Hip joint replacement Health Article

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Reviewer Info: C. Benjamin Ma, MD, Assistant Professor, Chief, Sports Medicine and Shoulder Service, UCSF Dept of Orthopaedic Surgery. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.; ADAM Health Illustrated Encyclopedia, 02/09/2009
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Definition

Hip joint replacement is surgery to replace all or part of the hip joint with an artificial joint. The artificial joint is called a prosthesis.

Alternative Names

Hip arthroplasty; Total hip replacement; Hip hemiarthroplasty

Description

The artificial hip joint has 4 parts:

  • A socket that replaces your old hip socket. The socket is usually made of metal.
  • The liner fits inside the socket. It is usually plastic, but some surgeons are now trying other materials, like ceramic and metal. The liner allows the hip to move smoothly.
  • A metal or ceramic ball that will replace the round head (top) of your thigh bone.
  • A metal stem that is attached to the shaft of the bone to add stability to the joint.

You may receive general anesthesia before this surgery. This means you will be unconscious and unable to feel pain. You may have a spinal or epidural anesthesia. In this kind of anesthesia, medicine is put into your back to make you numb below your waist.

After you receive anesthesia, your surgeon will make an incision (cut) to open up your hip joint. Often this incision is over the buttocks. Then your surgeon will:

  • Remove the head of your thigh bone.
  • Clean out your hip socket and remove the remaining cartilage and damaged or arthritic bone.
  • Put the new hip socket in place, then insert the metal stem into your thigh bone.
  • Fix all the new parts in place, sometimes with a special cement.
  • Repair the muscles and tendons around the new joint.
  • Close the incision.

This surgery usually takes 1 to 3 hours.

Why the Procedure Is Performed

The most common reason to have a hip joint replaced is to provide relief for severe arthritis pain that is limiting what a person is able to do.

Hip joint replacement is usually done in people age 60 and older. Younger people who have a hip replaced may put extra strain on the artificial hip. That strain can cause it to wear out, and part or all of it may need to be replaced again if that happens.

Other reasons for replacing the hip joint are:

  • Fractures in the thigh bone. Older adults often have hip replacement for this reason.
  • Hip joint tumors

Even when a hip replacement is needed, some medical problems may lead your doctor to recommend that you not have it done. Some of these problems are:

  • Morbid obesity (weighing over 300 pounds)
  • Very weak quadriceps, the muscles in the front of your thigh. Weak quadriceps could make it very hard for you to walk and use your hip.
  • Unhealthy skin around the hip
  • Severe mental dysfunction

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