Total Hip Replacement Surgery

General Information

The primary reason for joint replacement is the degeneration of a joint which usually results from an earlier accident or gradual wear and tear over the course of life, this condition known as arthritis which is ultimately the end result. Joint replacement can restore normal function and ,hence, improve quality of life.

What is a Hip Replacement Surgery

A hip replacement involves the placement of artificial (prosthetic) hip implants into the bones to re-create a smooth articulation between the pelvic and the thigh bones. Replacement of both the pelvic and thigh bone articulating parts with the prosthetic implants is known as a Total Hip Replacement (THR) or Total Hip Arthroplasty (THA).

Types of Hip Replacement Parts

Cemented Versus Cementless

Ceramic, Metal or Polyethylene

There are two ways to fix the implants to the bones; either with a cement or by simply applying them in a “press fit” manner and allow the bone to grow on them.

This describes the material of the articulating surfaces which is a crucial factor in determiming the longevity of the prosthesis.

Common Conditions Requiring Hip Replacement Surgery

Hip Artheritis

It means “Inflammation of the Joint,” and the hip joint is one of the most commonly affected joints in the body.

There are multiple causes of arthritis, but most arthritis is known as osteoarthritis, a relatively common degenerative condition. While some may have a genetic predisposition, the condition can be worsened with obesity, heavy activity and/or previous injuries to the joint. Other causes for arthritis include generalized inflammatory conditions, such as rheumatoid arthritis and related syndromes.

Patients with hip arthritis experience pain in different areas around the hip; most commonly in the groin or thigh, but that may also occur at the outside (lateral) part of the hip. The pain at first is gradual and relatively tolerable, but later, can be severe and progressive usually requiring surgery.

Image Source: Johns Hopkins Medicine

This diagram shows a normal hip and a hip joint with arthritis showing destroyed cartilage

This diagram shows a hip with preserved joint space on the right side and a totally destroyed one on the left side with bone rubbing on bone

It’s a condition affecting the femoral head in which its blood supply gets compromised and end up in degeneration and collapse of the head with severe pain.

Avascular Necrosis

Femoral Neck Fractures in the Elderly

These are fractures that occur in this critical age group that can happen following a trivial fall to the ground. Usually its gold standard treatment in replacement to allow early patient mobility and return to function to avoid complications that might happen from prolonged recumbency

This diagram shows a total hip replacement procedure

Image Source: Johns Hopkins Medicine

Frequently Asked Questions

Are there other alternatives for surgery?

In cases with total destruction of joint cartilage with x-rays showing “bone on bone” articulation with totally absent joint space, there’s no scientifically proven drug or procedure up to date that can regrow that cartilage and the only tested reliable cure is the hip replacement surgery.

When should I do the surgery? Is it urgent?

In cases of primary arthritis, it totally depends on the patient convenient timing. Unfortunately, there are cases that we have to do it relatively soon, for instance; patients who rely on a lot of pain medications to move around as these medication might irreversibly affect their stomach or kidneys with drastic complications. Another group also who should consider doing it earlier are the ones whose activities of daily living are substantially affected by the disease and they can’t live their life normally. However, if you have hip arthritis and still function well with relatively tolerable pain, it’s advised to do regular follow up visits every 6 months to 1 year with new x-rays every time, to detect deterioration in the bone quality of the joint or its clinical state that might entail doing it earlier better than postponing it and making the surgery and the postoperative rehabilitation more difficult and with inferior outcomes.

Will I be able to walk again normally?

It depends on the current state before the surgery of the nervous and soft tissues surrounding the joint. If the only problem is the joint, most patients are able to walk again normally with doing some exercises. Some may need the assistance of physical therapy to restore back the strength and resilience of the muscles.

How long will my new hip survive?

With proper choice of implants and patient adherence to postoperative instructions; reviewing the literature of published articles showed that it’s expected to last up to 25 years. But it’s sometimes variable depending on other factors including the hip bone quality before the surgery, whether it was a primary or a revision procedure, whether the patient is overweight, the activity of the patient.

Have any questions?

If you have any questions about the surgeries, feel free to contact us.