Hip Replacement

When the articular cartilage surrounding the ball and socket of your hip joint (where the femur meets the pelvis) is damaged beyond repair, most often due to osteoarthritis (or degenerative joint disease), hip replacement surgery seeks to remove the damaged portion of the hip and replace it with an artificial component.

The 3 most common approaches are as follows:

• Posterior Approach – Posterior approach (also known as the Moore or Southern approach) is the most traditional approach to hip replacement. It involves an incision from the back of the hip joint.
• Anterolateral Approach – Anterolateral approach (also known as the Watson-Jones approach) involves accessing the hip from the side.
• Anterior Approach – Anterior approach (also known as the Smith-Petersen approach or Direct Anterior Approach (DAA)) involves accessing the hip from the front.

A total hip replacement (or total hip arthroplasty) involves six main steps:

1. Preparation of the Hip Socket – The damaged cartilage, as well as a small amount of the bone, is removed from the hip socket (acetabulum) and the new surface is shaped to fit the designated implant.
2. Preparation of the Femur – The ball at the end of the femur, along with the damaged cartilage, is removed and the hollow center of the femur is reamed to fit the designated femoral stem implant.
3. Positioning of Hip Socket Implant – A cup-shaped metal implant is positioned in the hip socket. It can be secured with screws or press-fit into place.
4. Positioning of Femoral Stem Implant – A metal stem is inserted into the femur bone to a depth of around 6 inches. It can be cemented or press-fit into place.
5. Positioning of Femoral Head – A metal or ceramic ball is positioned on top of the femoral stem, taking the place of the damaged end of the femur, which was removed.
6. Spacing – A plastic spacer is inserted into the hip socket implant, creating a smooth surface for gliding (acting in place of cartilage for the artificial hip).

• Most patients will stay 2-4 days in the hospital and then begin physical therapy (either with a physical therapist coming to their home or in outpatient physical therapy sessions). Physical therapy progresses from walking with a walker to walking with a cane over the course of 2-3 weeks. Post-operative pain management will be provided through medication and/or injections, but most patients are pain free 2-3 weeks after surgery.
• After hip replacement surgery, you can reasonably expect to return to work in an office setting within 2-3 weeks, routine activities like driving within a month, work in an industrial setting involving heavy lifting within 2-3 months, and leisure activities such as golfing and swimming within 3 months.
• After recovering from hip replacement, you can expect to live a normal lifestyle, including activities like walking, hiking, biking, hunting, and fishing.  Most total hip replacement patients experience a significant reduction in pain as well as a vastly increased ability to perform daily activities.