Hip replacement surgery, also known as total hip arthroplasty, involves the hip joint being replaced by an implant. Hip replacement is a major surgery and recovery doesn’t happen overnight. Learn if you may need a hip replacement and how that process will look in this all-encompassing guide.
A hip implant is comprised of various parts: the stem, hip cup, ball, and liner.
The femoral stem goes inside the thigh bone. The stem can be composed two different ways. A cementless stem allows your bone to grow into the stem and is typically made of titanium. A cemented stem is typically made of titanium.
The hip cup goes into your pelvis. It is commonly made from titanium metals.
The liner replaces the cartilage around the hip socket. It is often made from plastic such as highly cross-linked polyethylene.
The ball, also known as the head, goes on the top of the stem. It can be made from various materials such as ceramic or cobalt-chromium.
Our Nashville hip surgeons offer various options, but we most commonly use a titanium-based cup and stem, a poly (plastic) liner, and a ceramic head.
The longevity of your hip replacement can be affected by various factors. Weight, osteoporosis, age, and lifestyle can all have an impact on the degeneration of your replacement over time.
That being said, the majority of hip replacements will last 15-20 years.
There are often other alternatives to hip surgery; however, it may be your only choice if you have severe osteoarthritis of the hip. In this case, the hip would degenerate so much that you would experience constant pain and it would be difficult to enjoy life.
Arthritis and bursitis may be treated with conservative treatment like medication, physical therapy, and joint injections. Additionally, regenerative medicine can be used to encourage new tissue growth. Our Nashville hip specialists sometimes use platelet rich plasma (PRP) injections to treat hip arthritis.
Treatment is not one-size fits all. You should consult a hip replacement specialist to see if there is an alternative that may work for you.
Elite’s orthopedic surgeons stay up to date with the newest hip replacement technology. We do this by using computer navigation and robotic technology to perform hip replacement surgery.
A total hip replacement, or a total hip arthroplasty, is the most common type of hip replacement. In this process the ball and hip socket are replaced with artificial parts.
A partial hip replacement involves replacing just the ball of the hip, not the socket. This procedure is typically performed on patients who have fractured their hip.
Hip revision surgery repairs an artificial hip joint from a pre-existing hip replacement. Prosthetic hips do not last forever, so revision surgery can be used to repair wear and tear to the implant. Additionally, revision surgery may be recommended if there is an infection near the joint.
In a total hip replacement, there are two approaches that your surgeon may choose from. Based on a variety of factors, your surgeon will either perform a posterior or anterior approach to hip replacement.
In a posterior approach to hip replacement, an incision is made in the low back region, behind the hip. This approach is more common, but it tends to have a slower recovery time.
In an anterior approach to hip replacement, an incision is made in the upper thigh and hip joint is accessed by pushing through the muscles. This approach tends to have a quicker recovery time, but not everyone is a good candidate for it.
A minimally invasive hip replacement involves your hip surgeon making 1-2 very small incisions. Instead of cutting through muscle to access the hip joint, they will push it aside.
Minimally invasive hip replacement offers a quicker and less painful recovery; however, not everyone is a candidate for it. Patients who are young and healthy are typically a good candidate for this type of surgery. If you are overweight or very muscular, your doctor may recommend a traditional hip replacement.
Every patient is different, so be sure to evaluate all options with your hip doctor to determine what is right for you.
Outpatient hip replacement surgery, also known as same-day hip replacement surgery, is possible for many patients. Patients who are young and healthy typically have a better chance of getting outpatient surgery.
If you are interested in outpatient hip replacement surgery, please note that you will need someone willing and able to help you while you recover from your home. Not all hip replacement surgeons perform outpatient surgery, so be sure to ask your hip surgeon if this is an option for you.
Recovery time for a hip replacement varies from person to person, but generally you can expect to be living independently and doing light activities within 3-6 weeks.
After three weeks, your hip doctor may allow you to drive again. You will be able to do some light activities and can typically stop using a walker/crutch. Every recovery is different, so be sure to listen to your doctor and your body.
After three months of surgery, you will be able to partake in many of your normal activities. Talk to your hip surgeon or physical therapist before doing any intense sport or exercise. At this point in time, it is normal to experience some soreness and hip pain after a day of activity.
After one full year, you can expect to resume all the activities you enjoy as normal. Feeling pain from time to time can be normal.
Many patients will only need to use opioid pain medication for 1-2 weeks after surgery. Your provider may also prescribe anti-inflammatory drugs and over-the-counter medication such as acetaminophen.
