Hip replacement


Hip replacement is a procedure in which the surgeon removes damaged or diseased parts of the patient's hip joint and replaces them with new artificial parts. The operation itself is called hip arthroplasty . Arthroplasty comes from two Greek words, arthros or joint and plassein , "to form or shape." It is a type of surgery done to replace or reconstruct a joint. The artificial joint itself is called a prosthesis. Hip prostheses may be made of metal, ceramic, plastic, or various combinations of these materials.


Hip arthroplasty has two primary purposes: pain relief and improved functioning of the hip joint.

Pain relief

Because total hip replacement (THR) is considered major surgery, with all the usual risks involved, it is usually not considered as a treatment option until the patient's pain cannot be managed any longer by more conservative nonsurgical treatment. These alternatives are described below.

Joint pain interferes with a person's quality of life in many ways. If the pain in the hip area is chronic, affecting the person even when he or she is resting, it can lead to depression and other emotional disturbances. Severe chronic pain also strains a person's relationships with family members, employer, and workplace colleagues; it is now recognized to be as the most common underlying cause of suicide in the United States.

In most cases, however, pain in the hip joint is a gradual development. Typically, the patient finds that their hip begins to ache when they are exercising vigorously, walking, or standing for a long time. They may cut back on athletic activities only to find that they are starting to limp when they walk and that sitting down is also becoming uncomfortable. Many patients then begin to have trouble driving, sitting through a concert or movie, or working at a desk without pain. It is usually at this point, when a person's ability to live independently is threatened, that he or she considers hip replacement surgery.

Joint function

Restoration of joint function is the other major purpose of hip replacement surgery. The hip joint is one of the most active joints in the human body, designed for many different types of movement. It consists of the head (top) of the femur (thighbone), which is shaped like a ball; and a part of the pelvic bone called the acetabulum, which looks like a hollow or socket. In a healthy hip joint, a layer of cartilage lies between the head of the femur and the acetabulum. The cartilage keeps the bony surfaces from grinding against each other, and allows the head of the femur to rotate or swivel in different directions inside the socket formed by the acetabulum. It is this range of motion, as well as the hip's ability to support the weight of the upper body, that is gradually lost when the hip joint deteriorates. The prostheses that are used in hip replacement surgery are intended to restore as much of the functioning of to the hip joint as possible. The level of function in the hip after the surgery depends in part on the reason for the damage to the joint.

Disorders and conditions that may lead to the need for hip replacement surgery include:


Between 200,000 and 300,000 hip replacement operations are performed in the United States each year, most of them in patients over the age of 60. According to the American Academy of Orthopaedic Surgeons (AAOS), only 5–10% of total hip replacements as of 2002 were in patients younger than 50. There are two reasons for this concentration in older adults. Arthritis and other degenerative joint disorders are the most common health problems requiring hip replacement, and they become more severe as people grow older. The second reason is the limited life expectancy of the prostheses used in hip replacements. Because THR is a complex procedure and requires a long period of recovery after surgery, doctors generally advise patients to put off the operation as long as possible so that they will not need to undergo a second operation later to insert a new prosthesis.

This demographic picture is changing rapidly, however, because of advances in designing hip prostheses, as well as changes in older Americans' rising expectations of quality of life. Many people are less willing to tolerate years of pain or limited activity in order to postpone surgery. In addition, hip prostheses are lasting longer than those used in the 1960s; one study found that 65% of the prostheses in patients who had had THR before the age of 50 were still intact and functioning well 25 years after the surgery. A larger number of hip replacements are now being done in younger patients, and the operation itself is being performed more often. One expert estimates that the annual number of hip replacements in the United States will rise to 600,000 by 2015.


Hip replacement surgery is a relatively recent procedure that had to wait for the invention of plastics and other synthetic materials to make reliable prostheses that could withstand years of wear. The first successful total hip replacement was performed in 1962 by Sir John Charnley (1911–1982), a British orthopedic surgeon who designed a device that is still known as a Charnley prosthesis. Charnley used a stainless steel ball mounted on a stem that was inserted into the patient's thighbone to replace the femoral head. A high-density polyethylene socket was fitted into the acetabular side of the joint. Both parts of the Charnley prosthesis were secured to their respective sides of the joint with an acrylic polymer cement. More recent developments include the use of cobalt chrome alloys or ceramic materials in place of stainless steel, as well as methods for holding the prosthesis in place without cement.

As of 2003, there are three major types of hip replacement surgery performed in the United States: a standard procedure for hip replacement; a newer technique known as minimally invasive surgery (MIS), pioneered in Chicago in February 2001; and revision surgery, which is done to replace a loosened or damaged prosthesis.

