Hip Replacement Surgery

About Hip
The hip is one of the body's largest joints. It is a ball-and-socket joint. The socket is formed by the acetabulum, which is part of the large pelvis bone. The ball is the femoral head, which is the upper end of the femur (thighbone). The bone surfaces of the ball and socket are covered with articular cartilage, a smooth tissue that cushions the ends of the bones and enables them to move easily. A thin tissue called synovial membrane surrounds the hip joint. In a healthy hip, this membrane makes a small amount of fluid that lubricates the cartilage and eliminates almost all friction during hip movement. Bands of tissue called ligaments (the hip capsule) connect the ball to the socket and provide stability to the joint.

Why you may need a Hip Replacement
There are several reasons why your doctor may recommend hip replacement surgery. People who benefit from hip replacement surgery often have:
1. Hip pain that limits everyday activities, such as walking or bending
2. Hip pain that continues while resting, either day or night
3. Stiffness in a hip that limits the ability to move or lift the leg
4. Inadequate pain relief from anti-inflammatory drugs, physical therapy, or walking supports

Total hip replacement
In a total hip replacement (also called total hip arthroplasty), the damaged bone and cartilage is removed and replaced with prosthetic components.
1. The damaged femoral head is removed and replaced with a metal stem that is placed into the hollow center of the femur. The femoral stem may be either cemented or "press fit" into the bone.
2. A metal or ceramic ball is placed on the upper part of the stem. This ball replaces the damaged femoral head that was removed.
3. The damaged cartilage surface of the socket (acetabulum) is removed and replaced with a metal socket. Screws or cement are sometimes used to hold the socket in place.
4. A plastic, ceramic, or metal spacer is inserted between the new ball and the socket to allow for a smooth gliding surface.

Causes of Hip Pain
The most common cause of chronic hip pain and disability is arthritis. Osteoarthritis, rheumatoid arthritis, and traumatic arthritis are the most common forms of this disease.
1. Osteoarthritis. This is an age-related "wear and tear" type of arthritis. It usually occurs in people 50 years of age and older and often in individuals with a family history of arthritis. The cartilage cushioning the bones of the hip wears away. The bones then rub against each other, causing hip pain and stiffness. Osteoarthritis may also be caused or accelerated by subtle irregularities in how the hip developed in childhood.
2. Rheumatoid arthritis. This is an autoimmune disease in which the synovial membrane becomes inflamed and thickened. This chronic inflammation can damage the cartilage, leading to pain and stiffness. Rheumatoid arthritis is the most common type of a group of disorders termed "inflammatory arthritis."
3. Post-traumatic arthritis. This can follow a serious hip injury or fracture. The cartilage may become damaged and lead to hip pain and stiffness over time.
4. Avascular necrosis. An injury to the hip, such as a dislocation or fracture, may limit the blood supply to the femoral head. This is called avascular necrosis (also commonly referred to as "osteonecrosis"). The lack of blood may cause the surface of the bone to collapse, and arthritis will result. Some diseases can also cause avascular necrosis.
5. Childhood hip disease. Some infants and children have hip problems. Even though the problems are successfully treated during childhood, they may still cause arthritis later on in life. This happens because the hip may not grow normally, and the joint surfaces are affected.

Rehabilitation Post surgery
Several modifications can make your home easier to navigate during your recovery. The following items may help with daily activities:
Securely fastened safety bars or handrails in your shower or bath
Secure handrails along all stairways
A stable chair for your early recovery with a firm seat cushion (that allows your knees to remain lower than your hips), a firm back, and two arms
A raised toilet seat
A stable shower bench or chair for bathing
A long-handled sponge and shower hose
A dressing stick, a sock aid, and a long-handled shoe horn for putting on and taking off shoes and socks without excessively bending your new hip
A reacher that will allow you to grab objects without excessive bending of your hips
Firm pillows for your chairs, sofas, and car that enable you to sit with your knees lower than your hips
Removal of all loose carpets and electrical cords from the areas where you walk in your home