patient’s life.

Whether you have just commenced exploring treatment options for your hip pain or already have decided to go for a hip replacement surgery, we’ve got some information that might help you in your decision making. It has been proven that hip replacement surgery is one of the most successful procedures performed by orthopaedic surgeons for relieving chronic hip pain. With more than 90% success rate, hip replacement implants have managed to drastically reduce pain and improve function for people with damaged joints. The most conventional reason for having a hip replacement is osteoarthritis while other possible reasons include rheumatoid arthritis, a hip fracture or hip dysplasia; a condition where the hip joint hasn’t developed properly. It is essential to understand that a hip replacement implant is usually done when all other options including medication have failed to provide sufficient pain relief. The main objective behind the procedure is to relieve a sore hip joint, thus making walking and other activities easier.

The surgery involves taking off parts of the hip joint that are problem causing (usually the ball and socket) and then replacing them with new parts made from metal, plastic, and ceramic. Many people undergo this surgery every year and it usually brings great effects in terms of enhanced strength and well-being. However, it’s always vital to discuss with your doctor about the probable risks involved in it.

The material for the hip implant is normally selected by your surgeon depending on your medical condition and unique requirements. Full metal implants are now not readily preferred by surgeons due to the high risk of metal poisoning. Thus came titanium metal and ceramic implants at your rescue. Let’s find out how both of these are different from each other and which one can be the right fit for you.

Ceramic Implants

Ceramic hip implants are among the latest type of prosthesis being used for hip replacement, giving greater resistance to damage and smooth movement of the joint. For those who are not aware of Ceramic material, it’s a tough substance and does not get worn out easily as compared to metals and plastic. However, ceramic is also not completely devoid of problems. They tend to develop cracks and breaking down easily. However, newer ceramic materials have demonstrated lesser problems but, long-term clinical outcomes with ceramic implants are less published contrary to the metallic implants. This fact somewhat restricts the preference for ceramic implants.

Titanium Implants

Most hip implants these days consist of Titanium. Both the ball and the socket of the hip joint are replaced with a titanium implant, and a plastic spacer is placed in between. Titanium metal has a long history of established effectiveness in hip replacement and continues to be preferred by many surgeons. Based on current practice, metal (Titanium) implants are preferred in aged patients, while ceramic implants are being increasingly recommended in younger candidates due to their reliable durability.

Despite rising concerns over metal and other material implants used in the surgery, the majority of the hip replacement implants have been successful and have improved the quality of life and function.

To round off, when it comes to choosing the best material, both have their pros and cons. While ceramic does not get as worn out as metal or plastic, they can develop cracks or break suddenly.  It will eventually depend on the surgeons to pick the best one for you after analyzing the risks and benefits of various implants.

Hip pain is not normal and can cause serious trouble if not treated wisely. Any discomfort or painful sensation near the thighbone or pelvic girdle can be termed as hip pain. The hip joint is a ball and socket synovial joint that is responsible for providing a wide range of motion for the lower torso. It is because of the hip joint one can stand, walk, dance or lift. It is also considered as one of the most important joint when it comes to stability. However, as the person ages, the joint may undergo wear and tear.

Though hip pain to an extent can be treated with medication, injections and physical therapy, hip replacement surgery is the safest and the best option to treat hip-related problems when nothing else finds success in relieving the pain. A hip replacement could be recommended to any patient, in case they are suffering from chronic hip pain which is hindering their daily activities and other non-invasive methods of pain reduction have proved to be ineffective or are no longer effective to improve their condition. A patient with symptoms of severe hip arthritis, including as stated below, could be suggested to go for Hip replacement surgery.

1) Hip pain: An aching hip can make any patient’s life miserable. The most vital factor in selecting to have a hip replacement is quantifying the extent to which pain is affecting a patient. Pain that leads to interference in performing daily activities, even not letting anyone have a sound sleep, and is restricted between hip and knee could indicate arthritis of the hip. Some patients need the support of a cane or are also seen limping. A set of such patients regularly rely on pain-killer consumption to deal with their pain. In such cases, doctors usually suggest a patient with a replacement surgery to get long-lasting relief.

2) Stiffness: Difficulty in performing certain normal activities like doing weight training, cycling or even bending down for picking basic objects

3) Sprain: A sprain in a muscle occurs when the ligament is stretched than the usual limit causing the area to swell. A sprain can be caused by any sudden fall, twist, and turn of the muscle groups/joints.

 4) Difficulty in weight-bearing: In case a patient is not able to stand on his/her paining leg even for a minute with support, it indicates that their hip’s condition is very bad and they need a total hip replacement surgery.

5) Muscle stress: When the body is stressed, muscles tense up. Muscle tension is the body’s way of guarding against injury and pain. For e.g when you sit in one position for some time, you may end up making them stressed. This causes a change in the body’s nervous system by contracting blood vessels and reducing blow flow.