Standard hip replacement surgery

A standard hip replacement operation takes 1-1/2–3 hours. The patient may be given a choice of general, spinal, or epidural anesthesia. An epidural anesthesia, which is injected into the space around the spinal cord to block sensation in the lower body, causes less blood loss and also lowers the risk of blood clots or breathing problems after surgery. After the patient is anesthetized, the surgeon makes an incision 8–12 in (20–30 cm) long down the side of the patient's upper thigh. The surgeon may then choose to enter the joint itself from the side, back, or front. The back approach is the most common. The ligaments and muscles under the skin are then separated.

Once inside the joint, the surgeon separates the head of the femur from the acetabulum and removes the head with a saw. The surgeon uses a power drill and a special reamer to remove the cartilage from the acetabulum and shape it to accept the acetabular part of the prosthesis. This part of the new prosthesis is a curved piece of metal lined with plastic or ceramic.

After selecting the correct size for the patient, the surgeon inserts the acetabular component. If the new joint is to be cemented, the surgeon will attach the component to the bone with a type of epoxy. Otherwise the metal plate will be held in place by screws or by the tightness of the fit itself.

To replace the femoral head, the surgeon first drills a hollow inside the thighbone to accept a stem for the femoral component. The stem may be cemented in place or held in place by the tightness of the fit. A metal or ceramic ball to replace the head of the femur is then attached to the stem.

After the prosthesis is in place, an x ray is taken to verify that it is correctly positioned. The incision is then washed with saline solution as a safeguard against infection. The sutures used to close the deeper layers of tissue are made of a material that the body eventually absorbs, while the uppermost layer of skin is closed with metal surgical staples. The staples are removed 10–14 days after surgery.

Finally, a large triangular pillow known as a Charnley pillow is placed between the patient's ankles to prevent dislocation of the hip during the first few days after surgery.

Minimally invasive hip replacement surgery

Minimally invasive surgery (MIS) is a new technique of hip replacement introduced in 2001. Instead of making one long incision, the surgeon uses two 2-inch (5 cm) incisions or one 3.5-1/2-inch (9 cm) incision. Using newly designed smaller implements, the surgeon removes the damaged bone and inserts the parts of the new prosthesis. MIS hip replacement takes only an hour and a half; there is less bleeding and the patient can leave the hospital the next day. As of 2002, however, obese patients or those with very weak bones are not considered for MIS.

Revision surgery

Revision surgery is most commonly performed to replace a prosthesis that no longer fits or functions well because the bone in which it is implanted has deteriorated with age or disease. Revision surgery is a much more complicated process than first-time hip replacement; it sometimes requires a specialized prosthesis as well as bone grafts from the patient's pelvis, and its results are not usually as good. On the other hand, some patients have had as many as three revision operations with satisfactory results.


Because pain in the hip joint is usually a gradual development, its cause has been diagnosed in most cases by the time the patient is ready to consider hip replacement surgery. The doctor will have taken a careful medical

In a hip replacement, the upper leg bone, or femur, is separated from the hip socket, and the damaged head is removed (A). A reamer is used to prepare the socket for the prosthesis (B). A file is used to create a tunnel in the femur for the prosthesis (C). The hip and socket prostheses are cemented in place (D), and finally connected (E). (Illustration by Argosy.)
In a hip replacement, the upper leg bone, or femur, is separated from the hip socket, and the damaged head is removed (A). A reamer is used to prepare the socket for the prosthesis (B). A file is used to create a tunnel in the femur for the prosthesis (C). The hip and socket prostheses are cemented in place (D), and finally connected (E). (
Illustration by Argosy.

and employment history in order to determine the most likely cause of the pain and whether the patient's job may be a factor. The doctor will also ask about a family history of osteoarthritis as well as other disorders known to run in families. The patient will be asked about injuries, falls, or other accidents that may have affected the hip joint; and about his or her use of alcohol and prescription medications—particularly steroids, which can cause avascular necrosis.

The patient will then be given a complete physical examination to evaluate his or her fitness for surgery. Certain disorders, including Parkinson's disease; dementia and other conditions of altered mental status; kidney disease; advanced osteoporosis; disorders associated with muscle weakness; diabetes; and an unstable cardiovascular system are generally considered contraindications to hip replacement surgery. People with weakened immune systems may also be advised against surgery. In the case of obesity, the operation may be postponed until the patient loses weight. The stress placed on the hip joint during normal walking can be as high as three times the patient's body weight; thus each pound in weight reduction equals three pounds in stress reduction. Consequently, weight reduction lowers an obese patient's risk of complications after the operation.

The doctor will also order a radiograph, or x ray, of the affected hip. The results will show the location and extent of damage to the hip joint.

Diagnostic tests

The doctor may also order one or more specialized tests, depending on the known or suspected causes of the pain:

Preoperative preparation

Hip replacement surgery requires extensive and detailed preparation on the patient's part because it affects so many aspects of life.

