About Total Hip Replacement
If hip pain limits your ability to walk, work or perform simple activities and less invasive procedures (such as medication, physical therapy, and injections) have failed, then total hip replacement might be right for you. Hip replacement surgery removes the parts of the hip that are causing you pain and replaces them with artificial parts. This procedure aims to make it less painful to move the hip, improve its function and improve your quality of life.
Frequently Asked Questions
- What is a joint replacement made of?
- Who needs a total joint replacement?
- How do I know if I need surgery?
- Why have a total joint replacement?
- What does the surgery involve?
- Will I need a blood transfusion?
- How long will I be in the hospital?
- What therapy will I have to do?
- What are the major risks to the surgery?
- What if I get an infection?
- What are total hip precautions, and how long do I have to follow them?
- What happens when I leave the hospital?
- What do I do at home while recovering?
- How long do I take narcotics?
- When can I drive?
- When do I see my surgeon after surgery?
- Who do I call if I'm having problems after surgery?
- How long do total joints last? Will I need another surgery?
- What lifelong activities can I do or not do?
- Why do I have to have x-rays every two years?
- Why do total joints wear out?
- Why should I take prophylactic antibiotics for the rest of my life?
A replacement joint is a manufactured prosthesis made of titanium, chrome cobalt and polyethylene to replace an arthritic hip, knee and sometimes the ankle, shoulder, elbow or wrist.
Someone who has moderate to severe arthritis, significant limits on normal daily activity, and severe pain they can no longer live with.
As a patient you may want to choose surgery if you have pain that is not managed by anti-inflammatories (NSAIDS) and your daily activities are limited by this pain to the extent that you cannot do what you would like to do; for example, you cannot go grocery shopping without severe pain in the involved joint.
A total joint replacement will allow you to return to more normal activities and relieve your pain (95% success rate).
For total hip arthroplasty, the femoral head is removed, the canal in the middle of the femur is shaped to accept the stem and the acetabulum (socket in the pelvis) is shaped to accept the cup. A liner is inserted into the cup and a head onto the stem.
You may; though, we no longer need you to donate your own blood in advance.
In general, for an uncomplicated total knee or hip, the hospital stay is about one to three days after surgery.
Starting the afternoon after surgery you will have physical therapy and after that twice a day, which includes exercises, learning to sit, stand and walk with your new total joint. Patients usually take a few steps the first day, then walk around their room and so on. After you leave the hospital, you will have a list of the exercises you have learned to continue yourself at home. Many patients will receive physical therapy at home.
The major risks include the following:
Blood clot: We do reduce risk of this by using blood thinners (Enoxaparin, Aspirin or Coumadin), T.E.D. hose (compressive stockings) and compression boots on your feet to increase circulation.
Infection: You are given IV antibiotics before and after surgery.
Nerve, blood vessel damage: Because specialists performing this replacement work close to important vessels and nerves, they take great care not to injure these structures.
Total hip arthroplasty (THA) dislocation: As a patient you can avoid this by following total hip precautions. Complications with existing or new medical problems.
Infection is very rare, but a diffcult complication. Read more about joint infection after replacement.
Avoid internal and external rotation of the operated hip. Keep knees and toes straight ahead. Avoid flexing hip past 90% (for six weeks), though it’s best to follow precautions for life. Please no excessive stretching/yoga. Your THA could dislocate anytime even 10–20 years after surgery.
You will usually need 24-hour help for a week. If you don't have adequate help at home, you should consider a rehab facility or extended care facility. You can check with your insurance to see who is approved, but the final plans will be made with our case management team while you are in the hospital.
Recovery will involve the following:
First four to six weeks: Do your physical therapy exercises; keep the wound clean: no ointments or lotion on the wound; wear your T.E.D. hose for those four weeks; take blood thinners (Coumadin managed by the anti-coagulation service); walk as tolerated with crutches/walker; transition to a single crutch/cane as tolerated.
After six weeks: Continue exercises and walk or ride a stationary bicycle; use a crutch/cane until walking without a limp; return to work part time or full time as tolerated (as early as four to six weeks from surgery). You may return to full activity when ready except for running/jumping activities; kneeling on a TKA may be difficult but won’t damage it.
The best lifelong activities at this point are walking, swimming and biking.
Only as long as you need them, but usually about 5–14 days from the day of surgery; then Tylenol will usually handle the pain.
