Surgery Overview

A partial hip replacement removes and replaces the ball of the hip joint. It does not replace the socket. This surgery is most often done to repair certain types of hip fractures.

The ceramic or metal ball is attached to a metal stem. This is called a hip implant. The stem is set down into the core of the thighbone (femur). It is firmly fixed in the femur in one of two ways. It may be:

• Cemented to the bone.
• Uncemented. This kind of stem has a porous coating that the bone grows into.

Your doctor may use regional anesthesia. This means you can't feel the area of the surgery. You'll have medicine that makes you unaware and lightly asleep. Or a doctor may use general anesthesia. This means you'll be asleep during surgery. Which type of anesthesia you get depends on your doctor and on your overall health. Your doctor might also ask what you prefer.

What To Expect

When you wake up from surgery, your pain will be controlled with intravenous (I.V.) medicine. You will also likely have medicines to prevent infection, blood clots, and nausea. If you had regional anesthesia, expect to have little or no feeling below your waist for a while.

Coming out of surgery, you may have a cushion between your legs. This is to keep your new hip in the right position. To help prevent blood clots, you'll likely be wearing compression stockings. And you may have compression sleeves on your legs. These squeeze and release your lower legs to help keep the blood moving.

Your recovery

On the day of surgery or the day after, you'll get out of bed with help. You will learn how to walk with a walker or crutches. By the time you leave the hospital, you will be able to safely sit down and stand up, dress yourself, use the toilet, bathe, and use stairs.

During the first week or so after surgery, you will need less and less pain medicine. For a few weeks after surgery, you will likely take medicine to prevent blood clots.

As soon as possible, you will be taught how to move your body without hurting your hip. Until your hip is fully healed, you will need to follow "hip precautions." Your doctor and physical therapist will tell you how to do this.

Many artificial hip joints last for 10 to 20 years. It depends on your age, how much stress you put on the joint, and how well your new joint and bones mend. Your weight can make a difference. Every extra pound of body weight adds 3 pounds of stress to your new hip joint. More weight may cause it to wear out sooner.

At home

When you go home, you will be able to move around with crutches or a walker. But you will need someone to help you at home for the next few weeks until your energy returns and you can move around better.

You'll be able to drive when your doctor says it's okay. You may be able to go back to work in 4 weeks to 4 months.

For most people, it's safe to have sex about 4 to 6 weeks after a hip replacement. Talk to your doctor about when it's okay to have sex and what positions are safe for your hip.

Be sure you go to all of your follow up appointments.

Rehabilitation

You will be in a rehab program. Your physical therapist will get you started and teach you exercises. Then you will do them on your own.

Rehab often lasts 6 months or more. It's not easy, and it takes time. Many people say that it's like "having a second job."

Exercise

Exercise (such as swimming and walking) is important for building your muscle strength. And it helps you feel better overall. Discuss with your doctor what type of exercise is best for you.

• You probably will be able to do most of the activities that you did before surgery, such as golf, bike, swim, or dance.
• Your doctor may discourage you from running, playing tennis, and doing other things that put a lot of stress on the joint.

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Why It Is Done

A partial hip replacement surgery is most often done to repair certain types of hip fractures. It's an option when the socket of the hip joint is healthy.

How Well It Works

Surgery usually works well. But recovery does take patience and time. Your hip will likely be able to do most, if not all, of what it used to do.

Because of the way the hip is structured, every added pound of body weight adds 3 pounds of stress to the hip. Controlling your weight will help your new hip joint last longer. Your hip should also last longer if you don't do hard physical work or play sports that stress the joint.

Risks

The risks of hip replacement surgery can be divided into two groups.

• Risks of the surgery and recovery period. These include:
  • Blood clots. These can be dangerous if they block blood flow from the leg back to the heart, or if they move to the lungs.
  • Infection. Infection in the wound is usually treated with antibiotics. Infection deep in the joint may need more surgery. In some cases, the hip implant has to be replaced with another one.
  • Nerve injury. This is rare. It can cause tingling, numbness, or difficulty moving a muscle.
  • Problems with wound healing.
  • Problems with anesthesia.
  • Hip dislocation after surgery.
  • Difference in leg length. Any difference is usually very small and can be corrected by using a shoe insert.
• Long-term risks. These risks may occur months to years after the surgery. They include:
  • Loosening of the hip implant in the bone.
  • Infection in the joint.