FAQ's on HIP Replacement

Q- What is TOTAL HIP REPLACEMENT?
Ans- A total hip replacement is a surgical procedure whereby the diseased cartilage and bone of the hip joint is surgically replaced with artificial materials. The normal hip joint is a ball and socket joint. The socket is a "cup-shaped" bone of the pelvis called the acetabulum. The ball is the head of the thigh bone (femur). Total hip joint replacement involves surgical removal of the diseased ball and socket, and replacing them with a metal ball and stem inserted into the femur bone and an artificial plastic cup socket. The metallic artificial ball and stem are referred to as the "prosthesis." Upon inserting the prosthesis into the central core of the femur, it is fixed with a bony cement. Alternatively, a "cementless" prosthesis is used which has microscopic pores that allow bony ingrowths from the normal femur into the prosthesis stem. This "cementless" hip is felt to have a longer duration and is considered especially for younger patients.

Q- Who is a candidate for TOTAL HIP REPLACEMENT?
Ans- Progressively severe arthritis (osteoarthritis) in the hip joint. This type of arthritis is generally seen with aging, congenital abnormality of the hip joint, or prior trauma to the hip joint.
Other conditions leading to total hip replacement include bony fractures of the hip joint, rheumatoid arthritis, and death (aseptic necrosis) of the hip bone. Hip bone necrosis can be caused by fracture of the hip, drugs (such as alcohol or prednisone), diseases (such as systemic lupus erythematosus), and conditions (such as kidney transplantation).
The progressively intense chronic pain together with impairment of daily function (despite use of anti-inflammatory and/or pain medications) including walking, climbing stairs and even arising from a sitting position, eventually become reasons to consider a total hip replacement.

 Q- What are the risks of TOTAL HIP REPLACEMENT?
Ans- The blood clots in the lower extremities can travel to the lungs (pulmonary embolism) which can cause respiratory failure and shock. Other problems include difficulty with urination, local skin or joint infection, fracture of the bone during and after surgery, scarring and limitation of motion of the hip, and dislocation and loosening of the prosthesis which eventually leads to prosthesis failure.

Q- What does the preoperative evaluation entail?
Ans- Total hip joint replacement can involve blood loss so blood transfusion may be required.
The preoperative evaluation generally includes a review of all medications being taken by the patient. Anti-inflammatory medications, including aspirin, are often discontinued one week prior to surgery because of the effect of these medications on platelet function and blood clotting. They may be reinstituted after surgery.
Other preoperative evaluations include complete blood counts, electrolytes (potassium, sodium, chloride, and bicarbonate), blood tests for kidney and liver functions, urinalysis, chest x-ray, ECG, and a physical examination. Any indications of infection, severe heart or lung disease, or active metabolic disturbances such as uncontrolled diabetes, may postpone or defer total hip joint surgery.