Hip Replacement

Hip replacement surgery is done by the replacement of the hip socket and upper portion of the femur with plastic or metal prosthetic parts. The surgery treats osteoarthritis and hip replacement surgeryrheumatoid arthritis of the hip that may not be controlled with drugs; fractures of a thigh or hip; malignant and benign tumors.

Before the hip replacement surgery starts, the patient is given spinal or general anesthetic and the hip to be operated on is washed with soap and antiseptic. The fat, muscle, fascia are cut open, bleeding vessels are tied off or cauterized, and the lips of the incision are retracted to give the doctor access to the joint. The ligaments holding the hip together are cut and trimmed away. Using a chisel, hammer, drills, files, the hip socket is trimmed back until the opening is large enough to hold the artificial prosthesis, which is made of metals well-tolerated by the body and lined on the inside with high-density plastic. After sufficient trimming, the doctor tries to fit the hip part of the prosthesis in place.

If a cementless procedure is used, the artificial hip socket is pressed into the pelvis until it locks into place. If cement is used, it is applied before the final fitting of the artificial socket. The top of the femur cut away and the medullary canal is cleaned and reamed out. The doctor places the femoral part of the prosthesis into the canal, then checks for fit with the hip socket and for proper alignment of the bones and correct length of the leg. If the cement is used, it is applied before the final fitting. When the fit is as good as may be achieved, the ligaments of the hip joint are reattached over the prosthesis; and the fascia, skin, and the muscle are closed in layers.

The patient transferred to the recovery room.

Postsurgery treatment includes physical therapy, inhalation therapy, and medications for the prevention of blood clots in the lower limbs. The individual tries to start walking within 1 to 2 days after hip replacement surgery.

Hip replacement should be done only by board-certified orthopedic surgeons in the hospital. Complications such as major bleeding during and after the surgery are common. Fatal complications such as clotting, infection, tearing or destruction of the veins, and valves were reported. Damage to the nerves in the part of the operation is also a possibility.

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