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Total Hip Replacement: Frequently Asked Questions

Posted in: Education

Hip replacement surgery is one of the most important surgical advances of this century and has a very high success rate. Here are answers to questions you may have.

What is arthritis and why does my hip hurt?
In the hip joint there is a layer of smooth cartilage on the ball of the upper end of the thigh bone (femur) and another layer within your hip socket. This cartilage serves as a cushion and allows for smooth motion of the hip. Arthritis is a wearing away of this cartilage. Eventually it wears down to bone. Rubbing of bone against bone causes discomfort, swelling and stiffness.

What is a total hip replacement?
A total hip replacement is an operation that removes the arthritic ball of the upper thigh bone (femur) as well as damaged cartilage from the hip socket. The ball is replaced with a metal ball that is fixed solidly inside the femur. The socket is replaced with a plastic liner that is usually fixed inside a metal shell implanted into the pelvis. This creates a smoothly functioning joint that does not hurt.


What types of materials are used in joint replacement?
The materials are designed to enable the joint to move just like your normal joint. Several metals are used, including stainless steel and alloys of cobalt, chrome and titanium. The plastic material, polyethylene, is durable and wear resistant. A bone cement may be used to anchor the prosthesis into the bone. Some joint replacements are implanted without cement.

What are the results of joint replacement?
Ninety-five percent of patients achieve good to excellent results with relief of discomfort and significantly increased activity and mobility.

Why do they fail?
The most common reason for failure is loosening of the artificial ball where it is secured in the femur or loosening of the socket. Wearing of the polyethylene liner may also result in the need for a new liner.

When should I have joint replacement surgery?
The goal is to relieve pain in the joint caused by the damage done to the cartilage. The pain may be so severe, a person will avoid using the joint, therefore, weakening the muscles around the joint and making it even more difficult to move. Your orthopedic surgeon will ask you to decide if your discomfort, stiffness and disability justify undergoing surgery. There is no harm in waiting if conservative, non-operative methods are controlling your discomfort. Total joint replacement is considered when other treatment options do not relieve your pain and disability. Based on your history, exam and X-rays, your surgeon will determine if you are a good candidate for joint replacement.

Am I too old for joint replacement?
Age is not a problem if you are in reasonable health and have the desire to continue living a productive, active life. You may be asked to see your personal physician for his/her opinion about your general health and readiness for surgery.

How long will my new joint last and can a second replacement be done?
We expect most knees to last more than 20 years. However, there is no guarantee and 10-15 percent may not last that long. Younger patients may need a second replacement or a revision of the implant components. Materials and surgical techniques are continually improving.