Frequently Asked Questions (FAQs) About
Hip Replacement at Palomar Health
Who Should Have Hip Replacement Surgery?
The most common reason for hip replacement surgery at Palomar Health is osteoarthritis in the hip joint.
Your doctor might also suggest this surgery if you have:
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Injury of the hip joint
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Bone tumors that break down the hip joint
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Osteonecrosis (a disease that causes the bone in joints to die)
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Rheumatoid arthritis (a disease that causes joint pain, stiffness, and swelling)
Your doctor will likely suggest other treatments first, including:
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Medications
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Physical therapy
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An exercise program
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Walking aids, such as a cane
These treatments may decrease hip pain and improve function. Sometimes the pain remains and makes daily activities hard to do. In this case, your doctor may order an x ray to look at the damage to the joint. If the x ray shows damage and your hip joint hurts, you may need a hip replacement. Healthy, active people often have very good results after hip replacement surgery.
How Should I Prepare for Hip Replacement Surgery?
To prepare for hip replacement surgery at Palomar Health, you should:
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Stock-up on food
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Make and freeze meals
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Ask the doctor for booklets about the surgery
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Ask someone to drive you to and from the hospital
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Learn what to expect before, during and after joint replacement surgery
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Place items you use every day at arm level to avoid reaching up or bending down
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Arrange for someone to help you for a week or two after coming home from the hospital
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Put things you need in one place at home (for example, put the remote control, radio, telephone, medicine, tissues, and wastebasket next to your chair or bed
What is Minimally-Invasive Hip Replacement Surgery?
In recent years, some surgeons have begun performing what is called a minimally invasive—or mini-incision—hip replacement, which requires smaller incisions and a shorter recovery time than traditional hip replacement.
Candidates for minimally invasive hip replacement surgery at Palomar Health are usually:
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Age 50 or younger
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Normal weight (based on body mass index)
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Healthier than candidates for traditional surgery.
What Happens During Hip Replacement Surgery?
The hip joint is located where the upper end of the femur, or thighbone, meets the pelvis, or hipbone. A ball at the end of the femur, called the femoral head, fits in a socket (the acetabulum) in the pelvis to allow a wide range of motion.
During a traditional hip replacement at Palomar Health, which lasts from 1–2 hours, the surgeon makes a 6–8-inch incision over the side of the hip through the muscles and removes the diseased bone tissue and cartilage from the hip joint, while leaving the healthy parts of the joint intact.
Then the surgeon replaces the head of the femur and acetabulum with new, artificial parts. The new hip is made of materials that allow a natural gliding motion of the joint.
What are the Differences Between Cemented and Uncemented Hip Replacement Parts?
Regardless of whether you have traditional or minimally-invasive surgery at Palomar Health, the parts used to replace the joint are the same and come in two general varieties: cemented and uncemented.
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Cemented parts are fastened to existing, healthy bone with a special glue or cement. Hip replacement using these parts is referred to as a "cemented" procedure.
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Uncemented parts rely on a process called biologic fixation, which holds them in place. This means that the parts are made with a porous surface that allows your own bone to grow into the pores and hold the new parts in place.
Sometimes a doctor will use a cemented femur part and uncemented acetabular part. This combination is referred to as a hybrid replacement.
The prosthesis (artificial hip) is comprised of the following two components:
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Metal ball component
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Plastic socket component (which may have a metal outer shell)
While undergoing surgery, the patient may be under general anesthesia or awake with spinal anesthesia.
What Should I Do After Hip Replacement Surgery?
Soon after hip replacement surgery at Palomar Health, you will meet a respiratory therapist and a physical therapist. The respiratory therapist may ask you to breathe deeply, cough, or blow into a device to check your lungs. Deep breathing helps to keep fluid out of your lungs after surgery.
The physical therapist will teach you how to sit up, bend over, and walk with your new hip. The therapist will also teach you simple exercises to help you get better. In some cases, within 1–2 days after surgery, you may be able to sit on the edge of the bed, stand, and even walk with help.