LEGAL AND FINANCIAL CONSIDERATIONS. In the United States, physicians and hospitals are required to verify the patient's insurance benefits before surgery and to obtain precertification from the patient's insurer or from Medicare . Without health insurance, the total cost of a hip replacement as of 2002 can run as high as $35,000–$45,000. In addition to insurance documentation, patients are legally required to sign an informed consent form prior to surgery. Informed consent essentially signifies that the patient is a knowledgeable participant in making healthcare decisions. The doctor will discuss all of the following with the patient before he or she signs the form: the nature of the surgery; reasonable alternatives to the surgery; and the risks, benefits, and uncertainties of each option. Informed consent also requires the doctor to make sure that the patient understands the information that has been given.

MEDICAL CONSIDERATIONS. Patients are asked to do the following in preparation for hip replacement surgery:

LIFESTYLE CHANGES. Hip replacement surgery requires a long period of recovery at home after leaving the hospital. Since the patient's physical mobility will be limited, he or she should do the following before the operation:

Many hospitals and clinics now have "preop" classes for patients scheduled for hip replacement surgery. These classes answer questions regarding preparation for the operation and what to expect during recovery, but in addition they provide opportunities for patients to share concerns and experiences. Studies indicate that patients who have attended preop classes are less anxious before surgery and generally recover more rapidly.


Aftercare following hip replacement surgery begins while the patient is still in the hospital. Most patients will remain there for five to 10 days after the operation. During this period, the patient will be given fluids and antibiotic medications intravenously to prevent infection. Medications for pain will be given every three to four hours, or through a device known as a PCA (patient-controlled anesthesia). The PCA is a small pump that delivers a dose of medication into the IV when the patient pushes a button. To get the lungs back to normal functioning, a respiratory therapist will ask the patient to cough several times a day or breathe into blow bottles.

Aftercare during the hospital stay is also intended to lower the risk of a venous thromboembolism (VTE), or blood clot in the deep veins of the leg. Prevention of VTE involves medications to thin the blood; exercises for the feet and ankles while lying in bed; and wearing thromboembolic deterrent (TED) or deep vein thrombosis (DVT) stockings. TED stockings are made of nylon (usually white) and may be knee-length or thigh-length; they help to reduce the risk of a blood clot forming in the leg vein by putting mild pressure on the veins. TED stockings are worn for two to six weeks after surgery.

Physical therapy is also begun during the patient's hospital stay, often on the second day after the operation. The physical therapist will introduce the patient to using a walker or crutches and explain how to manage such activities as getting out of bed or showering without dislocating the new prosthesis. In addition to increasing the patient's level of physical activity each day, the physical therapist will help the patient select special equipment for recovery at home. Commonly recommended devices include a reacher for picking up objects without bending too far; a sock cone and special shoehorn; and bathing equipment.

Following discharge from the hospital , the patient may go to a skilled nursing facility, rehabilitation center, or directly home. Ongoing physical therapy is the most important part of recovery for the first four to five months following surgery. Most HMOs in the United States allow home visits by a home health aide, visiting nurse, and physical therapist for three to four weeks after surgery. The physical therapist will monitor the patient's progress, as well as suggest specific exercises to improve strength and range of motion. After the home visits, the patient is encouraged to take up other forms of physical activity in addition to the exercises; swimming, walking, and pedaling a stationary bicycle are all good ways to speed recovery. The patient may take a mild medication for pain (usually aspirin or ibuprofen) 30–45 minutes before an exercise session if needed.

Most patients can start driving six to eight weeks after the operation and return to work full time after eight to 10 weeks, depending on the amount and type of physical exertion their jobs requires. Some patients arrange to work on a part-time basis until their normal level of energy returns.


Hip replacement surgery involves both short- and long-term risks.

Short-term risks

The most common risks associated with hip replacement are as follows:

Long-term risks

The long-term risks of hip replacement surgery include:

Normal results

Normal results are relief of chronic pain, greater ease of movement, and much improved quality of life. Specific areas of improvement depend on a number of factors, including the patient's age, weight, and previous level of activity; the disease or disorder that caused the pain; the type of prosthesis; and the patient's attitude toward recovery. In general, total hip replacement is considered one of the most successful procedures in modern surgery.

It is difficult to estimate the "normal" lifespan of a hip prosthesis. The figure quoted by many surgeons—10 to 15 years—is based on statistics from the early 1990s. It is too soon to tell how much longer the newer prostheses will last. In addition, as hip replacements become more common, the increased size of the worldwide patient database will allow for more accurate predictions. As of 2002, it is known that younger patients and obese patients wear out hip prostheses more rapidly.

Morbidity and mortality rates

Information about mortality and complication rates following THR is limited because the procedure is considered elective. In addition, different states and countries use different sets of measurements in evaluating THR outcomes. One Norwegian study found that patients who had THR between 1987 and 1999 had a lower long-term mortality rate than the age- and gender-matched Norwegian population. A Canadian study found a 1.6% mortality rate within 30 days of surgery for THR patients between 1981 and 1999. A 2002 report from the Mayo Clinic found that the overall frequency of serious complications (heart attack, pulmonary embolism, deep vein thrombosis, or death) within 30 days of THR was 2.2%, the risk being higher in patients over 70. The most important factor affecting morbidity and mortality rates in the United States, according to a 2002 Harvard study, is the volume of THRs performed at a given hospital or by a specific surgeon; the higher the volume, the better the outcomes.


