Hip Replacement: aka total hip replacement
What is it?
A hip replacement is a surgical procedure during which a surgeon removes parts of a hip that are diseased or damaged, replacing the parts with new parts that are artificial.
When a person is having a hip replacement, it takes anywhere from one and a half hours to three hours. Depending on the patient, they may be given their choice of epidural, general, or spinal anesthesia. When the patient is given an epidural, it facilitates less chance of blood clots and less loss of blood. Once the patient has been anesthetized, the
surgeon will make an incision which is eight to twelve inches long down the side of their patient’s thigh. The surgeon may choose to put the joint in from the back, the front, or the side, but the approach from the back is the most used. The muscles and the ligaments that are below the skin are separated.
When the surgeon is inside the joint, he or she will separate the femur’s head from the patient’s acetabulum and uses a saw to remove the head. Then the surgeon will use a special reamer and power drill to remove the cartilage from the patient’s acetabulum. It will be then shaped so that it will accept the acetabulum of the prothesis.
Once the size that is right for the patient is selected, the surgeon will insert the acteabular component. If the joint is to be cemented, the surgeon will have to attach the component to the patient’s bone with epoxy. Otherwise, the plate is going to be held in place with screws or a tight fit.
When the femoral head is replaced, the surgeon will drill a hollow into the thighbone in order to accept a femoral head stem. The stem may be either cemented in place or held in place by a tight fit. A ball made of metal or ceramic that will replace the femur’s head will be attached to the head stem.
Once the artificial hip is in place, there will be an x-ray taken to make sure that it was positioned correctly. The incision is washed with a solution to make sure that its guarded against infection and sutures that used to close the layers of deep tissue are made of something that the body will absorb. The skin will be closed using surgical staples made of metal, which are removed ten days to two weeks after surgery. At last, a pillow that is large and triangular will be placed between the ankles of the patient. This helps to prevent the new hip from dislocating in the first days after the surgery.
Alternatives to Surgery
For a patient who has pain in their hip, surgery isn’t the only option. They can use something like a cane or a walker to help them with getting around, take pain medication by mouth, or be given cortisone shots by the doctor. They can also try things such as tai chi, yoga, or other types of dance therapy.
Before the operation
That patient will have a physical examination to check how fit they are for surgery. For some patients, it may be found that hey are ineligible for hip surgery and the doctor may want the patient to lose weight before the surgery is done. They may do tests on the patient, such as a CT scan, MRI, arthrogram, or aspiration. The patient will want to donate some of their own blood in case it is needed during or after the surgery. They will also want to arrange for time off from work for their recovery, arrange for help with driving and help at home.
After the Surgery - in the hospital
The patient will be in the hospital from five to ten days after the surgery. They will be given antibiotic medications and fluids through their IV in order to prevent infection. Pain medicine will be administered anywhere from three to four hours, or the patient may be able to administer to themselves using a PCA. The patient will see a respiratory therapist who will ask the patient to cough a few times a day. This helps the lungs and keeps pneumonia from setting in.
The patient will also start having physical therapy while they are in the hospital, and often times it starts on the second day after surgery. The therapist will show the patient how to use a walker or crutches, and show them how to manage everyday activities, such as showering or getting out of their bed without worrying about dislocating the prosthesis.
After the surgery - home
Once the patient is released from the hospital, the patient may go home or to a nursing facility. No matter where they go, they will have more physical therapy which will continue for four or five months after the surgery. The therapist’s job is to monitor the progress of the patient and suggest exercises. The patient may be able to start driving between 6 and 8 weeks after the surgery and they will be able to return to work on a full time basis eight to ten weeks after surgery, depending on their type of work.
There are a few complications that are involved with hip replacement surgery, including:
dislocation of prosthesis
deep vein thrombosis
Hip replacement is major surgery, and everything should be done to help the patient before it is decided as a course of action.
Estimated Costs for Total Hip Replacement Surgery