6) Fractures. A hip fracture is a fracture of the upper region of the femur or the thighbone. Fractures lead to swelling, difficulty in walking, sitting, etc causing severe pain.

Also, if the patient is suffering from Osteoarthritis or Osteoporosis, they can be advised to undergo a Total Hip Replacement. With Osteoarthritis, the joints become stiff and swollen due to inflammation and a breakdown of cartilage, causing pain and deformity are observed. Talking about Osteoporosis, it is a bone disease that occurs when the body loses too much bone, makes too little bone, or both.

So, in case you are experiencing severe pain with no sign of pain killers bailing you out of the dreadful situation, a hip replacement surgery then can be regarded as the best treatment option. Remember that the surgery option should only be considered when all other conservative treatment options have failed to provide relief from continuous hip pain and restricted mobility.

Also, remember that whatever the cause is, hip pain is more common as you grow older. And over time, your joint will see a lot of wear and tear. So make sure you are taking adequate care of the joints by eating healthy and doing the right exercises to keep your bone health at its best. 

Pain in any part of our body can be severely restricting. More so when the pain prevents us from leading our normal lives and carrying out our favorite activities, like the pain experienced by those who have chronic hip pain whether due to trauma or arthritis. The most unfortunate part about this pain is that it severely hampers the patient’s mobility; leaving them confined to their rooms or at the mercy of a cane or walker.

Total Hip Replacement or Total Hip Replacement is most and often the best option for patients in this situation. But how does one come to the realization that surgery is required or what is an orthopedic surgeon looking for before recommending surgery?

More often than not, these symptoms are:

  1. Chronic hip pain that hinders daily activities and is unabated by non-invasive therapies like weight reduction, physical therapy and painkillers. Lack of sleep due to pain is also an indicator that a Total Hip Replacement is required.
  2. If the stiffness of the hip prevents the patient from going about their daily lives.
  3. Inability to stand on the affected leg without support for even a minute.
  4. The patient can no longer walk short distances.
  5. Pain that is beginning to affect the patient mentally as well as physically
  6. The patient is experiencing severe side effects of pain-killers.
  7. Last but not the least, the doctor has determined that non-invasive or conservative treatments are no longer effective or helpful.

Is a hip replacement safe and successful and what restrictions will that place on the patient?

A large majority of Total Hip Replacement Surgery  are successful with most patients experiencing significant relief from their symptoms. While there are some risks like infection and blood clots associated with Total Hip Replacement, they are easily preventable. Overall, the procedure is one of the safest surgeries to undergo, with millions of patients getting their hips replaced every year. The evolving technology and surgeon skills are also improving the procedure every day. New and improved implant design also reduces the chances of dislocation. As to post-surgery restrictions, patients who decide to undergo a Total Hip Replacement should adapt a few permanent changes to their posture for the maximum benefit and in order to prevent any negative effect to the hip implant.

For preventing such incidents, certain movements or activities need to be avoided. They are:

  1. Cross-legged sitting
  1. Forward Bending: Avoiding bending one’s knees beyond 90 degrees is a crucial thing to keep in mind. Postures where the knee is not below one’s hip joints can lead to complications and difficulties.

As with anything surgery related, any doubts related to one’s condition should be cleared with one’s surgeon. 

How do I convince my loved ones to undergo a hip replacement?

The possibility of undergoing a major surgery can be quite intimidating to anyone especially elderly patients. Convincing them requires patience and time. While the final decision rests in their hands, here are some things that may help you in helping them make the right choice.

  1. Firstly, have a sit-down conversation with your loved one and their orthopedic doctor to fully understand the procedure, the risks and expected results. Encourage your loved one to get their doubts cleared by the doctor no matter how insignificant they may seem.
  2. Have a heart to heart conversation with them about how the procedure can help get rid of the chronic pain.
  3. Take them to meet other people who have undergone Total Hip Replacement recently, preferably those who have been operated on by their orthopedic surgeon. This will help them see how the procedure has helped these patients.
  4. Describe to them how people undergoing Total Hip Replacement can not only get relief from their pain but also regain their normal movements like navigating stairs and sit on the floor with folded legs.
  5. Discuss how current technology and expert surgeon availability means that they can undergo the procedure both successfully and with fewer chances of side effects.
  6. Alleviate their fears by providing them encouragement and assuring them that you will be with them every step of the way.
  7. Explain to them how keeping a positive attitude with regard to the operation will help them come through the procedure with much better outcomes.
  8. If they are worried about the physical therapy that will follow, then convince them that it will strengthen the muscles supporting the hip and allow them to recover faster.

The idea of undergoing surgery can be immensely daunting, even if the patient is already in significant pain. Coupled with the thought of physical therapy and recovery period, it is quite understandable for patients to refuse surgery or put it off until it’s too late. But the thing to know here is that beyond the surgery, physical therapy, and recovery, lies the light at the end of the tunnel. A light that is not only the promise of a pain-free life but also one in which the patient can regain their old life back.