Nonsurgical alternatives

The most common conservative alternatives to hip replacement surgery are assistive devices (canes or walkers) to reduce stress on the affected hip; exercise regimens to maintain joint flexibility; dietary changes, particularly if the patient is overweight; and analgesics , or painkilling medications. Most patients who try medication begin with an over-the-counter NSAID such as ibuprofen (Advil). If the pain cannot be controlled by nonprescription analgesics, the doctor may give the patient cortisone injections, which relieve the pain of arthritis by reducing inflammation. Unfortunately, the relief provided by cortisone tends to diminish with each injection; moreover, the drug can produce serious side effects.

Complementary and alternative (CAM) approaches

Complementary and alternative forms of therapy cannot be used as substitutes for hip replacement surgery, but they are helpful in managing pain before and after the operation, and in speeding physical recovery. Many patients also find that CAM therapies help them maintain a positive mental attitude in coping with the emotional stress of surgery and physical therapy. CAM therapies that have been shown to relieve the pain of rheumatoid and osteoarthritis include acupuncture, music therapy, naturopathic treatment, homeopathy, Ayurvedic medicine, and certain herbal preparations. Chronic pain from other disorders affecting the hip has been successfully treated with biofeedback, relaxation techniques, chiropractic manipulation, and mindfulness meditation.

Some types of movement therapy are recommended in order to postpone the need for hip surgery. Yoga, tai chi, qigong, and dance therapy help to maintain strength and flexibility in the hip joint, and to slow down the deterioration of cartilage and muscle tissue. Exercise in general has been shown to reduce a person's risk of developing osteoporosis.

Alternative surgical procedures

Other surgical options include:



Pelletier, Kenneth R., MD. The Best Alternative Medicine , Part II, "CAM Therapies for Specific Conditions." New York: Simon & Schuster, 2002.

Silber, Irwin. A Patient's Guide to Knee and Hip Replacement: Everything You Need to Know. New York: Simon & Schuster, 1999.

Trahair, Richard. All About Hip Replacement: A Patient's Guide. Melbourne, Oxford, and New York: Oxford University Press, 1998.


"Arthritis—Hip Replacement." Harvard Health Letter 27 (February 2002): i4.

Chapman, K., Z. Mustafa, B. Dowling, et al. "Finer Linkage Mapping of Primary Hip Osteoarthritis Susceptibility on Chromosome 11q in a Cohort of Affected Female Sibling Pairs." Arthritis and Rheumatism 46 (July 2002): 1780–1783.

Daitz, Ben. "In Pain Clinic, Fruit, Candy and Relief." New York Times , December 3, 2002.

Drake, C., M. Ace, and G. E. Maale. "Revision Total Hip Arthroplasty." AORN Journal 76 (September 2002): 414–417, 419–427.

"Hip Replacement Surgery Viable Option for Younger Patients, Thanks to New Prostheses." Immunotherapy Weekly (March 13, 2002): 10.

Hungerford, D. S. "Osteonecrosis: Avoiding Total Hip Arthroplasty." Journal of Arthroplasty 17 (June 2002) (4 Supplement 1): 121–124.

Joshi, A. B., L. Marcovic, K. Hardinge, and J. C. Murphy. " Total Hip Arthroplasty in Ankylosing Spondylitis: An Analysis of 181 Hips." Journal of Arthroplasty 17 (June 2002): 427–433.

Laupacis, A., R. Bourne, C. Rorabeck, et al. "Comparison of Total Hip Arthroplasty Performed With and Without Cement: A Randomized Trial." Journal of Bone and Joint Surgery, American Volume 84-A (October 2002): 1823–1828.

Lie, S. A., L. B. Engesaeter, L. I. Havelin, et al. "Early Postoperative Mortality After 67,548 Total Hip Replacements: Causes of Death and Thromboprophylaxis in 68 Hospitals in Norway from 1987 to 1999." Acta Orthopaedica Scandinavica 73 (August 2002): 392–399.

Mantilla, C. B., T. T. Horlocker, D. R. Schroeder, et al. "Frequency of Myocardial Infarction, Pulmonary Embolism, Deep Venous Thrombosis, and Death Following Primary Hip or Knee Arthroplasty." Anesthesiology 96 (May 2002): 1140–1146.

Solomon, D. H., E. Losina, J. A. Baron, et al. "Contribution of Hospital Characteristics to the Volume-Outcome Relationship: Dislocation and Infection Following Total Hip Replacement Surgery." Arthritis and Rheumatism 46 (September 2002): 2436–2444.

