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An Overview of Hip Replacement Surgery
What Is Hip Replacement Surgery?
Hip replacement surgery, also called hip arthroplasty, is a surgical procedure that addresses hip pain and discomfort. The surgery is done to replace damaged parts of the hip joint with artificial implants (prosthesis). The implants, usually made up of metal, ceramic or plastic, help to reduce pain and improve function.
A hip replacement surgery is often done if all other conservative measures have failed and the pain is so severe that it interferes with the daily life of the patient. While this surgery can be done for many reasons, arthritis damage in the hip is the most common reason people undergo it.
Procedure Name
Female Infertility
Symptoms indicating need
Irregular menstrual cycles, recurrent miscarriages, chronic pelvic pain, and painful intercourse
Causes
Age, ovulatory disorders, uterine abnormalities, endometriosis, and hormonal imbalances.
Diagnosis
Physical examination , ovulation testing, pelvic ultrasound, and HSG
Treated By
OB-GYN and Fertility specialists
Treatment options
Fertility medications, surgery, ART
Hip Anatomy
The hip joint is a complex structure made of a ball and a socket. It is one of the body’s largest and most weight-wearing joints, providing a wide range of motion important for walking, running and everyday activities.
- Femoral: Head (Ball) The rounded top part of the thigh bone fits into the socket. It helps the hip to rotate and move smoothly.
- Acetabulum (Socket): It is a cup-shaped hollow cavity in the pelvis where the femoral head fits. The acetabulum is lined with cartilage that cushions the joint and lessens friction during movement.
- Cartilage: Cartilage is the smooth tissue covering the surfaces of the ball and socket, allowing for smooth, frictionless movement.
- Synovial Membrane: The synovial membrane generates synovial fluid which lubricates the joint, reducing friction and making movements smooth.
- Ligaments: Ligaments are strong connective tissues that help hold the joint in place, providing stability and control during movement.
When these components of the hip joint deteriorate due to injury, overuse, or arthritis, individuals may experience pain, stiffness and or loss of mobility, prompting a replacement surgery.
Types of Hip Replacement Surgeries
Depending on the injured joint area that requires an implant, there are various types of hip replacement surgeries. Your orthopaedic surgeon will take into account your age, lifestyle and overall health to decide which procedure is ideal for your condition. Now, let’s take a look at the major types of hip replacement surgeries:
Total Hip Arthroscopy (Replacement)
Total Hip Replacement (THR) involves replacing the entire ball-and-socket joint in your hip with an implant. Most commonly recommended to treat hip fractures or severe arthritis, it is one of the most common hip procedures. Recovery after a THR can take a few weeks and physical therapy plays a significant role during this period.
Partial Hip Arthroscopy (Hemiarthroplasty)
Unlike a total hip replacement surgery, a partial hip replacement is very rare. In this procedure, your surgeon will not replace the entire joint, but only the damaged part of the hip. It is usually recommended in older patients with a fractured hip where the socket is still intact. After a hemiarthroplasty, recovery is relatively shorter than for total hip replacement, though individual cases may vary.
Hip Resurfacing Surgery
Instead of replacing the entire joint, the femoral head is trimmed and then capped with a metal covering. After that, the acetabulum is resurfaced with a metal shell. Ideal for younger, more active patients, it helps to preserve more bone than in THR.
Hip Revision Surgery
A revision surgery is performed to repair or replace an artificial hip joint when a previous hip replacement has failed due to wear-tear, infection, misalignment or dislocation.
Hip revisions are generally only undertaken when there is a clear structural issue causing problems for the patient. Though more complex than the initial replacement surgery, the hip revision procedure provides relief from pain and improves joint function.
Our Specialist Best Doctors for Hip Replacement
Why Is Hip Replacement Surgery Done?
Hip replacement surgery is only considered in cases where the hip joint is so damaged that it causes severe pain even while resting and mobility is significantly reduced.
There can be many reasons for a hip replacement. Some of the most common ones include:
- Osteoarthritis
- Hip fractures
- Osteonecrosis (AVN)
- Tumour in the hip joint
- Septic arthritis
Preparing for Hip Replacement Surgery
It’s important to be prepared before your hip replacement surgery to ensure a successful outcome and a seamless recovery process. By taking the time to prepare mentally and physically, you can ensure that everything goes as planned so that you can focus on rehabilitation afterwards. Remember to always follow your surgeon’s guidelines and ask them if you have any queries regarding the whole process.
1. Preoperative Assessment
Before you undergo hip replacement surgery, your orthopaedic surgeon will perform a physical examination and some tests including hip X-rays, MRI, blood tests and EKG to name a few.
Your current symptoms and range of motion will be noted down. At this point, tell your surgeon about any medications or supplements that you’re taking. Also, discuss your medical history or any underlying health condition you may have. This will help assess your suitability for surgery.
2. Fasting Instructions
Your surgeon will give you instructions regarding your diet before the surgery. You may be required to fast for a specific period before the procedure.
Why Choose CureMe?
