Total Hip Replacement (Arthroplasty)

Total hip replacement is also referred to as hip arthroplasty. This is a surgical procedure performed to replace certain parts of damaged or arthritic joints. Body parts that undergo arthroplasty are the hips, knees, and shoulder joints. Typically, these parts are surgically removed and replaced with metal, ceramic and plastic devices called prostheses. A prosthesis is designed specifically to help the artificial joint move just in the same way as the normal and healthy joint. 

With a hip replacement, surgeons replace the proximal end of your femur (thighbone) and the acetabulum or hip socket. The artificial socket is made of medical-grade titanium and high-quality plastic material. During the total hip replacement, the surgeon anchors the prosthesis into place using an advanced material designed to allow bone tissue to attach. Read on to learn more about total hip replacement, causes and symptoms, diagnosis, treatment, and post-operative care.

Causes and Symptoms of Conditions That Lead to a Total Hip Replacement

Here are common causes of hip degeneration and thigh-bone fractures that need medical attention:

Causes

When it comes to causes of chronic hip and thigh pain or related disability, arthritis takes the lead. Examples of these forms of arthritis are osteoarthritis, traumatic arthritis, and rheumatoid arthritis. 

Osteoarthritis: This type of arthritis is considered age-related common wear and tear. Osteoarthritis occurs commonly among individuals aged 50 years and older. It is also common among people with a known family history of arthritis. Osteoarthritis occurs when the cartilage cushioning your bones (around the hips) wears out. Once these bones are worn out, they start to rub against each other, leading to stiffness and hip pain. Another cause of osteoarthritis is the subtle irregularities during hip development among young people.

Post-traumatic arthritis: This condition can occur after a serious fracture or hip injury. In this case, your cartilage may become injured or damaged, leading to stiffness and hip pain over time.

Rheumatoid arthritis: This is one of the autoimmune diseases where the synovial membrane becomes thickened and inflamed, causing a lot of pain in your hips and thighs. Rheumatoid arthritis can easily damage your cartilage, leading to stiffness and pain. This chronic inflammation is the most common type of disorder known as “inflammatory arthritis.” These patients are at increased risk of several complications at the time of hip replacement.  

Osteonecrosis: This type of arthritis describes an injury or damage to your hip. Some of these injuries may be due to a fracture or dislocation. Osteonecrosis can limit the blood flow in and out of the femoral head. It is called “avascular necrosis or osteonecrosis.” The lack of enough blood may cause the surface of the affected bone (femur) to collapse, leading to arthritis. 

Childhood hip disease: Some children and infants are bone with hip problems due to abnormal growth of the hip, which ultimately affects joint surfaces.

Hip Degeneration Symptoms:  that may lead to hip replacement

The most common symptom that may lead to  total hip arthroplasty is end-stage symptomatic hip osteoarthritis. Additionally, hip osteonecrosis, congenital hip disorders, hip dysplasia, and inflammatory arthritic conditions are examples of common reasons for performing the total hip replacement. These conditions are traditionally manifested by groin, thigh or knee pain with activities. 

Other common indicators include:

• Hardware failure following internal fixation of hip injury and fractures
• Inability to enjoy restful sleep due to pain
• Inability to participate in physical activities you enjoy the most
• Difficulty doing certain tasks such as climbing stairs or getting dressed
• Difficulty when getting up from a seated position
• Persistent hip pain even after taking pain medication
• Hip pain worsens with walking

Total Hip Replacement Diagnosis

When it comes to diagnosing patients in need of total hip replacement surgery, symptom-based indicators are the deciding factors. Regardless, hip specialists should perform a comprehensive differential hip test for those complaining of discomfort in their hips. This is because the pain could be due to pelvis or spine injuries originating from your hip joint itself. Therefore, your orthopedic surgeon will conduct a diagnosis using the following techniques:

1. X-ray: This should be the first and only radiological diagnosis done to establish your hip and thigh condition. X-ray images can help your orthopedic surgeon determine the damage, injury, or deformity within your hip. 
2. MRI: Magnetic resonance imaging scan can also be used to determine the condition of your soft tissues and the bone of your hip. This is rarely required.
3. EMG: Electromyography may be used to help assess the conditions of muscles and nerve cells in your hips. This electrodiagnostic testing will certainly enable your physician to rule out other causes of hip pain and decide on the most appropriate treatment option for your condition.

Total Hip Replacement (Arthroplasty) Treatment

There are three major types of hip replacement surgeries: total hip replacement (total hip arthroplasty), partial hip replacement, and hip resurfacing. Besides, there are two major surgical methods for performing total hip replacement: the posterior approach and the anterior approach or muscle-sparing hip replacement. Total hip replacement is more common in adults.

During the total hip replacement surgery, your orthopedic surgeon will carry out the following procedure:

1. The damaged hip bone and cartilage will be surgically removed and replaced with matching prosthetic components. 
2. The injured femoral head will be taken out and replaced with a ceramic or metal stem. 
3. The metal stem will be inserted in the hollow center of your femur. The femoral stem may either be press fitted or cemented into the bone.
4. A ceramic/metal ball will be placed on the upper side of the stem to replace the removed femoral head.
5. Once the damaged femoral head is replaced, the surgeon will remove the damaged cartilage surface. After that, the surgeon will replace the damaged cartilage with a metal socket. 
6. A ceramic, metal, or plastic spacer will be placed between the socket and the new ball to provide a smooth gliding surface.

Risks of Total Hip Replacement (Arthroplasty) Surgery

Just like any other type of surgical procedure, arthroplasty comes with its risks. However, the complication rate associated with total hip arthroplasty is very low, with only 0.5 – 2% of patients experiencing joint infections. Nevertheless, patients are likely to be at risk of blood clots in the veins, fractures, dislocation, loosening of the new joint, change in leg strength, wound healing problems, numbness and the likelihood of second hip replacement after some time. 

Post-Operative Care of Total Hip Replacement Surgery

After a successful arthroplasty, you should expect post-operative care such as:

• Keeping the surgical area clean and dry
• Taking all medications as instructed by your healthcare provider
• Keeping all the follow-up appointments 
• Attending physical therapy
• Observing recommended home exercise
• Elevating the leg to avoid injuries
• Using ice cubes to control swelling

Find the best total hip replacement (arthroplasty) center near you in Sarasota, Florida. 

At Sforzo l Dillingham l Stewart Orthopedic + Sports Medicine, Dr.Charles E. Stewart will take care of your hip joint and thigh problems. Dr. Stewart is a  board-certified orthopedic surgeon with many years of experience in hip replacement surgery. Dr. Sforzo and Dr. Dillingham are also fellowship-trained medical professionals in hand, arm, and shoulder surgery. 

Their specialty includes the treatment of medical conditions related to rotator cuff disorders, joint replacement, carpal tunnel syndrome, fracture repair, arthritis surgery, and tendon repair among others. In addition, Dr. Stewart is an expert in performing technically challenging total femur replacement or total hip replacement. So, if you need arthritis hip replacement, make an appointment to see Dr. Charles E. Stewart.  

Final Thought

Total hip replacement or arthroplasty is a frequently done surgical procedure. It is mostly done electively to manage hip fractures, osteoarthritis  and injuries to the thighs caused by trauma or pathological processes.  Schedule your appointment for  hip orthopedics at Sforzo | Dillingham | Stewart Orthopedics + Sports Medicine today to learn more about total hip replacement surgery.