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Hip Replacement

Hip replacement is a surgical procedure in which the hip joint is replaced by a prosthetic implant, that is, a hip prosthesis. Hip replacement surgery can be performed as a total replacement or a partial replacement.

Common reasons for hip replacement surgery include damage to the hip joint from:

  • Arthritis.

  • Disease that causes the bone in joints to die.

  • Injuries or fractures.

  • Bone tumors that break down the hip joint.

Symptoms:

  • Pain that prevents you from walking or bending the joint.

  • Pain while at rest, during the day, or at night.

  • Stiffness in the hip that prevents you from lifting your leg.

  • No relief from non-surgical treatment methods.

  • Joint stiffness that occurs as you are getting out of bed.

  • Joint stiffness after you sit for a long time.

  • Any pain, swelling, or tenderness in the hip joint.

  • A sound or feeling ("crunching") of bone rubbing against other bone.

 

Generally speaking,hip replacement patients do recover sooner than knee replacement patients, for example. It should be noted, however, that recovery time for a total hip replacement can differ vastly from patient to patient. Some patients may take 6 months to recover; while others may recover in just 4 weeks.

The replacement parts can be plastic (polyethylene), metal or ceramic and are used in different combinations:

  • Metal-on-plastic (a metal ball with a plastic socket) is the most widely used combination.

  • Ceramic-on-plastic (a ceramic ball with a plastic socket) or ceramic-on-ceramic (where both parts are ceramic) are often used in younger, more active patients.

  • Metal-on-metal (a metal ball with a metal socket) is very occasionally used in younger, more active patients.

 

Resurfacing the original socket and the ball of the thigh bone is a different form of hip replacement. Instead of removing the head of the thigh bone and replacing it with an artificial ball, a hollow metal cap is fitted over the head of the thigh bone. The socket part of the joint is also resurfaced with a metal component.

People who have this type of operation have a lower risk of dislocation and may be able to return to a higher level of physical activity compared with those having a conventional hip replacement.

Hip resurfacing has been developed as a surgical alternative to total hip replacement (THR). The procedure consists of placing a cobalt-chrome metal cap, which is hollow and shaped like a mushroom, over the head of the femur while a matching metal cup (similar to what is used with a THR) is placed in the acetabulum (pelvis socket), replacing the articulating surfaces of the patient's hip joint and removing very little bone compared to a THR. When the patient moves the hip, the movement of the joint induces synovial fluid to flow between the hard metal bearing surfaces lubricating them when the components are placed in the correct position. 

Recovery time -Many hip resurfacing patients are back walking just 4 hours after surgery. The total time spent in hospital is approximately about one to two days. Within two or three weeks, most patients can get back to regular activities including driving.

Younger active male patients who suffer from hip pain due to non-inflammatory arthritis (degenerative joint disease) such as osteoarthritis, traumatic arthritis, avascular necrosis, or dysplasia/DDH, or inflammatory arthritis such as rheumatoid arthritis, may benefit from the bone-conserving approach of the BIRMINGHAM HIP Resurfacing System (BHR).

Acetabular cartilage wear or persistent pain is the primary cause for failure. ... For patients with low femoral head-neck ratio (<1.2), such as those with osteoarthritis secondary to Legg-Calvé-Perthes disease or slipped capital femoral epiphysis, removal of more acetabular bone is often necessary during hip resurfacing.

Symptoms may include hip/groin pain, local swelling, numbness, or changes in your ability to walk. There are many reasons a patient with a metal-on-metal hip implant may experience such symptoms and it is important that you contact your surgeon to help determine why you are having them.

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