Every recovery is different. If you are experiencing intense pain while using medication, be sure to tell your hip replacement doctor. It is important to know the risks of opioid medication avoid driving while on medication.
Getting back to work will depend on how quickly you are recovering, and the type of job that you have. Many patients will be able to go back to work after two weeks, and some patients will need more time.
If you work a job where you are doing manual labor or are on your feet often, talk to your hip doctor about when you can get back to work.
Patients may be able start driving again anytime between 2 weeks to 2 months. If the patient receives surgery on their left hip, they should be able to drive relatively soon after surgery. If the patient receives surgery on their right hip, they will need to make sure that they have mobility of their hip, so that they can brake quickly.
If it is too difficult or painful to get into your car, it is likely that it will not be safe for you to drive yet. As always, the patient should not drive if they have taken any prescription pain medication.
No, you will not be able to swim after surgery. Typically, patients can start swimming again 4 weeks after surgery, or once their wound is fully healed.
Length of surgery will depend on the type of hip replacement surgery you receive. Generally, surgery will take less than 2 hours.
In addition to surgery, you will need to spend time in the hospital before the surgery and after. Talk to your hip replacement doctor if you have questions about how long you will need to be at the hospital for your surgery.
You will likely experience pain for the first 2-4 weeks after surgery. Of course, this pain can be managed through medication. Pain levels will depend on how quickly your recovery is going. Generally, younger, and healthier patients have less pain compared to patients who are elderly or overweight.
When we think of recovery, we typically think of post-op recovery. However, exercising before surgery can help to strengthen the muscles in and around the hip, making recovery quicker.
Be sure to start doing your prehab exercises multiple times per week or daily in the weeks leading up to your surgery. Here are 3 examples of exercises you can do:
Lay down on your back. Bring your feet towards your glutes and your knees up. Keep your arms at your sides and your feet shoulder-width apart. Lift your hips toward the ceiling and hold for 10 seconds. Repeat 3 times.
Lay on your back with your legs straight. Move your heel towards your glutes. Hold for 10 seconds. Repeat 5 times.
Lay on your side with your arm at your side. Slowly lift your leg up. Hold for 5 seconds and repeat 5 times.
Be sure to practice your pre-surgery and post-surgery exercises on the leg of the affected hip. If you have a double hip replacement, practice on both legs. If you experience uncomfortable pain, do not continue doing that exercise.
Doing exercises post-op is a great way to speed up recovery and ease discomfort. At Elite Sports Medicine + Orthopedics, we have a team of physical therapists and occupational therapists that can help you recover from your hip replacement.
Recovery exercises will depend on each individual patient, but you may start with exercises that increase circulation and then later in your recovery work on building strength in the hip. Some exercises your physical therapist may suggest include:
Lay on the floor with your legs straight. Lift the leg of the affected hip up and hold for 10 seconds. Gradually lower your leg and repeat until your leg is tired. If you had a double hip replacement, practice this exercise on both legs.
Lay on the floor with your legs straight. Pull your foot towards you and then pull it towards the floor. Repeat this movement 10 times.
Lay on the floor with your legs straight. Move your leg to side while keeping it straight. Repeat this 10 times, moving slowly.
Before trying these exercises, ask your physical therapist or orthopedic surgeon if this is something you can do. You want to avoid any further injury or setbacks during your recovery.
When you get a hip replacement, there is always the risk of dislocating your artificial hip. You will want to avoid crossing your legs or bending too far forward until you are cleared to do so.
If you are feeling pain in certain positions, it is a sign that you should stop. If you are concerned about doing certain activities, talk to your hip doctor or physical therapist.
References:
Cleveland Clinic. (n.d.). Hip Revision. Cleveland Clinic. Retrieved September 20, 2021, from https://my.clevelandclinic.org/health/treatments/17104-hip-revision.
Hecht, M., & Lamoreux, K. (2021, January 20). What helps with hip replacement recovery? Healthline. Retrieved September 20, 2021, from https://www.healthline.com/health/hip-replacement-recovery#next-3-months.
OrthoInfo . (n.d.). Minimally Invasive Total Hip Replacement. OrthoInfo. Retrieved September 20, 2021, from https://orthoinfo.aaos.org/en/treatment/minimally-invasive-total-hip-replacement/.
Ihekweazu, U. (n.d.). What are hip replacement implants made of? Retrieved September 20, 2021, from https://www.uiorthomd.com/blog/what-are-hip-replacement-implants-made-of.
