TOTAL HIP REPLACEMENT
Replacing Your Problem Hip
A painful, stiff hip can keep you from doing the simple
things in life, even walking without pain. Today, Dr. Kalbac (orthopedic surgeon)
can replace your hip, thanks to breakthroughs in surgical techniques and materials.
Total hip replacement is a safe, reliable procedure that can relieve your pain and
stiffness and return you to most of the activities you enjoy.
When Walking Hurts
As hip pain and stiffness increase, you may find more and more things you can't do.
Simply walking or getting up from a chair can hurt. Hip pain and stiffness often
result from osteoarthritis (the breakdown of cartilage in your joints), which makes your
hip bones grate painfully together. Other hip problems include rheumatoid arthritis,
injury, and loss of blood supply to the bones of your hip. |
Your New Hip
Technical advances have given us new materials to replace your problem hip with a
prosthesis (artificial hip joint). Like your own hip, your prosthesis is made up of
a ball and socket that fit together to form a joint. Our doctor will choose the best
prosthetic design for you after carefully diagnosing your particular hip problem.
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Your Hip Anatomy
Your hip is a simple ball-and-socket joint where your
thigh bone joins with your pelvis. Surrounded by cartilage, muscles, and ligaments,
your hip is one of your largest weight-bearing joints. Smooth cartilage and bone
help you walk easily and without pain. |
Your Orthopedic Evaluation
Dr. Kalbac specializes in bone and joint surgery.
Your surgery is recommended only after careful diagnosis of your hip problem, including
your degree of pain and lack of mobility.
Your History includes questions about your hip pain,
medications you may be taking, prior injury, and other bone and joint problems you may
have, such as rheumatoid arthritis.
Your Physical Exam Includes assessing the range of motion
in you hip and observing how you walk, sit, bend, and move.
X-rays provide us with a picture of your hip bones and
joint. X-rays also help in the precise fitting of your new hip.
Joint aspiration (removing a small amount of fluid from the
affected hip joint) may sometimes be performed to check for infection.
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Your Hip Prosthesis
Your hip prosthesis (cemented or cementless) has the same basic parts as your own hip.
A ball, often metal, replaces the worn head of your thigh bone, with a stem
inserted into the bone for stability. A cup, often plastic, replaces your worn
socket. Like a healthy hip, your prosthesis has smooth gliding surfaces that allow
you to move easily and without pain. Unlike a healthy hip, however, your prosthesis
has a limited safe range of motion, and will need your special care after surgery.
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Understanding the Risks.
As with all major surgery, there are certain risks, such as infection, blood clots,
pneumonia, and other post-operative complications. We will discuss these before
surgery. |
Before Surgery
Before surgery, you may need a general physical exam by your regular doctor. In
addition to following your doctor's instructions, there are several things you can do to
prepare yourself for surgery. You may be asked to lose extra weight, since extra
weight puts extra stress on your new hip. You may be asked to avoid aspirin for two
weeks before surgery to minimize bleeding. You may also be asked to stop smoking to
help decrease the chance of post-operative lung complications.
Your Surgery
You may be admitted to the hospital the same day of surgery or the night before,
and cannot eat or drink anything after midnight. The day of surgery, you may be
given an IV line for medications and for blood transfusions, which are usually needed.
In the Recovery Room
After surgery, you may wake up feeling a bit groggy. Specially trained
nurses will be with you to make you comfortable and give you pain medication for any
discomfort. A pillow between your legs may be used to keep your new hip in
position. An IV provides antibiotics and fluids if needed, and a small tube drains
your incision. Your nurses can help you with coughing and deep breathing exercises,
to help prevent lung complications and start you on the road to a safe recovery.
Your Hospital Recovery
The key to your successful hospital recovery is keeping your hip in position as it
heals. After a short period of initial healing, you'll be started on easy physical
therapy exercises to promote healing and get you walking again before you go home.
Initial Healing
After your total hip replacement, you can expect one or two days of bed rest. To
keep your new hip in position, you may have a special bed that keeps your hip from bending
beyond 90 degrees. An abduction pillow keeps your legs shoulder-widt6h apart and
prevents them from rotating inward. Support stockings may be used to help prevent
circulation problems.
Physical Therapy
Gentle physical therapy exercises help strengthen the muscles around your new hip
and regain your hip's range of motion. As soon as possible, your physical therapist
helps you start walking, a few steps at a time, to promote healing. As you progress
from a walker to crutches and then a cane, you may feel somewhat off balance at first.
Gait training helps you regain confidence and your normal walking motion before you
go home.
Going Home
Once your hospital recovery is complete, the doctor will discharge you, and your
nurses can help you get ready to go home. Your sutures and bandages are usually
removed before going home, and you may be given pain or other medications to take with
you. Before you leave the hospital, an occupational therapist may show you how to
perform home activities safely. You also will be given any other necessary
instructions for your home recovery. Be sure to ask any questions you may have. |
Your Home Recovery
At home again, you'll still need to limit your hip bending; other wise, your new
hip can slide out of position. Your family and friends can help you follow the
doctor's home recovery instructions, especially important during the first few months.
Limit Hip Bending
with your new hip, your safe maximum hip bend is 90 degrees. Four rules of
thumb to remember to keep your hip in position:
- when sitting, keep your knees below your hips (sitting on a
small pillow helps)
- avoid crossing your legs while lying down or sitting
- avoid bending over at the waist;
- sit with your legs three to six inches apart.
Caring for your Hip
Your prosthesis is the result of years of research. but like any other
device, your new hip's lifespan depends on how you care for it. In your follow up
visits after surgery, we will follow your progress and answer any questions you may have
about caring for your new hip.
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