White, R. H. and M. C. Henderson. "Risk Factors for Venous Thromboembolism After Total Hip and Knee Replacement Surgery." Current Opinion in Pulmonary Medicine 8 (September 2002): 365–371.


American Academy of Orthopaedic Surgeons (AAOS). 6300 North River Road, Rosemont, IL 60018. (847) 823-7186 or (800) 346-AAOS. http://www.aaos.org .

American Physical Therapy Association (APTA). 1111 North Fairfax Street, Alexandria, VA 22314. (703)684-APTA or (800) 999-2782. http://www.apta.org .

National Center for Complementary and Alternative Medicine (NCCAM) Clearinghouse. P.O. Box 7923, Gaithersburg, MD 20898. (888) 644-6226. TTY: (866) 464-3615. Fax: (866) 464-3616. http://www.nccam.nih.gov. .

National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS) Information Clearinghouse. National Institutes of Health, 1 AMS Circle, Bethesda, MD 20892. (301) 495-4484. TTY: (301) 565-2966. http://www.niams.nih.gov .

Rush Arthritis and Orthopedics Institute. 1725 West Harrison Street, Suite 1055, Chicago, IL 60612. (312) 563-2420. http://www.rush.edu .


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Rebecca Frey, Ph.D.


Hip replacement surgery is performed by an orthopedic surgeon, who is an MD and who has received advanced training in surgical treatment of disorders of the musculoskeletal system. As of 2003, qualification for this specialty in the United States requires a minimum of five years of training after medical school. Most orthopedic surgeons who perform joint replacements have had additional specialized training in these specific procedures. If surgery is being considered, it is a good idea to find out how many hip replacements the surgeon performs each year; those who perform 200 or more have had more opportunities to refine their technique.

Hip replacement surgery can be performed in a general hospital with a department of orthopaedic surgery, but is also performed in specialized clinics or institutes for joint disorders. As of 2002, MIS is performed in a small number of specialized facilities and teaching hospitals attached to major university medical schools.


Also read article about Hip Replacement from Wikipedia

User Contributions:

Dear Sir/Madame:

I was actually in the Orthopaedic Field and was on my way down the hall to a patient's room and collapsed. After quite an effort and excrusiating pain, I could not get up. We shot x-rays that afternoon and they blatanly showed that I had AVN with notable femural head collapse. Thereafter I had an MRI done of both hips which indicated that I had late stage 3 bi-laterally.

I had THR bi-laterally which seemed tohelp for a short time but within 5 months, I had to have revisions on both hips. Before a year had ended, I had to have 2 more revisions to each hip. After leaving the staples in for 10 days on both hips, the left hip and granulated quite well that the suture line looked well. However, after 30 minutes of removing the staples on my right hip, the incision line burst open. In a matter of 1.5 weeks the wound took on the classic smell of psuedomonus. At this time my temp. hit 106 with many episodes mental cloudiness.

After 3 months in the hospital, I was released only to developed a very high grade fever 8 days later and was told I would have to have aGirdle-Stone Procedure on my left side to save my life. Much to my dismay, I agreed. However, while attemptiong to remove the prosthesis, my femur shattered.

I take Methadone to help with chronic pain but over the years I have developed a toloerance and was wondering is THERE ANYTHING I CAN DO TO REVERSE THIS? I promise you that I am not a drug abuser, I just want to get back to being the best father I know how.

Any help you can provide I would be most appreciative.
dr arvind
i want all new information about spine,back ache .i need regular information about cervical pain and ,hip pain ,paralisis, hemiplegia,paraplegia
June Harrison
I had a left total hip replacement done July 2008, came home from the hospital after 1 week and within a few days was able to walk a mile (on crutches) and continued to go from strength to strength and now 12 days ago I have had a right total hip replacement. The difference I is like chalk from cheese, my knee is badly swollen and extremely painful and after only a couple of hundred yard on the crutches my foot also swells, When I awoke after the surgery I noticed that my right leg was rotated inwards and no matter how much I tried to repositon it it become inwardly rotated again, before discharge I had an Xray and my surgeon told me that the position was good. Have you any advice on the pain and swelling or exercises that I can do to help relieve same. Thank you June Harrison Jeddah, Saudi Arabia.
ron d
I had hip replacement 9 weeks ago.Can I start ride my bike out side now. This won't cause problems with with new hip right.
thanks Ron
Sue Thomas
Ask your suregeon! What else? Why ask here? Have you had any P.T. Ask the physical therapist then.
Shirley S.
This is a request for information. In 1975, I had a left hip replacement. In 1995 I had a left hip revision and again in 2005. On March 30, 2009 I had to have a total hip removal (Girdlestone Surgery). I am completely dependent on a walker and home health care, and although I have little pain on my left side where the surgery was performed, I now suffer with back pain, sciatica (rt. side) and a torn rt. Rotater Cuff. This is due to putting so much pressure on my rt. arm on the walker. Also, the left leg is 1 and 1/2 inches shorter than the right. Is there any research being done to reinsert a prosthesis after Girdlesone? Life is just not the same anymore and I am looking for some advice.
I also would like some information about reinserting a prosthesis after Girdlestone to my right hip. I had mine done in 2006/7 and have had pain in my shoulders, back and left knee as a reust of additional pressure of using crutches. I do find that swimming(back crawl) alleviates shoulder pain But in general it is not easy to get around, to say nothing of the discomfort through stiffness and nerve damage in the girdlestone leg/hip
March 2010 fell and had fracture (ball). Had a hemi done. Surgery and recovery went smoothly. Now it's 3 months post op and have pain still in the hip area but also severe pain in the groin area. Any ideas!!!
i would like to know what are the pharmacology used in this procedure.And what kind of sutures or stapling device, and dressings used during the surgery.Thanks!
refering your comment, i'm also operated for fracture near by hip,in 2008,but now i found pain in my leg,after consultation with doctor they found that the ball got damaged due to poor blood circulation,they suggested for hip joint replacement , is there any non surgical option that can rebuild the blood circulation in hip joint area so one can prolonge the surgery, any adv. technology or option or consultant for it in india
I had Left total hip done 4/28/10 and revision for fractured femur 5/10/2010. Now I have severe groin pain neccessitating high dose narcotics with poor pain relief. AP and lateral xrays show the prosthesis in good alignment,yet the pain is debilitating. Help!!!
I was told 2 yrs. ago that i needed a hip replacement, I am a 48 years old,a female and weigh 257, I am also 5 feet and 1 inch tall, the first doctor said there was know way he would do it, that I would have to lose 100 pounds, My family doctor has made a appointment with a different orthopedic doctor, has anyone ran any to anything like this, I am really tired of the pain.
my son is 18 years old he brocken his hip his pelvis is tilted and his leg is 4cm shorter than the other . he is in pain most of the time . the doctors dont know what to do next ?? im very worried about this/ he might need a hip replacement and his only 18 .
Bianco Wall
Here is hip arthroplasty research for simulation lab.
is post operative pain due to less muscle strength, does bone scanning revaels post operative pain cause.please anser me as early as possible.thankyou.
I am having my 1st dental procedure since my total hip replacement (metal) as I am only 48, and I have to have a root canal & a tooth extraction, I have already picked up my Anti biotics & know I have to take 4 of them one hour before my procedure, but what about afterwards? Is this something your dentist will prescribe if you need further antibiotics? If your hip did get an infection what is the recourse to battle this? I also heard that there is a risk of death too?
Thanks for taking the time to respond to my questions.
Cheryl Matthews: Your situation sounds exactly like mine when I went to the dentist initially after the THR just a few weeks ago. I asked the same questions and was told to just take them a half hour before and there is no need to take any afterwards. My dentist needed to have the hip doctor approve it which it sounds like you had done since you have the antibiotics. My script has refills on it but the dentist's office said once you have the initial prescription they can prescribe it too if you run out. From what I've been told there is a risk of an infection getting into the blood stream and it would first go to the site of the implant so it's best to just take the antibiotic before any dental work as a precaution. I've had to do it a few times since because I broke a tooth and the worse part is taking all the pills and then the dentist does nothing but look in your mouth! I've had no problems and it's better to be safe than sorry so I've even kept them in my purse in case I have to leave from work for a dentist appt. Hope this helped a little. Good Luck!
I am having thr tomorrow, March 14. I have a prolapsed mitral valve (heart murmur). I am assuming, because of the procedure, in general, that antibiotics will be administered prior to and during the surgery. Right?
Great, great resource! I wonder if the community would like to comment on the idea of the anterior approach to THR's. It seems like the only option considering the benefits. I understand that it is a more difficult procedure and requires a special bed. But when considering a major surgery like this one I would think making the extra calls to find a facility with the equipment, and a doctor with the consideration for your muscle would be well worth it.

depuyhipimplantrecall .org
hip arthoplasty review, risks and benefits, presurgical procedures n all
I found your article most helpful, I just had my second hip replacement the first one only lasted 2 years. When the surgeon was using the remer the hea broke off anf he could not retrieve it and it is now floating free inside my femur, at first I wa doing great but now am suffering a large amount of pain and stiffness ad somedays cant get around very well. Please advise me what is happening.
Good afternoon from Vancouver Island. I had a Girdlestone operation on my right hip seven weeks
ago and had an orthotist fit me for shoes to compensate for the 4" difference in leg length.The
raised shoe is so very heavy it tires me out just walking around our small house. Anyone with
a similar experience and solution who reads this I would appreciate you contacting me please.
Almost four years ago I suffered a fracture in my femur. So I was operated on , having a hip replacement of titanium. I followed the instructions but I didn't do exercise, as soon as I could put my foot on the ground I started working. I always suffered a tremendous pain. I was said that it was because each person has a different span of tolerance to it .The problem is that now after four years having my x/rays ok according to my doctor's opinion. I go on a constant pain. My legs are swallowed, myleg veins are more and more visible. The consequences are that I can't stand up so long, I can't walk as I used to do it. I also can't carry on my bags when coming back from my errands, heavy things are forbiden for me. As far as time goes on I feel depressed and doctors don't give me a solution. Thepain is still there and more and more installed in my brain make my life miserable life if I were a crippled. That is not what doctors promised to me . I would recover my normal life ,,and after a short period of time pain would disappear. However, I suffering worst ,more than when I had the fracture itself. I would like to have another opinion to face my doctors.I am from South America.Doctors are good and we count on very good and accessible Healthy System so. I need some ideas about the different reasons for the constant suffering, bearing in mind that x-rays don;t show anomalies. Doctors assert everything is ok from the point of view of the bones and the recovery. I consulted 12 different specialists so as to be enough convinced of their diagnostic.Would you mind giving me any possible explanation for this unbearable pain in my leg,I really appreciate your worrying and sending me any answer.thanks
Levi Winks
Hello I have perthes disease and I'm only 17 years old and have to have hip replacement and don't know where to get it done at any help would be appreciated.
iam verymuch intrested in doing surgical instruments in hip sugery
iam verymuch intrested in making surgical instruments in hip sugery like reamerhandle,rasphandle exist type,acetabular cup positioner,stem cup holder,T-handle
Larry Shively
Hello, I have had three hip replacements the left hip was done wrong and had to be replaced in less than two years. That was in 2002 in 2004 I had it redone and it is fine. Now I will get to the point. I just had a new hip put in on the right side in july buy a different dr. He did the antirior in the front small scar. I did this because I read it was so much better no muscle cutting. Now to my problem I have been on pains meds since the surgery as I can not walk without them. I have been back to the doctor three times he says that I my pelvis is not lined up right so I have this bad limp. When I limp that is when I have the pain. I did not have this limp before the surgery. so I checked out my right leg is now 1/2 inch shorter than my right this causing me great pain i even put a lift in my right shoe. still no help is the anything I can do can I have a bigger ball put in ? Or did this doctor just mess up. Please let me know as I am going crazy wondering what can be done Thank you
I was diagnosed with Stage 1 Avascular Necrosis (AVN) of the right femoral head in 2006. The ortho surgeon said it was because of steroids which was prescribed to treat my asthma. There was no medication prescribed, only a high dosage pain reliever which I never took. I was 37yo then. The ortho surgeon told me to come back if I'm ready (financially and medically, bec. I need to have a clearance from my pulmonologist since I am asthmatic) to have the hip replacement, which he said was the only remedy. I started using cane in 2007 because I was limping. I did research on my condition, because I was very apprehensive about the surgery, I research on the alternative medicines. I came across a research about AVN treatment in China, using traditional chinese medicine as the basic method of treatment. You can look it up in the internet, it was a good material. I then researched a doctor here in the Philippines who practiced Traditional Chinese Medicine. He is Dr. Tan, he has a clinic in Binondo. I went to him in August 2010 (after a series of asthma attacks, and again a series of steroid treatments). I took his herbal medicines religiously. I was without my cane since Oct 2011. I still go to him, it's been more than a year since I first went to his clinic, there has been occasional pain from my hip. but I dont limp anymore. I even often forget I have AVN. Maybe you should try seeing him, or because he is so far from you, try looking for a Chinese doctor who still practices traditional chinese medicine. It's better than having surgery, trust me. I hope I was of help.
jacqueline picard
Is there a place in Ghana to have a hip replacement ? please it is urgent for me to know
stanley klueh
three months after a hip operation w/three screws, all three screws loosened up causing a steady pain, another operation was performed removing the screws, and 3 shorter ones inserted, the pain almost stopped, after 5 weeks the pain has started again,I use a walker 100% of the time, I Am considering a replacement hip, would you advise that,??
gwen anderson
i had hip replacement done three months ago how soon can i have the second one done ?i am in a lot of pain.
Have to have total hip replacement. I am from MO. Could U please refer a doctor for me.
sherry sloan
Hello to all of you that are having complications or either asking questions pertaining to surgical procedures. Most importantly always go for a second opinion. Next find a doctor who has experience (good track record in that area) Do research on the type of surgery or health issues you are having. Finally, I noticed there are a few of you that ask for medications that can relieve the pain, there are options out there but as usual you have to pay attention to the side effects etc.. I will admit Motrin 800 was a big relief for me, it helped to take away the inflammation. Most importantly, I have seen information stating the benefits out way the risk. Taking medication sometimes bring other health issues. Therefore, to Those that believe look to the healer, he will direct your path. MY prayers are with you all.
My mom had her hip replaced and both knees replaced ever since all of these surgeries she has uncontrollable blood pressue, had a stroke please help with any info to help
Hello, I am six weeks post op for THR. Having lots of pain in new joint, numbness lateral side of upper leg. Also knee and back pain. Shouldn't I be feeling better by now? Still need a cane.
steven driver
I am in Sydney Australia aged 55 6 foot tall 17.5 stone,, solid strong guy. I had a real bad left hip for 25 years and have been living on pain killers and anti inflamitry drugs and its really impacted on my job and family.
I had a Total hip replacement 6 july 2015 just 2 weeks ago,,they cut me in the front on my thigh and apparently had trouble getting through the muscle,,i woke up with the surgeon telling me that they had complications and a revision would be done in 4 days time and they needed to look at a hole that was drilled.
He told me they cut the bone and removed the ball at the top of the bone and inserted the new ceramic cup that the ball sits in.
Apparently the didn't have the tools to do a different procedure and I needed to wait 4 days in traction as the bone had been cut. I went under the knife the 4th day and the came from a different angle as they told me my muscle was like working on a rhino and prior to the new revision they called it,,i was Xrayed extensively,,CT scan and other Xrays to look for the hole they drilled and get it done right.
I feel ok at this point but I am doped up on Oxycodone,,,Targin,, and Endone all day and all night. My skin behind my neck stinks like Parmisan cheese and I am losing weight and feel great,, I shower 2 times a day and eat healthy. Does this operation sound like it was done right. Will the stink on my skin go away as im back at work in 4 weeks.
Steve Driver.

