Procedure for Total Hip Replacement Unilateral

Total hip replacement is a surgical procedure in which the structures in the hip joint are removed and replaced by metal, plastic and/or ceramic parts.

Symptoms of pain, stiffness, loss of movement and deformities; in conditions such as arthritis, trauma, childhood deformities and osteonecrosis (dead bone because of loss of blood supply) call for this procedure.

Children born with hip dysplasia have hip deformity because of the abnormal development of the joint, they even in later life develop osteoarthritis hip early in adulthood.

Symptoms of Needing a Hip Replacement would be suggested in case one’s hip joint pain is interfering with your daily activities, affecting your sleep and day-to-day activities. Normal life is disrupted and affecting your mental health as well.

Types of Hip Surgery

The hip surgery is called for, when the above mentioned symptoms appear and all alternative methods (medications, physical therapy, weight loss, use of cane) fail to give any relief. The types of hip surgery are:

• Hip resurfacing: Done in younger patients. In this only the surface joint parts are removed and replaced with metal prostheses.

This also gives a chance for future total hip replacement.

• Osteotomy: Another option in younger individuals is hip fusion when they want an active lifestyle, which may not be possible with hip replacement.
• Total Hip Replacement: Under spinal or general anesthesia the surgeon removes the head of the femur (thigh bone) and replaces it with a metal ball with a stem and the socket with a prosthesis having a metal shell and plastic rim.

Types of Hip Prosthesis

Prosthesis (plural - prostheses) means the artificial man-made part for replacing the diseased joint parts. The materials used are metal, plastic or ceramic. Discussing with your doctor for the best possible option for you is advisable, the following options are available:

• Metal on metal - Wearing is somewhat sooner.
• Metal on plastic - Have better longevity.
• Ceramic on ceramic - Latest addition giving good results.

Hospital Stay, Postoperative Care and Recovery

Even before the surgery, it is advisable to be active and continue with the exercises that will strengthen your muscles which will aid in the early recovery after surgery.

• Drain is placed at the wound site to drain any excess fluid.
• Measures are taken to prevent blood clots by placing an elastic hose and compression stocking after the surgery.
• Any complaints such as fever, chest pain, cough, painful urination, swollen legs have to be reported to the doctor immediately.
• The patient is encouraged to walk on the second day itself and are given exercises which they can do while lying on the bed to pump the blood and prevent clotting.
• Physical therapy as already stated starts from the first day itself. At first small exercises and then gradual rehabilitation to help step, walk, and climb are given.
• Patients can use support such as a cane or a walker for few weeks.
• Heavy lifting, certain postures such as squatting, sitting cross legged on the floor are advised against.
• Extreme joint movements such as moving the leg across the body and strenuous exercises are not advised.
• Steps for safety at home like side rails on stairs, grab bars in shower, commode chair, removing throw rugs and loose wires or cords, pillow on a low chair can avoid dislodgement of the prosthetic parts.
• It is always favorable to do the physical exercises often to avoid contractures (shortening of muscles).
• Complete recovery takes 6-8 weeks. Though normal movements begin by 2-3 weeks.
• Success rate of hip replacement surgery is 95% for 10 years and 20 years or more in 85% cases.