Hip replacement surgery is performed when there is damage to the hip area, such as severe arthritis and fractures. This surgical procedure is also called a total hip replacement. In some cases, arthritis and fractures that affect a person’s life badly may not be cured by conservative treatment methods. It is therefore possible to consult for surgical intervention.  A hip prosthesis made of metal, ceramic, and plastic is placed in a place on the hip. These biocompatible implants are designed to fit the body. Therefore, they are resistant to corrosion, wear, and rust. This surgical treatment method, which is applied due to hip arthritis, fractures, and injuries, is then supported by physical rehabilitation. The overall aim of this treatment is to reduce pain in the hip and leg area and improve the quality of daily life.

Why Is Hip Replacement Performed?

If the hip fracture, injury, or arthritis is severe, it causes a lot of pain and negatively affects daily life.  If this condition has persisted for a long time and conservative treatment methods have not been effective, hip replacement is considered a suitable solution. This surgical treatment reduces the pain caused by hip arthritis, fractures, or injuries. It also improves a person’s physical mobility during the day. There are several causes of hip fractures, injuries, or arthritis. Therefore, if a person has the following conditions in the hip area, hip replacement treatment is applied:

• Bone tumor
• Osteonecrosis
• Rheumatoid arthritis
• Osteoarthritis
• Hip fracture
• Severe pain that does not go away during the night
• Difficulty standing up or walking
• Conservative treatment methods do not work
• Difficulty going up and down stairs

Hip Replacement Surgery Process

As with any surgical procedure, there is a certain process before hip replacement. There are processes before, during, and after the operation. Below you will find information about the processes involved in hip replacement:

Before surgery:

The surgeon obtains information about the patient’s medical history and any medications. He or she first performs a physical examination to test whether the patient is fit for surgery. X-rays, blood tests, and MRI scans are then performed to make sure, and the results are evaluated. If surgery is decided upon according to the results of the evaluation, the necessary preparations for surgery are made. The surgeon gives the patient some instructions before the treatment. One of these instructions is to do appropriate exercises before surgery. These exercises are determined by the surgeon or doctor. It is very beneficial to ask all the questions that remain in the patient’s mind before the surgery.

During Surgery: 

When the day of surgery arrives, the patient is taken to the operating room in the hospital. General anesthesia or a spinal block is used to prevent the patient from feeling physical pain during the operation. The doctor may prescribe antibiotics or blood thinners to prevent possible risks during the operation. There are two main components of an artificial hip joint. These are the ball component and the socket component. The prostheses to be used for the artificial hip are prepared.

At the start of the operation, the surgeon makes an incision through the layers of tissue next to the hip. The damaged and dysfunctional hip bone is carefully removed. The prosthetic socket is inserted into the pelvic bone to replace the damaged hip socket.  Two different methods are used to place the prosthetic components on the bone. Press-fitting or cementing the prosthesis to the bone is among these methods. Bone soundness and strength are among the main factors to be considered when choosing this method. Cemented stems or uncemented sockets are also among the combinations that can be used. In a knee replacement, which takes about 1-2 hours, the damaged bone and cartilage are removed, and one of the implants made of different materials is inserted to restore the alignment and function of the hip. The orthopedic surgeon will choose the type of prosthesis according to the structure of the hip bone.

After The Surgery:

After the surgery is completed, the patient is taken to the recovery room. Blood pressure, pulse, alertness, and pain are monitored by nurses or anesthesia assistants. It is possible to be discharged in one or a few days. After the operation, the recovery process continues at home.  During the patient’s recovery at home, the doctor will prescribe certain medications. During the recovery process, movements that will strain the hip and leg should be avoided. Movements such as sitting cross-legged and crossing legs should not be done during the recovery period after surgery. In about 3–4 weeks, the patient can recover and continue with daily housework. After this period, support from a physiotherapist should be sought. If physical exercises are done regularly, the healing process will accelerate.

Risks Of Hip Replacement Surgery

Although hip replacement is a successful and safe surgical procedure, as with any surgery, some complications may develop. If the risk factors are serious, they can be prevented by treatment. The risks of hip replacement are as follows:

• Infection

An infection may occur at the incision site during surgery. Minor infections can be treated with antibiotics, while major infections may require a new surgical intervention.

• Blood clots

During hip replacement surgery, blood clots can form in the leg veins or pelvis. This life-threatening complication can be prevented with blood thinners, early mobilization, and support tubing.

• Fractures

Fractures can occur in other parts of the hip joint during surgery. Most of the time, these fractures are small, but sometimes they can be large. In the case of large fractures, it is possible to fix them with wires, cables, and bone grafts.

• Change In Leg Length

One of the complications after hip replacement surgery is a change in leg length. These changes are likely to occur to maximize the stability and biomechanics of the hip.

• Loosening

The prosthetic hip is likely to loosen sometime after surgery. This can cause hip pain and may require a new operation.

• Dislocation

When the joint of the prosthetic hip is dislocated, a dislocation occurs. To prevent this, the hip should not be bent more than 90 degrees, and the legs should not be crossed. If the hip is permanently dislocated, reoperation may be necessary to stabilize it.

• Prosthesis Wear Or Fracture

Over the years, wear or fracture of the hip prosthesis is likely to occur. This is also due to osteolysis and daily movements. A second operation, called a revision, is needed to repair the worn or broken joint.

• Stiffening Of The Joint (Ossification) 

Ossification occurs when the soft tissue around the joint hardens. Although it is not a painful complication, it can make it difficult to move the hip. This complication can also be prevented with medication or radiation therapy.

Result Of Hip Replacement Surgery 

Hip replacement surgery is a mostly successful surgical procedure. This surgery reduces pain in the hip joint and will restore physical mobility. However, it may not be possible to do high-paced sports. Instead, non-strenuous sports such as walking, golf, and swimming can be practiced. It is important to conserve the hip prosthesis. For this purpose, appropriate physical exercises should be performed, and the risks of falls and injuries should be avoided as much as possible. At the same time, the condition of the prosthesis should be controlled through routine check-ups.