If hip pain affects your quality of life or gets in the way of your daily activities, you may be considering a total hip replacement, also called total hip arthroplasty. It is a common procedure in the United States, with almost a half-million replacement procedures performed in 2020. That number is expected to nearly triple by 2040.
How Total Hip Replacement Can Help
Total hip replacement is typically recommended for patients suffering from advanced osteoarthritis, a degenerative disease that occurs when the cartilage cushioning the ball-and-socket joint wears away causing the rounded end of the thighbone to rub on the pelvis.
Nonsurgical options, including exercise and medication, may not be enough to manage your hip pain and stiffness. If this is the case, a total hip replacement may be a good option for reducing pain and helping you stay active and independent. Knowing the details about what to expect from a total hip replacement can help you make the best decision for yourself.
Download a Free Guide: Your Guide to Hip Pain
Technological Advancements in Hip Replacement Surgery
Beaufort Memorial has always been an early adopter of innovative technology and approaches to hip replacement, including the leading-edge Mako SmartRobotics™ Arm-Assisted Surgery System for both knee and hip replacement used today.
“The Mako has been a game changer for hip replacement,” says Dr. H. Kevin Jones, a board-certified orthopedic surgeon at Beaufort Memorial Orthopaedic Specialists in Port Royal and Bluffton. “This system allows us to make a precise model of your hip before surgery and gives us a clear view during surgery. This means increased accuracy, a lower risk of complications and more natural movement in the joint.”
The precision of the robotic arm allows cuts to occur in a way that they do not impact the tissue surrounding the bone.
Beaufort Memorial surgeons are also using muscle-sparing techniques, such as the direct anterior approach, to improve hip replacement outcomes. With the technique, the surgeon avoids having to cut and then reattach the key muscle group that enables you to walk and bend.
Dataw Island resident Jerry Devisser had always been active and loved to spend time outside with his wife, Barb. However, when hip pain began to affect his daily activities and quality of life, he discussed his options with Dr. Jones.
“I was able to play golf and tennis, but I couldn’t bend forward to do normal, everyday activities — tying my shoes, taking my socks off, getting in and out of the chair,” Devisser says. “The pain from my hip radiated down into my knee.”
After consulting with Dr. Jones, Devisser decided a total hip replacement was the best treatment option.
Read More: Joint Pain Q&A with Dr. Edward Blocker
What Happens During a Hip Replacement Surgery?
Hip replacement surgery involves removing the arthritic bone and damaged cartilage and replacing them with prosthetic implants designed to move like a healthy hip.
The hip joint includes two main parts: the pelvic bone and the femur (the long thigh bone). A knob called the head of the femur fits into a socket in the pelvic bone. A material that lines the pelvic socket, called cartilage, cushions the joint and keeps the bones from rubbing together. Medical conditions, such as arthritis, and injuries can damage cartilage or one or both bones.
During a total hip replacement, your surgeon removes the head of the femur and cartilage in the socket of the pelvic bone and replaces them with manufactured materials. After the head of the femur is removed, a metal piece called a stem is put into the femur. A ceramic or metal ball is then attached to the stem. The removed cartilage is replaced by a ceramic or plastic artificial socket or lining.
With Mako robotic surgery, a CT scan is taken of the hip joint to create a 3-D virtual model of the patient’s anatomy. The surgeon uses the model to evaluate bone structure, disease severity, joint alignment and the surrounding bone and tissue to determine the optimal size, placement, and alignment of the implant components.
During the operation, the surgeon follows the preoperative plan, guiding the robotic instrument arm to remove only the diseased bone. A virtual boundary established by the robot prevents the surgeon from crossing the bone field into surrounding tissue, preserving the healthy bone and ligaments around it.
A new artificial joint typically lasts for 20 years or more, and most people who have a hip replacement see significant reductions in pain. According to the Arthritis Foundation, approximately 90% of patients with mild or severe arthritis pain experienced little to no pain five years after surgery.
Safe Surgery
Total hip replacement is one of the safest surgeries, but it’s still major surgery. Fewer than 2% of people who have a total hip replacement have serious complications, but they are possible. Serious complications may include:
- Blood clots, or deep vein thrombosis
- Hip dislocation
- Infection
Your surgeon and other care team members will talk with you about possible complications and what signs and symptoms to look for that may signal a problem.
Pain is a normal part of the healing process, but the pain level varies from person to person. Devisser was lucky. After being told he might experience pain once the nerve block and anesthesia wore off, he didn’t have any lingering pain.
Read More: Operating Room to Living Room in One Day or Less
Recovery From a Total Hip Replacement
Recovery begins as soon as you’re able to move around after surgery.
“Within two hours, I was up and walking,” Devisser says.
While the majority of joint replacement patients at Beaufort Memorial have an overnight stay, currently up to 30% are discharged the same day.
“Moving from an inpatient to an outpatient surgery isn’t for everyone,” Dr. Jones says. “But patients who are healthy and who have family and other support measures in place have the same outcomes as patients who stay in the hospital.”
No two people have the same recovery process, but there are certain things that everyone can expect. You will receive physical therapy right away in the hospital. You will also need to designate a “first mate,” a friend or family member who can support you in the recovery process. This person can help prepare your home while you have surgery and support you throughout your recovery.
You will likely see an occupational therapist and physical therapist during outpatient rehabilitation. The goals of rehabilitation are to help you heal and increase your balance, endurance, independence and strength. Before you know it, you’ll be back to your regular routine.
“In eight weeks, I was playing a full 18 holes,” Devisser says. “Tennis was a little slower. Now I’m at the point where I don’t even think about it anymore.”
To learn more about joint replacement at Beaufort Memorial, register for an upcoming Solving Hip and Knee Pain seminar or discuss your options with an orthopedic specialist.