Most people spend 10 days or less in the hospital after hip replacement surgery. Full recovery from the surgery takes about 3–6 months, depending on the type of surgery, your overall health and the success of your rehabilitation.
Physical therapy will continue at home. Pain medication will also be administered to keep the patient comfortable. The incision will have stitches or staples that will be removed after a few weeks.
After you go home, be sure to follow the doctor's instructions. Tips for getting better:
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Work with a physical therapist
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Wear an apron to carry things around the house. This leaves your hands and arms free for balance or to use crutches.
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Making certain modifications to your home may help you during your recovery. These modifications include the following:
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Dressing stick
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Firm pillows to raise the hips above the knees when sitting
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Long-handled shoe horn
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Long-handled sponge and shower hose
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Proper handrails along all stairs
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Raised toilet seat
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Reaching stick to grab objects
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Removing loose carpets and electrical cords that may cause you to trip
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Safety handrails in the shower or bath
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Shower bench or chair
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Sock aid
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Stable chair with firm seat cushion and firm back with two arms, which will allow your knees to be positioned lower than your hips
Will Exercise Help After a Total Hip Replacement?
Exercise can reduce joint pain and stiffness after a total hip replacement at Palomar Health. It can also increase muscle strength and joint range of motion (how much you can move the joint).
Your doctor or physical therapist will decide when you can do harder exercises. Your doctor may say not to jog or play basketball or tennis. These can damage or loosen the new hip joint.
The types of exercise that may help you meet these goals are:
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Increase range of motion
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Make muscles strong
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Avoid injuring the new joint
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Increase muscle strength
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Increase your blood circulation and overall fitness
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Bicycling (on a bike machine)
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Cross-country skiing
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Swimming
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Walking
What Problems Can Happen After Hip Replacement Surgery?
The most common problem soon after hip replacement surgery is hip dislocation. Because man-made hips are smaller than normal ones, the ball can come out of the socket. This can happen if you are in certain positions, such as pulling the knees up to the chest.
Sometimes, a person's body reacts to the man-made joint. If that happens, there is usually inflammation (or swelling), and then special cells might eat away some of the bone, causing the joint to loosen. To treat this problem, your doctor may suggest medicines or surgery to replace the joint
Most people (more than 90 percent) who have hip joints replaced do not need more surgery. Researchers are trying out joints made of different materials that last longer and cause less inflammation.
Less common problems after surgery are:
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Infection
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Blood clots
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Bone growth past the normal edges of the bone
Risks of problems after hip replacement surgery are much lower than they used to be. Joint replacement is usually a success in more than 90 percent of people who have it. When problems do occur, most are treatable. Possible problems include:
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Blood clots: If your blood moves too slowly, it may begin to form lumps of blood parts called clots. If pain and swelling develop in your legs after hip or knee surgery, blood clots may be the cause. The doctor may suggest drugs to make your blood thin or special stockings, exercises, or boots to help your blood move faster. If swelling, redness, or pain occurs in your leg after you leave the hospital, contact your doctor right away.
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Dislocation: Sometimes after hip or other joint replacement, the ball of the prosthesis can come out of its socket. In most cases, the hip can be corrected without surgery. A brace may be worn for a while if a dislocation occurs.
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Infection: Areas in the wound or around the new joint may get infected. It may happen while you’re still in the hospital or after you go home. It may even occur years later. Minor infections in the wound are usually treated with drugs. Deep infections may need a second operation to treat the infection or replace the joint.
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Loosening: The new joint may loosen, causing pain. If the loosening is bad, you may need another operation. New ways to attach the joint to the bone should help.
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Nerve and blood vessel injury: Nerves near the replaced joint may be damaged during surgery, but this does not happen often. Over time, the damage often improves and may disappear. Blood vessels may also be injured.
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Wear: Some wear can be found in all joint replacements. Too much wear may help cause loosening. The doctor may need to operate again if the prosthesis comes loose. Sometimes, the plastic can wear thin, and the doctor may just replace the plastic and not the whole joint.
Do you have questions about joint replacement surgery at Palomar Health? Visit Patient Resources, Contact Us or Find our Location(s).