Your 10-Minute Guide to Hip Replacement Surgery

Hip replacement surgery can significantly improve your pain and quality of life. Read on to learn about what it is, what happens before, during, and after the surgery, and whether you’re eligible to undergo the procedure.

What is hip replacement?

Hip replacement surgery (also called total hip replacement or total hip arthroplasty) is a procedure in which the damaged portions of the hip joint are removed and replaced with artificial components. The main aim of this procedure is to relieve your pain and improve the quality of your life.

Who requires hip replacement surgery?

Your doctor will recommend this surgery to you if you have hip pain that has severely impacted your day-to-day activities and quality of life. It is usually advised if you’re suffering from –

Osteoarthritis: Osteoarthritis is the most common joint disease in India, affecting up to 39% of the population
Rheumatoid arthritis
Post-traumatic arthritis
Osteonecrosis, or avascular necrosis of the femoral head: This is a condition where the bone tissue dies due to a lack of blood supply
Femoroacetabular or hip impingement: This is a condition where there is abnormal contact between the two bones that make up the hip joint (acetabulum of the hip bone and the head of the femur)
Trauma
Tumours
Childhood hip disorders

A 2020 study found that avascular necrosis of the femoral head accounted for almost half of the hip replacement surgeries in India, followed by osteoarthritis.

When do children need hip replacement surgery?

Hip replacement is not just for the elderly. Children can suffer from hip disorders such as –

Congenital dislocation of the hip (also called developmental hip dysplasia): This is a condition where there is spontaneous dislocation of the hip in babies, that can occur before, during or shortly after birth.
Legg-Calvé-Perthes disease: It is a type of avascular necrosis in children where the blood supply to the head of the femur gets interrupted, resulting in death of the bone tissue
Slipped capital femoral epiphysis: This usually occurs in teens and pre-teens where the head of the femur slips out of its socket and goes backwards
Tumours of the hip joint

Who is not eligible for hip replacement surgery?

You may not be a suitable candidate if –

There is an infection in your hip joint
You have severe osteoporosis
You smoke or regularly use tobacco
You cannot follow pre- and post-surgical instructions properly
You’re severely overweight
Your muscles around the joint are weak

What are the symptoms of hip disorders in children?

If your child has a hip disorder, they can have the following symptoms –

Pain or stiffness in the hip, knees, or thighs
Limping while walking
Altered manner of walking, sitting, climbing the stairs etc.
Favouring a particular side while sleeping
Refusing to walk or move the affected leg
Refusing to bear weight on the affected side

What’s the difference between partial and total hip replacement?

The former is done when only one part of the joint is affected – eg. fracture of the femur bone while in the latter both the head of the femur, as well as the acetabulum of the hip bone are replaced.

Is it possible to replace both the hips at the same time?

Usually, your doctor will not recommend replacing both the hips at the same time due to issues with positioning. Instead, a gap of 4-5 days is given between the two surgeries in case of bilateral surgery.

What happens before hip replacement surgery?

During the consultation, the surgeon will thoroughly explain the procedure, its outcome, and any potential complications. They will also respond to any queries or worries you might have.

You’ll sign a consent form giving permission to do the procedure
Your doctor will ask you for your medical and surgical history, including any bleeding disorders, allergies or sensitivities, along with any family history of illnesses
A comprehensive history of your medications will also be taken, including blood thinners, over-the-counter and prescription medicines, vitamins, herbal supplements and ayurvedic and homoeopathic medicines
You’ll undergo a general physical examination where your vital signs like pulse rate, blood pressure, oxygen saturation, and respiratory rate will be measured. You’ll also be required to undergo a blood test to know your blood parameters before surgery and ensure everything is normal
Your doctor will give you specific instructions regarding anything else that needs to be done before the procedure
You’ll change into a hospital gown and wait in the pre-operative area before your surgery

What happens during hip replacement surgery?

Your surgery takes place under general anaesthesia usually and your vital signs are monitored by your anaesthetist
Your orthopaedic surgeon will slice off all the damaged areas and prepare your bones to take the prosthesis and ensure that they optimally align
They’ll then close the incision and suture or staple it
They’ll dress the wound and you’ll be shifted to the post-op ward

What happens after hip replacement surgery?

The duration of your post-op stay depends on whether you got one or both hips replaced.

Your vital signs will be checked in the recovery area following the treatment
Your surgical team will start ankle/foot pump exercises within 6-8 hours of your surgery to minimise the chances of blood clots and also give you a sense of control
You’ll be started on exercises and physiotherapy the following day and be made to walk with the help of a walker

What are the complications of hip replacement surgery?

Like any other surgery, this procedure comes with certain risks and complications that include –

Formation of blood clots, which can lead to pulmonary embolism, stroke, or heart attack
Infections
Persistent pain and stiffness of joint
Damage to the blood vessels, nerves, and tendons around the knee joint
Fracture
Dislocation of the implant
Formation of new bone around the implant, causing stiffness and decreased range of motion

How long do I need to stay in the hospital post my surgery?

For unilateral surgery, you’ll be asked to stay in the hospital for around 5-7 days. In case you’ve undergone surgery of both the hips, you’ll be discharged after a period of 9-10 days.