(Total Hip Arthroplasty, Hip Arthroplasty, Total Hip Replacement, Hip Replacement)
What is a hip replacement surgery?
Hip replacement, also called total hip arthroplasty, is a surgical procedure to replace a worn out or damaged hip with a prosthesis (an artificial joint). This surgery may be considered following a hip fracture (breaking of the bone) or for someone who has severe pain due to arthritis.
Various types of arthritis may affect the hip joint. Osteoarthritis, a degenerative joint disease that affects mostly middle-aged and older adults, may cause the breakdown of joint cartilage and adjacent bone in the hips. Rheumatoid arthritis, which causes inflammation of the synovial lining of the joint and results in excessive synovial fluid, may lead to severe pain and stiffness. Traumatic arthritis, arthritis due to injury, may also cause damage to the articular cartilage of the hip.
The goal of hip replacement surgery is to replace the parts of the hip joint that have been damaged and to relieve hip pain that cannot be controlled by other treatments.
A traditional hip replacement involves an incision several inches long over the hip joint. A newer approach that uses one or two smaller incisions to perform the procedure is called minimally invasive hip replacement. However, the minimally invasive procedure is not suited for all candidates for hip replacement. The physician will determine the best procedure for a person, based on that individual's situation.
Anatomy of the hip
Joints are formed where bones meet. Most joints are mobile, allowing the bones to move without friction or discomfort. The hip joint is a ball-and-socket joint, which allows backward, forward, sideways, and rotating movements. The ball part of the hip joint is the head of the femur (thigh bone), and the acetabulum is the socket, a cup-like structure in the pelvis.
A hip joint consists of the following:
Cartilage. A type of tissue that covers the surface of a bone at a joint. Cartilage helps reduce the friction of movement within a joint.
Synovial membrane. A tissue that lines the joint and seals it into a joint capsule. The synovial membrane secretes synovial fluid (a clear, sticky fluid) around the joint to lubricate it.
Ligament. A type of tough, elastic connective tissue that surrounds the joint to give support and limits the joint's movement.
Tendon. A type of tough connective tissue that connects muscles to bones and helps to control movement of the joint.
Bursa. A fluid-filled sac located between bones, ligaments, or other adjacent structures that helps cushion joints.
Femur. Thighbone or upper leg bone.
Acetabulum. A socket or cuplike structure that holds the femur head.
Reasons for the procedure
Hip replacement surgery is a treatment for pain and disability in the hip. The most common condition that results in the need for hip replacement surgery is osteoarthritis.
Osteoarthritis is characterized by the loss of joint cartilage in the hip. Damage to the cartilage and bones limits movement and may cause pain. People with severe pain due to degenerative joint disease may be unable to do normal activities that involve bending at the hip, such as walking or sitting, because they are painful.
Other forms of arthritis, such as rheumatoid arthritis and arthritis that results from a hip injury, can also lead to degeneration of the hip joint.
Hip replacement may also be used as a method of treating certain hip fractures. A fracture is a traumatic event that may result from a fall. Pain from a fracture is severe and walking or even moving the leg is difficult.
If medical treatments are not satisfactory at controlling pain due to arthritis, hip replacement surgery may be an effective treatment. Some medical treatments for degenerative joint disease may include, but are not limited to, the following:
Glucosamine and chondroitin sulfate
Limiting painful activities
Assistive devices for walking (such as a cane)