At CureMe, we are dedicated to delivering top-notch surgical care with a focus on patient comfort and advanced technology. We provide seamless surgical services across India, ensuring you receive the best care wherever you are.
Consultation for a Wide Range of Conditions
CureMe offers consultations for more than 50 conditions and treatments, including Piles, Hernia, Kidney Stones, Ear Infection, Abortion, IVF, Knee Replacement and more, across 45+ major cities in India.
Expert Care with Advanced Technology
Our experienced surgeons work closely with you to diagnose your condition. We provide thorough pre-surgery diagnostics and use advanced laser and laparoscopic techniques.
Support Throughout Your Surgery
A dedicated care coordinator will assist you from start to finish, handling everything from insurance paperwork to arranging free transport to and from the hospital and managing the admission and discharge process.
Care After Surgery
We offer free follow-up consultations and provide instructions, including dietary tips and exercises, to ensure a smooth recovery and help you return to your daily routine.
What To Expect During Hip Replacement Surgery
During hip replacement surgery, you can expect the following:
- Sedation – You will be given anaesthesia, which will numb the surgical area or put you to sleep during the procedure.
- Incision – Your Orthopaedic surgeon will make an incision either on the front, side or back of the hip to remove the damaged parts of the joint.
- Replacement with Implant – The surgeon will remove the replace the damaged parts with artificial components. The implant could either be press-fit or cemented – this will depend on the patient’s age, weight, activity level and bone quality.
- Closure – The incision will be closed with staples or sutures.
- Observation – You will be kept under medical observation for some time after the surgery.
After the Procedure
Hip replacement surgery usually takes an hour or two and the patient is shifted to the recovery room post-op and is kept there until the anaesthesia wears off. The medical team will continue to monitor the patient.
You will be prescribed some pain medications and other post-op care instructions including:
- Walking with a cane or walker after the surgery
- Sitting up after the surgery
- Stretches and exercises to start after 24 hours of the surgery
Most patients are kept for a couple of days in the hospital after the surgery, depending on their overall health and the type of procedure performed.
Recovery
How long does it take to recover after a hip replacement?
On average, hip replacement recovery can take around two to four weeks, but the exact time frame will differ for everyone. You will regain your range of motion over time and you might be able to use your hip with no restrictions 6 to 12 weeks post surgery. Soon after the surgery, you will be advised to start physical therapy right away and it will continue for a few months. Your rehab plan will also include muscle-strengthening exercises. During your recovery period, you must take care of your new joint, especially during the initial days. Remember to not push your body too hard.
Anterior, Posterior and Lateral Hip Replacement: Different Approaches of Surgery
Hip replacement surgery can done using three different surgical approaches. The three main approaches are anterior, posterior, and lateral. Your orthopaedic surgeon will choose the most suitable option for you based on your condition and anatomy.
Here’s an overview of each of these approaches:
1. Anterior Hip Replacement
In the anterior hip replacement, the orthopaedic surgeon makes an incision in the front of the groin, rather than on the side (as in the posterior approach) to remove the damaged bone and cartilage and add the implant. This approach helps the surgeon to work between muscles without cutting them, which can lead to a shorter recovery time.
2. Posterior Hip Replacement
The posterior approach for hip replacement surgery has been the 'standard' way for many years now. In this, the surgeon will make an incision to access the damaged joint near the buttocks on the back side of the hip. With better precision and a high success rate, this technique provides the surgeon with an excellent view of the surgical site.
3. Lateral Hip Replacement
In the lateral approach, the surgery is carried out by making an incision on the side of the hip joint. During this procedure, the patient is positioned on their side to make it easier for the surgeon to perform the surgery.
Minimally Invasive Hip Replacement Approaches
Minimally invasive hip replacement surgery focuses on making smaller incisions and fewer muscle cuts to ensure that the recovery period is shorter for the patient. MIS techniques are increasingly gaining popularity nowadays due to the significant benefits they offer over traditional replacement methods.
They offer various benefits over traditional hip replacement surgery including:
- Faster recovery
- Less tissue damage
- Smaller scar
- Minimal blood loss
- Shorter hospital stay
- Earlier return to normal activities
Although the MIS technique offers many benefits, not everyone is an ideal candidate for it. The patient’s age, weight and overall health will decide if this surgery is an option or not. There are different ways of performing a minimally invasive hip surgery, including:
01. Mini-Posterior Approach
Recent advancements to the ‘posterior approach’ allow for a smaller incision and less tissue trauma. In mini-posterior surgery, the surgeon is able to perform hip replacement through a small incision and without cutting the abductor muscles.
The incision is usually less than 10 cm long and has minimal risk of nerve damage and blood loss in comparison to other approaches.
02. Direct Anterior Approach (DAA)
The direct anterior approach (DAA) involves making a three to four-inch incision in the front (anterior) of the hip for a replacement. The DAA offers the most direct access to the surgical site and is considered to be a “muscle-sparing” method because it does not involve cutting into muscles or tendons to reach the damaged part of the joint.
