Cornerstone Orthopedics & Sports Medicine, P.C.: Surgical: Total Hip Arthroplasty
Injuries and Conditions : Hip : Total Hip Arthroplasty : Treatment : Surgical : Total Hip Arthroplasty
 
Evaluation of Patient for Surgery
  • Patients are given a complete physical examination to assess the patient's overall health.
  • An examination of the range of movement in both the involved and the uninvolved hip to evaluate motion and the production of pain.
  • Walking (gait) measurements and analysis are recorded.

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    Expectations for Recovery
  • A replaced hip will usually allow patients to regain a significant amount of strength, stability, and motion of the hip.
  • The longevity of the replaced hip is dependent upon the type of use and stresses to which the hip is subjected. High impact, shock-producing activities like running, soccer or basketball should be avoided to insure a longer lasting hip.
  • Pain should be minimal throughout the life of the replaced hip. Increasing pain may indicate that the implants have begun to separate or loosen from the bone. A second surgical procedure, or revision, may be necessary to replace the implants if pain becomes severe enough, or the loosening risks further damage to the surrounding bone.
  • Under normal use a replaced hip can last more than 20 years.

    • Post Operative Recovery
  • Immediately after surgery, as anesthesia wears off, patients will usually feel tired and slightly disoriented, though the after-effects of anesthesia can vary greatly from patient to patient.
  • The hip will remain tender and slightly painful after surgery. However, the pain will tend to decrease as painkillers are administered and the hip recovers from the operation.

    Post-Operative Instructions

    Activity
  • Follow general post operative guidelines
  • Be aware of any signs of infection
  • Use crutches, cane or a walker to assist with walking, place weight on the operative leg as much as can be tolerated.
  • Do not engage in activities that increase the stress that is placed on the newly replaced hip.
  • Return to sedentary work (school or desk work)
  • Avoid long periods of sitting and traveling long distance without frequent breaks or stops.
  • Do not drive until given clearance to do so by your surgeon.

    • Home Exercise

  • Begin exercise 24 hours after surgery
  • Straight leg raises
  • Quad sets
  • Heel slides,
  • Ankle pumps

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    Rehabilitation Program
    A period of time is required for the body to adjust or acclimate to the replaced hip. Physical therapy will be required for 3 months to restore the muscle strength, flexibility and balance lost after surgery.
  • The joint will be used immediately after surgery, and the patient will be asked to walk with assistance the first day after surgery.
  • Hip replacement surgery usually requires a hospital stay of 3 to 5 days and require the use of crutches, cane or a walker for 4-6 weeks.
  • After 3 months, the hip will likely allow a return to moderate athletic activity such as bicycling, golf, and swimming.
  • To help maintain the replaced hip, continued gentle use of the joint will be required.
    • Medication and Medical Products
    NSAIDs
     NSAIDs (Nonsteroidal Anti-Inflammatory Drugs) are a group of drugs used to control pain. This category of medications includes both prescription and common over-the-counter painkillers such as ibuprofen. NSAIDs are effective for many types of pain that can occur because of inflammation of muscles, joints and bones. The drugs work quickly and people often notice some benefit within a few hours of taking the tablet. However, the complete effectiveness of the drug may not be realized for up to four weeks. For each individual, some varieties of NSAIDs are more effective than others. Often, patients will find that one or two varieties are helpful whereas others may not be as effective in controlling symptoms. It is usually necessary to try several brands and continue with the one that is most suitable. NSAIDs can be used to treat:
  • Pain resulting from inflammation or swelling.
  • Pain after injury.
  • Joint pain and arthritis.

    • Abduction Pillow
     An abduction pillow is used to separate or hold a patient's leg apart at the thighs after total hip replacement or revision surgery. The pillow helps position the legs correctly to properly position the hip prosthesis in the hip joint; used after surgery, this device helps to reduce the likelihood of a dislocation after a hip replacement or revision procedure.

    The pillow is used immediately post-operatively, and is particularly important for maintaining an anatomically correct position while the patient rests and sleeps. As the muscles, tendons and ligaments gradually heal, the pillow will be used less frequently, until it is eventually discontinued.



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    Possible Complications and Risks
  • Risks during and after surgery include problems that may develop in relation to bleeding, the possibility of infection, and reactions to anesthesia.
  • DVT (Deep Vein Thrombosis) in which clots form within the blood vessels of the legs are a potential complication during this type of surgery.
  • Bleeding into the hip joint can be expected. The patient may have drains placed in the hip during surgery to lessen this accumulation of blood.
  • The most common reason artificial joints fail is due to the loosening of the cement where the implants meet the bone. As the artificial joint wears, increasing pain may mean that a revision, or second surgery, is required to replace the loosened implant.
  • Stiffness in the hip may result after surgery as scar tissue around the joint forms and interferes with motion. Unwanted growth of bone around the joint may occur infrequently after the surgery. If this severe problem occurs, a second surgery may be required to remove the bone to regain full motion.
  • It is possible that damage to adjacent nerves may occur during the surgical procedure.
  • Following the procedure, the hip may become dislocated.
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