In the hip joint there is a layer of smooth cartilage on the ball of the upper end of the thigh bone (femur) and another layer within your hip socket. This cartilage serves as a cushion and allows for smooth motion of the hip. Arthritis is a wearing away of this cartilage. Eventually it wears down to bone. Rubbing of bone against bone causes discomfort, swelling and stiffness.
A total hip replacement is an operation that removes the arthritic ball of the upper thigh bone (femur) as well as damaged cartilage from the hip socket. The ball is replaced with a metal ball that is fixed solidly inside the femur. The socket is replaced with a plastic or metal liner that is usually fixed inside a metal shell. This creates a smoothly functioning joint that does not hurt.
Results will vary depending on the quality of the surrounding tissue, the severity of the arthritis at the time of surgery, the patient’s activity level and the patient’s adherence to the doctor’s orders. Typically, hip replacement has the highest outcome scores of all the major joint replacements in orthopaedics.
Dr. Kang will decide if you are a candidate for the surgery. This will be based on your history, exam and x-rays. Your orthopedic surgeon will ask you to decide if your discomfort, stiffness and disability justify undergoing surgery. There is usually no harm in waiting if conservative, non-operative methods are controlling your discomfort.
Age is not an issue if you are in reasonable health and have the desire to continue living a productive, active life. You may be asked to see your personal physician for his/ her opinion about your general health and readiness for surgery.
Just as your original joint wears out, a joint replacement will wear overtime as well. The most common reason for revision is loosening of the artificial surface from the bone. Wearing of the plastic spacer may also result in the need for a new spacer. Dislocation of the hip after surgery is a risk. Dr. Kang will explain the possible complications associated with total hip replacement.
Most surgeries go well, without any complications. Infection and blood clots are two serious complications. To avoid these complications, we use antibiotics and blood thinners. We also take special precautions in the operating room to reduce the risk of infections. Your orthopedist will discuss ways to reduce that risk.
Yes, you should consult Dr. Kang and the Physical Therapist about the exercises appropriate for you.
With modern day minimally invasive techniques, the likelihood of transfusion is around 1% – 2%. If you do need blood, bank blood is considered safe.
You will get up the day of your surgery and begin walking short distances. The next morning all patients will get up, sit in a chair or recliner and should be walking 100 feet or more.
Most hip patients will be hospitalized for 2 days after their surgery. There are several goals that you must achieve before you can be discharged.
Two options are usually available to you. You may return home and receive help from a friend or relative. In certain circumstances, you can have home health care or home physical therapy. You may also stay at a sub-acute facility following your hospital stay depending on your insurance.
After Dr. Kang has scheduled your surgery, the pre-surgery nurses will contact you. Our surgical coordinator will guide you through the steps.
The hip replacement surgery takes Dr. Kang approximately one hour. There is some additional time taken by the operating room staff to prepare for surgery.
There are two types of anesthesia for hip surgery: A general anesthetic (“being put to sleep”) or a spinal anesthetic (which numbs your legs). The most common anesthetic is a spinal anesthetic with IV sedation. Dr. Kang and the Anesthesiologist will be able to discuss in further detail the differences between your anesthesia choices.
You will have discomfort following the surgery, but we will try to keep you as comfortable as possible with the appropriate medication. Most patients are able to stop strong pain medication within 1 day.
Your orthopedic surgeon will perform the surgery. An assistant and/or orthopaedic fellow will often help during the surgery.
The scar will vary in length depending upon your body makeup and size. Typically, it will be between 3 to 4 inches long. It will be along the side of your hip.
No, you do not need a private nurse, but if you want one, please call our discharge planner prior to surgery.
Yes, a walker is recommended for 2-4 weeks, after that you will progress to a cane. A wheeled walker is preferred. Since you will not need a walker for too long, you may want to consider borrowing one from a friend or family member. Another option is borrowing one from a local service organization, club or church.
After hip replacement surgery, you will need a high toilet seat for about 3 months. We also encourage you to have a long-handled shoe horn, sock aid, and a reacher to aid in dressing. These should be purchased before your surgery. You may also benefit from a bath seat or grab bars in the bathroom, which can be discussed with your occupational therapist.
Yes. Patients are able to go home directly after discharge. On rare occasions, patients may transfer to a sub-acute facility and stay there for 1-2 weeks. The discharge planner will help you with this decision and make the necessary arrangements. You should check with your insurance company to see if you have sub-acute benefits.
Yes, the first 7 to 10 days, depending on your progress, you will need someone to assist you with meal preparation, etc. If you go directly home from the hospital, the discharge planner will arrange for a home health care nurse to come to your house if appropriate. Family members or friends need to be available to help if possible. Preparing ahead of time, before your surgery, can minimize the amount of help required. Having the laundry done, house cleaned, yard work completed, clean linens put on the bed and single portion frozen meals will reduce the need for extra help.
You may or may not need formal physical therapy when you are discharged from the hospital. Many times we can discharge patient with exercises that they can do on their own at home.
You may have difficulty walking as well as continued pain and returning to the lifestyle that you were hoping for.
The ability to drive depends on whether surgery was on your right hip or your left hip and the type of car you have. If the surgery was on your left hip and you have an automatic transmission, you could be driving in 2 weeks. If the surgery was on your right hip, your driving could be restricted as long as 6 weeks. Getting “back to normal” will depend somewhat on your progress. Consult with Dr. Kang or therapist for their advice on your activity.
We recommend that most people take at least 1 month off work, unless their jobs are quite sedentary and they can return to work with crutches. An occupational therapist can make recommendations for joint protection and energy conservation on the job.
You will be seen for your first postoperative office visit 1 to 3 weeks after discharge depending on the complexity of the surgery. The frequency follow-up visits will depend on your progress. Many patients are seen at 6 weeks, 12 weeks and yearly.
Yes, high-impact activities, such as long-distance running, and basketball are not recommended. Injury-prone sports such as downhill skiing are also discouraged. Patients with a diagnosis of primary osteoarthritis will not have any hip precautions.
You are encouraged to participate in low-impact activities such as walking, dancing, golfing, hiking, swimming, bowling, doubles tennis, weight lifting, biking, and gardening.
In many cases, patients with hip replacements think that the new joint feels completely natural. However, we always recommend avoiding extreme position or high-impact physical activity. The leg with the new hip may be longer than it was before, either because of previous shortening due to the hip disease or because of a need to lengthen the hip to avoid dislocation. Most patients do get used to this feeling in time or can use a small lift in the other shoe. Some patients have aching in the thigh on weight bearing for a few months after surgery.