Hip Replacement: What to Expect

Hip replacement is a major surgical procedure in which diseased cartilage and bone of the hip joint is surgically removed and replaced with artificial materials. The normal hip joint is a ball and socket joint, with the socket being comprised of a "cup-shaped" bone of the pelvis called the acetabulum. The ball is the head of the thigh bone (femur).

In a procedure for total hip joint replacement an orthopedic surgeon removes the diseased ball and socket, replacing them with a metal ball and stem that is inserted into the femur bone and an artificial cup socket made of various materials that is placed in the pelvis.

The metallic artificial ball and stem are referred to as a "prosthesis." The surgeon grafts the prosthesis into the central core of the femur with special cement called methylmethacrylate. In some cases, a "cementless" prosthesis may be used which has microscopic pores that allow for bony in-growth from the normal femur into the prosthetic stem. This "cementless" hip is felt to have a longer life span than a cemented prosthesis and is considered preferable, especially for younger patients.

The procedure for hip replacement is performed in a hospital under general anesthesia and generally takes two to four hours. Pre-operative preparations can take additional time.

After surgery, the patient is taken to a recovery room for immediate observation which generally lasts one to four hours. Recovery room nurses closely observe the patient's lower extremities for both adequate sensation and circulation. Unusual symptoms of numbness or tingling should be noted to the recovery room staff immediately. Once stabilized, the patient is transferred to a hospital room for a recovery period of two to four days.

During the immediate recovery period, patients receive intravenous fluids. Intravenous fluids are important to maintain a patient's electrolytes as well as for administering antibiotics. Tubes also drain fluid from the surgical wound site. The amount and character of the drainage is important to the doctor and can be monitored closely by the attending nurses. A dressing is applied in the operating room, which remains in place for two to four days to be later changed by the attending surgeon and staff.