Total hip replacement is needed when the patient has persistent hip pain, limiting their daily activities despite medication; worsening hip pain when walking or bending; stiff hip, inability to move or lift the leg; having trouble moving out of a seated posture.

This can be due to the following conditions:
Osteoarthritis damage to the cartilage or wear-and-tear arthritis
Osteonecrosis due to dislocation or fracture of the hip affecting the mobility.
Rheumatoid arthritis or an inflammatory disease which causes inflammation, deformed or damaged joints.
Tumor in the hip joint.

Nonsurgical options

We at FirstCure Health will first recommend medicine for pain or inflammation, walking aids, joint injections and physical therapy and when these measures do not relieve pain and stiffness, hip replacement surgery is suggested to restore function and improve quality of life.

We offer three major types of hip replacement:

Total hip replacement also called total hip arthroplasty. This is the most common surgery to replace worn-out or damaged sections of hip with artificial implants. The socket is replaced with a durable polymer cup, which may or may not also include a titanium metal shell. The femoral head will be removed and replaced with a ball made from ceramic or a metal alloy. The new ball is attached to a metal stem that is inserted into the top of the femur.

Partial hip replacement also called hemiarthroplasty involves replacing only one side of the hip joint – the femoral head – instead of both sides as in total hip replacement. This procedure is most commonly done in older patients who have fractured their hip.

Hip resurfacing of the femoral head and socket is most commonly done in younger, active patients.

X-ray of a total hip replacement showing the ball, socket and stem implants.

To begin the operation the surgeon will make an incision:

At the back or called the posterior approach (most common)
From the front or anterior approach to hip replacement.

Both approaches offer pain relief and improvement in walking and movement within weeks of surgery.

Pre-surgery planning

A complete physical examination is conducted to assess if the patient is fit for the surgery.In addition, several tests such as blood and urine test, Electrocardiogram (ECG) and chest x-ray are taken to help the surgeon plan the surgery.
Ongoing consumption of medication must be discussed with the doctor before the surgery because some medications may cause problems with the surgery or during the recovery post-surgery. These medications must be avoided. Use of tobacco products must be stopped as it affects the recovery process.

The surgery process

Below the waist (epidural) or general anaesthesia (whole body) is given. The surgeon makes an incision on the back front or side of the hip to remove the damaged bone and cartilage.

Artificial hip joints have two components: the ball component and the socket component. The prosthetic components could either be press-fit or cemented depending on the patient's bone quality and strength. At times, a combination of non-cemented and cemented sockets may be used depending upon the orthopedic surgeon.

The prosthetic socket is implanted, after which the surgeon bends and moves the leg to ensure the proper function.

Layers of tissue are closed with stitches that dissolve and the outermost layer of skin is closed with sutures.

The procedure takes 1-2 hours, and post-surgery the patient is moved to the recovery room until the anaesthesia wears off.

The surgeon will inform you when it is safe to go home, depending on your condition.You may need an X-ray, immediately after the procedure and during recovery, to confirm that your surgery was successful and that the new hip is healing well.

Minimally invasive surgery

When the surgery is minimally invasive, the surgeon accesses the hip joint though one or two small incisions by moving the muscles aside. The surgeon will take into consideration your age, weight, fitness level and other factors to decide if you are a good candidate. This approach is less painful, offers quicker recovery and shorter hospital stay.