What is total hip replacement surgery?

During total hip replacement surgery, your doctor replaces the worn parts of your hip joint with artificial parts made of metal, ceramic, or plastic.

You may want this surgery if you have hip pain and trouble moving that you can't treat in other ways. Osteoarthritis or rheumatoid arthritis can cause these types of problems. Another cause is bone loss due to a poor blood supply.

Hip replacement is sometimes done after a hip fracture.

Total hip replacement surgery is usually done when hip pain and loss of function caused by osteoarthritis become severe and when treatment no longer relieves pain. Hip replacement is sometimes done after a hip fracture.

Hip replacement surgery is done through one or two cuts (incisions). The cuts may be toward the front (anterior) of your hip, or they may be on the side or toward the back (posterior). You and your doctor can discuss which surgery is best for you.

You may have anesthesia to block pain and medicine to make you drowsy. Or you may get medicine to make you sleep. After making the incision, your doctor will:

• Remove worn bone tissue and cartilage from the hip joint.
• Replace the ball at the upper end of your thighbone (femur).
• Replace your hip socket with a shell and liner.
• Fit the ball into the shell and liner to make a new hip joint.

There are two kinds of replacement joints.

• Cemented joints. The cement fits between the new joint and the bone.
• Uncemented joints. These have a metal coating with many small openings. The bone is shaped to fit the new joint almost perfectly. At first, there will be some small spaces between the bone and the new joint. Over time, the bone grows to fill these small openings.

Sometimes a doctor uses a cemented ball and an uncemented socket.

Your doctor can tell you which type of new hip joint is best for you.

Hip replacement surgery is done through one or two cuts (incisions). The cuts may be on the side of your hip or toward the back (posterior). Some muscles and other soft tissues, such as ligaments, are cut or moved so the doctor can get to the hip joint.

Another type of surgery is done through an incision in the front (anterior) of the hip. Anterior hip surgery causes less damage to muscles and other soft tissues than getting to the hip joint from the side or the back.

When hip replacement is done with smaller incisions (sometimes called minimally invasive surgery), it may cause less blood loss and leave a smaller scar. But it can also mean a longer time in surgery, because the surgery is harder to do. And if the new hip can't be fitted properly through the smaller incision, the doctor may have to make a larger cut.

Your doctor can explain your options and help you understand the risks and benefits of each type of surgery.

Surgery usually works well. You will probably have much less pain and be able to do most of your daily activities more easily. But recovery does take time and patience.

Most hip replacements (about 90 out of 100) last at least 15 years. And more than half last for 25 years or more. It depends on your age, how much stress you put on the joint, and how well your new joint and bones mend. Your weight can make a difference. Every extra pound of body weight adds 3 pounds of stress to your new hip joint. Controlling your weight will help your new hip joint last longer.