Osteoarthritis: Guide to Hip Replacement

Hip replacement is an operation to repair a damaged hip joint. The surgeon removes the worn-out parts of the joint and puts in an artificial joint made of metal, ceramic, or plastic. It is one of the most common surgeries done in the U.S., where more than 2.5 million people have had a total hip replacement.

Your doctor might suggest a hip replacement if you have lasting hip pain from arthritis or an injury -- pain that gets in the way of your normal activities and doesn't go away with medication and other treatments like physical therapy. Arthritis pain is the most common reason to need hip replacement.

The new hip has a metal stem that connects into your thighbone. The stem has a metal or ceramic ball on the end that fits into a metal cup placed in the socket of your hip joint. A plastic or ceramic liner goes between the ball and cup to help the joint glide. Your surgeon may cement the new hip to the bone or use a hip designed to allow your bone to grow onto it and attach itself.

Your new hip is designed to serve you well for a long time, but it won't last forever. If you're young and active, you may need the same hip replaced again down the road. 95% of hip replacements last at least 10 years, about 75% last 15 to 20 years, and just over half last 25 years or more. To help keep your artificial hip in good shape longer, stay active but avoid high-impact activities, and stay at a healthy weight.

During this operation, you'll either be asleep under general anesthesia or sedated with your lower body numbed. The surgery usually takes an hour or two. Your surgeon will make a cut (incision) over the front or side of your hip, remove the damaged parts of your hip, and insert the new hip pieces. The placement may be done robotically to help with alignment. They'll close up with surgical stitches or staples.

You will likely spend one or two nights in the hospital. Your nurses will give you pain medicine so you can start moving the new joint as soon as possible. This is important for recovery. You'll meet with a physical therapist in the hospital to get you started with a rehab plan.

To make your recovery safer and smoother, you may need to make a few changes to your home. If your home has stairs, avoid them, and if you can't, you'll need sturdy railings to prevent falls. Your physical therapist will show you how to go up and down stairs. Remove loose rugs and other things you could trip on. Keep everyday items at waist level so you won't need to bend or reach as much. Add a raised toilet seat and shower bench to your bathroom.

Full recovery from the surgery can take a few months, but it's important to stay active during this time. You'll probably use a walker or crutches at first. Your doctor will tell you when you can put weight on your leg and when it's safe to drive. You'll have some limits on what movements you can do, like bending and reaching in certain positions. Most people can return to work within a few days or weeks of surgery.

After hip replacement, and with physical therapy, your pain should be a lot less than before. You'll be able to move more freely and with better coordination and strength. You may feel some stiffness, but it should get better with time. Activities like running and jumping might put too much stress on your new hip, but you should be able to do things like swim, bike, golf, and hike without pain. Be aware that your hip may set off metal detectors.

This will start in the hospital, probably right after the surgery. Your doctor and physical therapist will recommend rehab either at home or short-term in a rehab center. You'll do certain movements every day to regain your strength and ability. The exercises will start out simple in order to improve your circulation and range of motion. Your physical therapist will teach you what to do and when to move on to more advanced moves.

Walking is the best way to help your new hip recover and should be a big focus in the weeks and months after surgery. You'll need to start small and work on proper form, with short walks a few times a day. As you get stronger, go for longer walks. Once you are fully recovered, regular strolls a few times a week will help you stay strong.

If you need both hips replaced, your surgeon may want to do them at the same time. This means a shorter total recovery time, and you'll only need anesthesia once. But the recovery will be more intense since you’ll be rehabbing two new hips. You also will need more support at home right after surgery, since it will be harder to get around. If you have two separate hip replacement surgeries, wait at least 6 weeks between surgeries.