Because there’s significantly less muscle and soft tissue damage, recovery will be relatively faster. You will generally be able to go home in a day or two – which means fewer pain medications and a quicker return to normal activities.
03. DAA with Bikini Incision
The Direct Anterior Approach (DAA) with Bikini Incision is an advanced version that aims to reduce tissue damage while also giving cosmetically pleasing results for the patients. This method is particularly great for patients who are concerned about the appearance of scars.
The ‘bikini’ incision as the name suggests is made along the natural skin crease in the front of the hip, resembling a bikini line. It is typically done in a horizontal or slightly diagonal way so that it can be blended more naturally with the skin folds and be less visible.
In addition to the benefits of a standard direct anterior approach, the bikini method also offers a more discreet and aesthetically pleasing scar.
04. Two-Incision Hip Replacement Technique
In this minimally invasive technique, two incisions are made by the surgeon – one to approach the pelvis (near the groin area) and another separate for the femur (near the buttock).
Since the incisions are small and more targeted, there is less trauma to the muscles and surrounding soft tissues.
FAQ's
Frequently Asked Questions About Hip Replacement Surgery
Can you get both hips replaced at the same time?
Yes, both hips can be replaced at the same time in a procedure called bilateral hip replacement. However, this decision depends entirely on factors such as the patient’s overall health, the extent of hip damage in both joints and the surgeon’s recommendation.
While it may offer some advantages such as a single recovery period, the procedure can be more physically challenging, so surgeons may recommend doing one hip at a time for older or high-risk patients.
How long after hip replacement can I walk?
After getting your hip replaced, you will be able to walk with a walker or crutches within a few hours of the surgery. After following your rehabilitation program, you can start walking unassisted within two to four weeks, although the exact timelines may vary based on age, activity level and other health factors.
What are hip implants made of?
Hip implants can typically be made from a combination of materials including metal, plastic and ceramic. The choice of materials for implants will be based on the specific case and the patient’s needs and activity level.
How long does a hip replacement last?
The prosthetic hips used in hip replacement surgeries usually last a long time. On average, you can expect them to last around 15 to 20 years, but it can be even longer with proper care and activity modification. New materials and advanced techniques have improved the longevity of implants.
How soon after surgery can I sit cross-legged (palthi)?
During the initial recovery period, patients should avoid sitting cross-legged (palthi), particularly after traditional hip replacement. However, with advanced techniques like the Direct Anterior Approach (DAA) or other minimally invasive methods, patients may be able to sit cross-legged within a few weeks post-surgery.
In contrast, traditional surgeries typically require 6 to 12 weeks before attempting this position. The timeline varies based on the type of surgery and individual flexibility. Always consult your doctor before resuming this activity.
Can you live a normal life after hip surgery?
Of course. In fact, most patients experience a significant improvement in their quality of life after hip replacement surgery. You will be able to return to a normal, active lifestyle without restrictions once you have fully recovered.
Can I climb stairs after hip replacement?
Yes, patients can begin climbing stairs just within a day after surgery with the help of assistive devices. Unassisted climbing on stairs can take a couple of weeks. Your physical therapy sessions will be vital during this time and help you accelerate the recovery process.
Can you sit on the toilet after hip surgery?
Yes, you can use Indian-style toilets after hip replacement surgery, but it will require time and careful recovery. Initially, you’ll need to avoid deep bending, and your surgeon may recommend waiting until you’ve fully healed and regained strength before using them comfortably.
Which technique is best for hip replacement?
There isn’t a single best technique for hip replacement, as each approach has its own benefits and drawbacks. The right choice depends on your specific condition, anatomy, and your surgeon’s expertise. Minimally invasive techniques, like the Direct Anterior Approach (DAA), are becoming increasingly popular due to faster recovery time and may be an ideal option for many patients.
Which implant is best for hip replacement?
The best implant for hip replacement will depend on an individual’s needs and the surgeon’s recommendation. There are various types of implants available today and your surgeon will choose one that best suits your needs, age, activity level and bone quality.
Implants made from materials like metal-on-polyethylene, ceramic-on-ceramic, and metal-on-metal are all rigorously tested to meet high safety and quality standards. Each type has its own advantages and potential drawbacks, which your surgeon will consider when recommending the most suitable option for you.
Still Have a Question?
Reach out to our healthcare experts at Cure Me for discussing any concerns and queries regarding Hip Replacement Surgery.
Looking to Get the Best Hip Replacement Surgery in India? Consult Surgeons at CureMe
Are you experiencing severe pain or discomfort in the hip while walking, climbing stairs or while sitting? Have you been advised to undergo hip replacement surgery by your orthopaedic surgeon? Then, it may be time for you to get a consultation with our experienced surgeons.
At CureMe, we have curated the best and most experienced orthopaedic surgeons, who not only have the expertise required for replacement surgery but are also trusted by countless patients, especially in minimally invasive hip procedures. Talk to us and let’s discuss what could be done, together!
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