Hip replacement surgery is a procedure done to remove a painful, broken, or diseased hip joint and replace it with an artificial hip joint.
Hip joint replacement is done mainly in people age 60 and older. Possible reasons for replacing the hip joint include:
This surgery is usually not recommended if:
Alternatives to this procedure include:
Ask your healthcare provider about these choices.
Talk to your hip surgeon about what he or she expects before and after surgery. Read the general information given to you by the surgeon’s office. Ask your surgeon for more precise information when you are unsure of what might be happening. Also talk to several people someone who have had a hip replacement to get an idea of what the procedure and recovery period are like.
Because you may need blood transfusions during the operation or during recovery, you may want to donate some of your own blood before the procedure. You should donate blood no more than 4 weeks before the procedure.
Get equipment that will help you while you recover at home, such as an elevated toilet seat, a shower seat, and grab bars or handrails. Remove rugs and cords that might cause a fall.
Plan for your care and recovery after the operation, especially if you are going to have general anesthesia. Allow for time to rest after the operation. Find people to help you with your day-to-day duties and care for at least the first week at home.
You may meet with a physical therapist before surgery to learn exercises that will help you after surgery. If you can, increase your leg motions and general exercise before surgery. The fitter you are, the easier time you will have recovering from the surgery. Everyone can improve a little bit. Getting yourself into an exercise habit helps you continue good exercise habits after surgery.
Follow your provider's instructions about not smoking before and after the procedure. Smokers heal more slowly after surgery. They are also more likely to have breathing problems during surgery. For these reasons, if you are a smoker, you should quit at least 2 weeks before the procedure. It is best to quit 6 to 8 weeks before surgery. Plan to stay smoke free for several months after surgery. Quitting forever would be good to do if you can.
If you need a minor pain reliever in the week before surgery, choose acetaminophen rather than aspirin, ibuprofen, or naproxen. This helps avoid extra bleeding during surgery. If you are taking daily aspirin for a medical condition, ask your provider if you need to stop taking it before your surgery.
Follow any instructions your healthcare provider may give you. Eat a light meal, such as soup or salad, the night before the procedure. Do not eat or drink anything after midnight on the day of the procedure. Do not even drink coffee, tea, or water.
You will be given a regional or general anesthetic. A regional anesthetic numbs the lower part of your body while you stay awake. A general anesthetic relaxes your muscles and puts you to sleep. Both types of anesthesia keep you from feeling pain during the operation.
The surgeon makes a cut along the side of your hip, moves the muscles connected to the top of the femur (thighbone), and exposes the hip joint. The surgeon pulls the ball portion of the joint (the end of the femur) away from the socket part of the joint (the hipbone). The ball of the femur is cut with a saw and an artificial replacement part is attached to the femur.
The surgeon prepares the surface of the hipbone and, if it is worn, attaches a metal or plastic socket part to the hipbone. The surgeon inserts the new ball part of the femur into the socket part of the hip. Two drains may be inserted to help drain any fluid or blood from the new joint. The surgeon then reattaches the muscles to the top of the femur and closes the cut in the side of your hip with stitches or staples.
You may need a blood transfusion. The hospital will use either your donated blood or blood from a donor that matches your blood.
After surgery, your hip will be covered with a padded dressing. Special boots or stockings will be put on your feet or legs to help prevent blood clots. A triangular shaped cushion may be positioned between your legs to keep your legs from crossing or rolling in. A tube (catheter) may be placed in your bladder if you have trouble urinating.
You will be given a regular program of exercises to do each day as long as you are in the hospital. Your physical therapist will start by helping you move from your bed to a chair. By the second day, you'll begin walking longer distances using your crutches or walker. Your therapist will teach you exercises to begin strengthening the thigh and hip muscles.
You may stay in the hospital about 4 to 6 days, depending on how fast your hip heals. You can leave the hospital and go to a short-term rehab facility or go home when:
After you go home from the hospital, your physical therapist may visit you for in-home treatments. Your therapist will review your exercise program and continue working with you on your hip precautions. Your therapist will suggest safety tips such as using elevated toilet seats and bathtub benches and raising the surfaces of couches and chairs. Raised sitting surfaces keep your hip from bending too much when you sit down. The visiting nurse or therapist will also suggest ways to make your home environment safe.
Constipation is common after joint replacement surgery. It is caused by narcotic pain killers as well as inactivity. You may be given a stool softener and a laxative after surgery to avoid this. When you are home again, be sure to eat a high-fiber diet and plenty of liquids according to your provider’s recommendations.
If medicine to help prevent clots has been prescribed for you, be sure to follow your healthcare provider’s instructions for taking this medicine.
Your staples will be removed 2 weeks after surgery. You will probably start using a cane instead of crutches 3 to 4 weeks after the surgery. You will probably be able to drive within 3 weeks and walk without a cane or walker by 6 weeks. With your healthcare provider's approval, you will be able to resume sexual activity 1 to 2 months after surgery.
Use a calendar or journal to keep track of what you think is happening each day from just before your surgery to several months after the surgery.
Let your dentist and healthcare providers know that you have an artificial joint. If you have a dental infection or skin infection, you may need to start antibiotics right away. If you have a condition such as diabetes that puts you at higher risk for infection, you may need to take antibiotics before dental procedures or some kinds of surgery. For simple dental and surgical procedures, most people with replacement joints do not need to take antibiotics in advance, but you should check with your provider about this.
Ask your provider what other steps you should take and when you should come back for a checkup. When you have hip surgery, a few regular follow-up visits are part of the service of having the surgery. These are for wound checks and to give you recovery advice close to the time you need it. Be sure to keep these appointments.
Some healthcare providers may recommend taking an antibiotic before and right after you have a dental or medical procedure or surgery. This may be done to help prevent an infection around the hip replacement. However, such infections are rare, and it’s not clear from studies that taking antibiotics before a procedure helps prevent an infection.
If you do get some other infection (such as a bad gum infection or sinus, bladder, or skin infection), the infection should be treated right away. Let all of your healthcare providers, including your dentist, know that you have an artificial joint. If you are having infections treated with a procedure (like deep cleaning of bad tooth and gum problems, or sinus surgery for infections), talk to your provider about having preventive antibiotics to protect your hip.
The hip replacement should relieve the problems of a painful hip. You will be able to move your hip more easily and fully and less painfully. It will be easier for you to walk and do other activities that use your hip. Most people get back to a more normal life.
Ask your healthcare provider how these risks apply to you.
Call your provider right away if:
Call during office hours if: