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Total Hip Replacement Surgery

What is a total hip replacement?

This is a surgical procedure where the diseased cartilage and bone of a hip joint is replaced with a hip joint prosthesis (artificial hip components).

Who is a candidate for total hip replacement surgery?

The most common indication for total hip replacements is osteoarthritis of the hip causing progressive hip pain and loss of quality of life.

What are total hip replacement complications?

Complications specific to hip replacements:

  • Blood clots in the lower limb veins (known as deep vein thrombosis or DVT).

What preparation is needed for the procedure?

The preoperative evaluation generally includes a review of all medications being taken by the patient. Anti-inflammatory medications, including aspirin, are often discontinued one week prior to surgery because of the effect of these medications on platelet function and blood clotting.

What will recovery be like for the patient after surgery?

A total hip joint replacement takes approximately two to four hours of surgical time. The preparation prior to surgery may take up additional time. After surgery, the patient is taken to a recovery room for immediate observation that generally lasts between one to four hours.

What is involved in the rehabilitation process after total hip joint replacement?

After total hip joint replacement surgery, patients often start physical therapy immediately! On the first day after surgery, it is common to begin some minor physical therapy while sitting in a chair. Eventually, rehabilitation incorporates stepping, walking, and climbing. Initially, supportive devices such as a walker or crutches are used.

What other postoperative instructions are given to patients with total hip joint replacements?

Patients will continue to use supportive devices as monitored and recommended by the therapist and attending physician. Medications are likely to be given to further prevent blood clots in the legs. These include Aspirin, Xarelto or Clexane injections. It is important to note that patients may be at risk to develop blood clots for as long as 6-12 weeks post surgery.

What is the prognosis of total hip joint replacement?

Patient education is important to ensure the longevity of the replaced hip. Strenuous exercises such as running or contact sports are discouraged since these activities can injure the replaced hip. Swimming is ideal for improving muscle strength and promoting mobility and endurance.

Total hip replacement facts.

Who is a candidate for total hip replacement surgery?

The most common indication for total hip replacements is osteoarthritis of the hip causing progressive hip pain and loss of quality of life

Osteoarthritis (diseased cartilage) of the hip may be associated with age or genetics – this is known as primary osteoarthritis.

Osteoarthritis (OA) can also be caused secondarily by other conditions:

  • post-traumatic OA
  • Congenital abnormalities of the hip e.g Slipped Upper Femoral Epiphysis (SUFE)
  • Hip Avascular necrosis due to loss of blood supply to the hip
  • Inflammatory arthritis e.g Rheumatoid or Psoriatic arthritis
  • Infections e.g. Tuberculosis

When the hip pain affects the patients quality of life (night pain, pain that prevents simple activities of daily living) the patient becomes a candidate for a total hip replacement

Once a patient is a candidate for hip replacement careful consideration of medical conditions (such as heart and lung conditions) are made to ensure the patient is safe for the surgery.

A total hip replacement is an elective procedure. The decision to have a hip replacement done is an informed decision where the surgeon and patient discuss the risks and benefits of surgery, the surgical procedure and post-surgical rehabilitation and the anticipated long-term outcome of the surgery.

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