Hip replacement, also called hip arthroplasty, is a surgical procedure to address hip pain. The surgery replaces parts of the hip joint with artificial implants. The hip joint consists of a ball (at the top of the femur, also known as the thigh bone) and a socket (in the pelvis, also known as the hip bone). Hip replacement surgery includes replacement of one or both parts. The goal of the procedure is to allow you to resume daily activities and exercise with less pain.
Who can benefit from a hip replacement?
Your doctor may recommend hip replacement if you have significant pain, inflammation and damage to your hip joint due to conditions such as:
- Osteoarthritis (most common)
- Rheumatoid arthritis
- Osteonecrosis (avascular necrosis)
- Injury such as hip fracture
- Tumor in the hip joint
How do you know if you need a hip replacement?
When your quality of life suffers due to hip pain, it may be time for hip replacement. Signs of declining quality of life include:
- Inability to get restful sleep because of pain
- Difficulty doing simple tasks such as getting dressed or climbing stairs
- Inability to fully participate in the activities you enjoy
At first, your doctor may recommend other treatments such as medicine for pain or inflammation, walking aids, joint injections and physical therapy. If these measures do not relieve pain and stiffness, hip replacement surgery may be necessary to restore function and improve quality of life.
Types of Hip Replacement Surgery
Several factors help determine the type of hip replacement you may need. Your doctor will consider each of the following when planning your care.
Total and Partial Hip Replacement: Which parts need to be replaced?
During total hip replacement (total hip arthroplasty), both the ball and the socket are replaced. A partial hip replacement only replaces the ball (the head of the femur).
Anterior, Posterior and Lateral Hip Replacement: How will the surgeon access the hip?
An orthopaedic surgeon can access the hip from different angles. Three common ways to access the hip joint are:
- From the front (anterior approach to hip replacement)
- From the side (lateral approach to hip replacement)
- From the back (posterior approach to hip replacement)
Traditional and Minimally Invasive Hip Replacement: How large will the incision be?
Minimally Invasive Hip Replacement
Minimally invasive hip replacement aims to minimize the impact of surgery on healthy tissues, such as muscles and blood vessels. While anterior hip replacement has been marketed as a minimally invasive approach, orthopaedic surgeons nowadays use minimally invasive techniques with all surgical approaches to access the hip. Your surgeon will discuss which approach might offer the best result.
When the surgery is minimally invasive, the surgeon accesses the hip joint though one or two small incisions by moving the muscles aside. This approach may have advantages, such as:
- Lower risk of muscle damage
- Less pain
- Quicker and easier recovery
- Less limping
- Shorter hospital stay
- Lower chance of hip dislocation
Minimally invasive hip replacement is not appropriate for all patients. Your age, weight, fitness level and other factors will help the surgeon decide if you are a good candidate.
Traditional Hip Replacement
A traditional hip replacement includes a single, large incision that helps the surgeon gain access to the hip, usually through the side (lateral approach) or from the back (posterior approach).
Recovery from a traditional hip replacement can take time, because the surgeon needs to cut through or detach some muscles and tendons to get to the joint. (The muscles and tendons are repaired when the hip implants are in place.) You may be at risk for a dislocation until all of your new hip’s supportive structures are healed.
Talk with your orthopedic hip surgeon to discuss which surgical approach may be best for you.
