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Think about all the activities in a typical day that involve your hip: standing, walking, running, sitting, bending, playing sports. Having a normally functioning hip joint is critical to keeping your body balanced, upright, and stable.
The hip joint is formed by the ball-shaped top of the thigh bone (femur) and the cup-shaped socket of the pelvis (acetabulum). This ball-and-socket arrangement helps ensure freedom of movement in several directions. Within the cavity of the joint is a substance called synovial fluid which promotes smooth movement and helps prevent friction between the two main bones. The surfaces of these bones are covered by a special protective material called articular cartilage. Surrounding the hip is a thick fibrous joint capsule whose job is twofold: to hold the synovial fluid within the joint cavity and to keep the joint stable. Smooth, pain-free motion in the hip joint depends on healthy cartilage and joint fluid, as well as strong and flexible surrounding ligaments and muscles.
To keep these ligaments strong and healthy you have to be able to move and stay active. Sometimes trauma (from a sport injury, fall, or car accident, for example) weakens the hip’s ligaments and cartilage and upsets the synovial fluid balance. Sometimes hip joints can weaken just from the normal wear and tear of aging. Whatever the cause, osteoarthritis or rheumatoid arthritis may develop.
Joint diseases such as these can result in stiffness, swelling, tenderness, and discomfort in the hip, often causing you to slowly restrict your movements. Even the simplest daily activities can become painful—slowly diminishing your mobility and, ultimately, your quality of life
To determine whether you need surgery, consult Dr. Longo. He will evaluate your medical history, take X-rays, and assess your walking, leg motion, and joint condition. It’s possible he may then recommend a total hip replacement with artificial materials made from metal and either ceramic or polyethylene. This is what is called a hip joint prosthesis. The aim of this surgery is to correct the deteriorating condition of your present hip and to help you regain movement and eliminate most of the pain you have been experiencing.
If you do opt to have the surgery done, it would help for you to do some homework ahead of time. Practice using a walking aid (you’ll use one temporarily after surgery) and become familiar with the specific exercises you will need to do after surgery.
After surgery, some leg movement may be initially limited, but this will improve over time as you become more comfortable with your new hip. Specially designed stockings and inflatable leg wraps may be used to maintain circulation in your legs. The walking aid (a cane, walker, or crutches) will allow gradual weight increase on your new hip and assist in healing and controlling the pain. Learn about using a safe walking pattern and equip your home with self-help devices such as a raised toilet seat, a bath bench, and reaching tools. Your activity will be restricted at first. Observe these restrictions to give your hip and surrounding tissues proper time to heal.
A personal exercise program designed by Dr. Longo and your physical therapist will help to restore muscle balance and allow you to walk more comfortably. Continuing exercises at home and in an outpatient physical therapy program for several months following surgery will help you regain strength and independence. An active lifestyle which includes water exercises, walking, and biking is essential in maintaining movement of your joints and keeping you and your new hip healthy. Gauge your daily activities with your new hip in mind. Avoid strenuous movements such as twisting, jumping, and running, which may damage your prosthesis.
After surgery, the hip pain you had will be gone, but you may have some discomfort when you stretch, and you may experience some pain at the site of the surgery. This will decrease and disappear over time.