FAQ Total Hip Replacement
Total Hip Replacement- Frequently asked questions
A smooth, slippery, fibrous connective tissue called articular cartilage acts as a protective cushion between bones inside the joint. Arthritis develops as the cartilage begins to deteriorate or is lost because of wear and tear as part of aging or because of disease like Rheumatoid arthritis. As the articular cartilage is lost, joint space between the bones become narrow. This is an early sign of arthritis and is easily seen on X Rays. Slowly over time bone ends rub against each other and wear away. This results in progressive pain and shortening. Normal activity becomes painful and difficult. Pain can even interfere with simple daily activities.
Common arthritis symptoms include pain, stiffness, some loss of joint motion, deformity, limp and shortening of limb
Who develops arthritis?
• Primary osteoarthritis typically affects patients over 50 years of age, but is uncommon in India
• It is more common in persons who are overweight, or suffering from Rheumatoid arthritis or Ankylosing spondylitis. In some patients arthritis tends to run in families.
• Other factors that can contribute to developing hip arthritis include injury to the hip (Acetabulum fracture or after fracture neck of femur), developmental abnormalities like dysplastic hip and Perthe's disease
What is the treatment of Hip arthritis?
• Conservative treatment does not have a significant role in management, once hip arthritis has set in.
• Initial treatment includes medications for pain relief, weight control and physical therapy.
• If all these fail to produce satisfactory response, one should consider hip replacement as the last resort treatment.
Total Hip Replacement
Who need a Hip Replacement?
If your answer is yes to most or all the questions, you probably are a candidate for Hip replacement surgery.
• Does severe hip pain limit your activities? (walking, climbing stairs, getting in and out of chair)
• Is your Hip stiff, which makes it difficult to move or your hip is fixed in one position?
• Pain associated with limb shortening and limp while walking
Hip joint is exposed using a incision on the back of hip, over the buttock. Joint is exposed after separating the muscle and cutting through the capsule. The worn and damaged surface of bone and cartilage from upper end of femur (thigh bone) and pelvis are removed and shaped to accept the prosthetic implants. These surfaces are replaced with metal and plastic / Ceramic implants which closely mimic natural hip motion and function.
• Ultimate goal of hip replacement surgery is pain relief and improved function.
• Hip replacement surgery will not treat pain arising from other joints or back. Although some improvement is expected because
of improve gait or walking pattern.
• Restrictions like avoiding running, high impact aerobics and sports like tennis are to be practiced for rest of life.
• Extreme bending, squatting and sitting cross-leg should be avoided to prevent dislocation and wear or early loosening of
• Hip replacements last many years, but may need revision surgery when they wear out or loosen.
Points to remember after total Hip surgery
After Hip replacement, certain important aspects of your recovery need to be kept in mind:
• Walking and limited post-op exercises are important and should be performed as instructed by your physiotherapist. These
have to be continued lifelong.
• Balance rest and activity, especially early in your recovery.
• Follow instructions to prevent clots.
• Know the signs of infection.
• Be careful and avoid falls.
• Carefully adhere to restrictions.
Frequently Asked Questions
Q. When I shall be able to walk?
A. You will be made to walk on second day after operation; physiotherapist will be there to assist you. At the time of discharge you will be able to walk to toilet or bathroom on your own with the help of walker or cane.
Q. What is the material used for replacement?
A. The implant is a special highly polished alloy (Cobalt-Chrome) or ceramic head on femoral component articulating with high quality polyethylene.
Q. How long I have to stay in the hospital after surgery?
A. In case you are getting one hip operated you will stay in the hospital for six days after surgery. In case, both the hips are operated together, duration of stay is for nine days after surgery.
Q. I am staying alone, how long I will need someone for help at home after discharge from hospital?
A. As discussed above, you will be able to walk to toilet or bathroom on your own at the time of discharge, but, if you are staying alone, you should have someone around for a month after surgery to assist you in daily activities.
Q. When can I start driving?
You can start driving after two months of surgery depending on the muscle strength and comfort.
Q When can I climb stairs?
A. You can climb to first floor in one go approximately 3 4 weeks after surgery.
Q. When can I travel abroad?
A. Traveling in the city for short duration may be started after 2 3 weeks. Going out of city may be done approximately after a month. Overseas travel should ideally be undertaken 3 months after surgery.
Q. What are the lifelong precautions after surgery?
A. 1. Not to sit cross legged, squat or use an Indian toilet or a low chair.
2. Avoid impact sports like jogging, jumping, badminton etc
3. Antibiotic prophylaxis before any dental, gynaecological or urinary procedure.
Q. How long I will need to do physiotherapy?
A. You will be guided in your exercises by our team of physiotherapist during your stay in the hospital. After discharge you will need to continue with some easy exercises that you can do on your own. This may be required for a period of 6 , 8 weeks or till the time you are comfortable with your walking. Physiotherapist assistance after discharge may be required for 2 weeks.
Q. I am over weight, should I lose weight first and then undergo surgery?
A. Thin patients are easy for us to operate and postoperative recovery is also good. But, losing weight and maintaining weight loss can be difficult in patients with osteoarthritis of the hip, since their symptoms often limit the amount and type of exercise in which they can participate.
Q. How long are these joints going to last?
A. Life of the artificial joint depends on number of variables, including the type of activities you are engaged, quality of bone, whether you are overweight etc. Normally these joints have a finite lifespan of 15 , 20 years.