Usually three to four weeks after surgery (make sure you have control of your leg, you have no spasms, you are off pain medication and use caution.)
Two weeks after your surgery, your surgeon will remove your staples. You will also be seen six weeks after surgery, six months, one year and two years for the rest of your life. X-rays will be obtained at six weeks and yearly. (Even if you live out of town, we like to see copies.)
Please call the nurse/MA who works with your surgeon, and your post-operative instructions will give you a phone number to use. If you feel like it is an emergency, please call the clinic immediately or the University Hospital operator to have the orthopedic resident on call paged at the following number:
If it is after 5 pm, go to your nearest emergency department.
Today, total joints last 15–20 years depending on the amount of activity (demand) and your general health. You may need another surgery depending on how old you are and how much wear and tear you put on your total joint.
We advise patients to resume just about everything, especially walking, swimming, and bicycle riding. We discourage repetitive jumping and running, yoga or excessive stretching.
When a total joint starts to wear out, we can often see changes on the x-ray before you feel symptoms. If we x-ray your joint every two years, we can better determine the need and time for another operation.
The metal components of total joints can loosen over time, but often the cause of wear is from the bearing surface. Your immune system attacks the particles from the bearing surface but also melts bone away. Now we are using a metal liner (metal-on-metal), ceramic-on-ceramic and cross-linked polyethylene liners that wear less than what we had years ago.
You should take prophylactic antibiotics because total joints are made of metal and are at risk for infection when bacteria circulate through your bloodstream. If your joint becomes infected, it requires more than two additional surgeries. Therefore, take antibiotics with any bacterial infection as prescribed by your family practitioner. We strongly recommend that you take antibiotics for all dental and invasive procedures for the rest of your life.
Jill Erickson has worked with our Adult Reconstruction Surgeons since 1999, and with Christopher Peters, M.D. exclusively since 2003, with Joint Replacements as well as Hip Preservation procedures. She is an integral member of our University of Utah Center for Hip & Knee Reconstruction team and coordinates our research, surgical and clinical ou... Read More
Adult Reconstruction, Femoroacetabular Impingement, Hip Arthroscopy, Hip Dysplasia, Hip Preservation, Hip Replacement, Joint Replacement, Knee Replacement, Minimally Invasive Joint Surgery, Orthopaedic Surgery, Periacetabular Osteotomy, Physician Assistant, Surgical Dislocation
|University Orthopaedic Center||801-587-7028|
Dr. Gililland specializes in adult reconstructive orthopedic surgery of the hip and knee. He performs routine and complex primary and revision joint replacement operations. Additionally, his focuses include partial knee replacement and direct anterior total hip arthroplasty. He considers himself very fortunate to have a profession that he is passi... Read More
Dr. Pelt specializes in hip replacement and revision, and knee replacement and revision. Minimally invasive joint replacement, partial knee replacement (unicompartmental, patellofemoral), cruciate preserving knee replacement, and direct anterior hip replacement are all aspects of his practice. Dr. Pelt is an Assistant Professor in the Department o... Read More
Adult Reconstruction, Direct Anterior Hip Replacement, Hip Dysplasia, Hip Instability, Hip Replacement, Hip Revision, Joint Infection, Joint Replacement, Knee Replacement, Knee Revision, Labral Tear, Minimally Invasive Joint Surgery, Orthopaedic Surgery, Oxford Partial Knee Replacement, Patello-Femoral Arthroplasty (PFA), Uni-Compartmental Knee Arthroplasty, Unicompartmental Knee Replacement
|University Orthopaedic Center||801-587-7109|
Dr. Chris Peters, Professor, specializes in adult reconstructive orthopaedic surgery of the hip and knee. He performs routine and complex joint replacements and bioregenerative hip preserving operations. One of his specialties includes the treatment of hip pain in young adults from acetabular dysplasia and/or femoro-acetabular impingement with pelv... Read More
Adult Reconstruction, Femoroacetabular Impingement, Hip Dysplasia, Hip Preservation, Hip Replacement, Hip Revision, Joint Replacement, Knee Replacement, Labral Tear, Minimally Invasive Joint Surgery, Orthopaedic Surgery, Periacetabular Osteotomy, Surgical Dislocation, Uni-Compartmental Knee Arthroplasty
|University Orthopaedic Center||801-587-7109|