Hip joint replacement

This surgery is performed to replace all or part of the hip joint with an artificial device (a prosthesis).

Hip arthroplasty; Total hip replacement; Hip hemiarthroplasty

The hip is essentially a ball and socket joint, linking the "ball" at the head of the thigh bone (femur) with the cup-shaped "socket" in the pelvic bone. A total hip prosthesis is surgically implanted to replace the damaged bone within the hip joint.

The total hip prosthesis consists of three parts:

• A cup that replaces your hip socket. The cup is usually plastic, although some centers are trying other materials like ceramic and metal.
• A metal or ceramic ball that will replace the fractured head of the femur.
• A metal stem that is attached to the shaft of the bone to add stability to the prosthesis.

If the surgery is a "hemi-arthroplasty," the only bone replaced with a prosthetic device is the head of the femur.

You will receive an extensive pre-operative evaluation of your hip to determine if you are a candidate for a hip replacement procedure. Your health care provider will assess the degree of disability, impact on your lifestyle, and pre-existing medical conditions. The health care provider will also evaluate your heart and lung function.

The surgery will be performed using general or spinal anesthesia. The orthopedic surgeon makes an incision, often over the buttocks, to expose the hip joint. The head of the femur is cut out and removed. Then, the hip socket is cleaned out and a tool called a reamer removes all of the remaining cartilage and arthritic bone.

The new socket is implanted, after which the metal stem is inserted into the femur. The artificial components are fixed in place, sometimes with a special cement. The muscles and tendons are then replaced against the bones and the incision is closed.

You will return from surgery with a large dressing on the hip area. A small drainage tube will be placed during surgery to help drain excess fluids from the joint area. Many surgeons also place a knee immobilizer or special pillow between the legs in the operating room to prevent the hip from dislocating.