I have Bilateral AVN of femoral head type 3, used steroids for Asthma for a long time. Am on pain killers(etorix) and I walk with a limp for the last 9 months though I continue with my life as usual despite.
I am on Sodium alendonrate and zedcal (calcium supplement|) for the whole duration- i stopped taking Diacerin, Glucosamine and tramadol.
Am contemplating having bilateral hip replacement as am worried one day I will be wheel chair bound.
Can the condition reverse or stop advancing. Is the hip replacement a good Idea?
I replaced my right hip ceramic on e poly& my recovery was very well .. can i drink lightly alchohal after my six weeks recovery?
4-weeks since thr. when I saw my surgeon two weeks after the total hip replacement and I still must do a toe touch without putting pressure on It. They tell me untill 6 weeks goes by.when I asked the PA why , she told me that I have osteoporosis.the doctor never came in the exam room which never happened before as the same dr.also did my left hip five years ago with great results.at no time was I ever tested for osteoporosis nor was it discussed further about what degree of it I have.should this doctor have tested my bone density prior to the surgery.if I do have it to some degree I am 57 now and started taking a hi grade calcium liquid.and multi vitamin. I would have waited till fall had I know my spring fishing was gonna be non existant. Im pissed. What risks do I have now.?
Thanks in advanced for answering my 2 questions
Are there any developments happening now that will improve this procedure further for future patients for hip replacement
Mary Ann Gilhooley
I am an 80yr old woman whose right hip is 19yrs old and the plastic around the ball is disintegrating. I am in no pain but I have just developed a slight limp. My Dr. took x-rays and he said if the rod is loose and has to come out, this is now a more complex operation. His advice was to wait until the pain becames a serious problem. Am I better off taking his advice and deferring the operation?
I am 30 years old been told by my doctor and physiotherapy that I need a hip replacement then my doctor tells me I might not be able to have it done because of my age. I have got no cartilage left it's just bone rubbing on bone.
I am 30 years old been told by my doctor and physiotherapy that I need a hip replacement then my doctor tells me I might not be able to have it done because of my age. I have got no cartilage left it's just bone rubbing on bone.
I have 1 broken screw in the THR cup- and have 3 other screws.My prosthesis wasrevised in 2002. The cup hasn’t shifted-but I have LOTS of pain.Is it dangerous to have a broken screw-never had this happen before! Also have lots of OA.
Steven Passant
Having, at 47, just had a THR at Wrightington Hospital UK (Charnley Ward), for OA ; I’ve just stumbled across this page/ article. I’m touched by its accuracy and how closely it reflects my personal experience. So well written, thanks.
Back pain is a common problem with many causes, from acute injuries to complications of medical conditions.
It can be also solved by using orthofeet Avery Island – Black shoes which reduces your pains and make you feel more comfortable. That’s why people are mostly orthofeet shoes it is not only providing shoes but also reducing the pain caused in legs to the people
Katie Fabulous
My 70 year old mother-in-law has severe osteoporosis, end stage COPD, a fractured coccyx, a bulging disc in the neck, AND last but not least, a fractured hip. Much to my surprise, she was scheduled to undergo an ORIF Total Hip Replacement yesterday. No surprises here, she started having respiratory distress once she was placed under general anesthesia and turned on her side (for the surgery?) What they ended up doing, was removing the femoral head and then closed her up. She'll be going back to the nursing home for 6 wks of rehab, and then come back to finish the procedure. Correct me if I'm wrong, but everything I've read in the last few hours says that the THR contraindicated, right? What could they be thinking??

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