Hip Replacement

Hip Pain

Arthritis is the leading cause of disability in India, and the most frequent cause of discomfort and chronic hip pain. In fact, it’s estimated that 1 in 5 people in India has some form of arthritis. Two-thirds of the people who have been diagnosed with arthritis are under the age of 65. Of the more than 100 types of arthritis, the following three are the most common causes of joint damage:

  • Osteoarthritis

  • Rheumatoid Arthritis

  • Trauma Related Arthritis

Osteoarthritis is a disease which involves the wearing away of the normal smooth joint surfaces. This results in bone-on-bone contact, producing pain and stiffness.

Rheumatoid Arthritis is a systemic disease because it may attack any or all joints in the body. It affects women more often than men and can strike young and old alike. Unlike osteoarthritis, rheumatoid arthritis causes destruction of the joint through severe inflammation. The body’s immune system attacks and destroys the synovial lining covering the joint capsule, the protective cartilage and the joint surface. This causes pain, swelling, joint damage and loss of mobility.

Trauma-related arthritis results from damage to the joint from a previous injury. It also results in joint damage, pain and loss of mobility.

Anatomical Overview?

  • The hip is one of your body's largest weight- bearing joints.

  • It consists of two main parts: a ball (femoral head) that fits into a rounded socket (acetabulum) in your pelvis.

  • Ligaments connect the ball to the socket and provide stability to the joint.

  • The bone surfaces of your ball and socket have a smooth durable cover of articular cartilage that cushions the ends of the bones and enables them to move easily. General Anatomical Overview

  • All remaining surfaces of the hip joint are covered by a thin, smooth tissue called synovial membrane. In a healthy hip, this membrane makes a small amount of fluid that lubricates and almost eliminates friction in your hip joint.

  • Normally, all of these parts of your hip work in harmony, allowing you to move easily and without pain.

Total Hip Replacement

When medication, physical therapy and other conservative methods of treatment no longer relieve pain, total hip replacement may be recommended. Total hip replacement helps relieve pain and allows patients to perform some activities that may have been limited due to hip pain. More than lakhs of people world wide annually undergo hip replacement surgery to relieve pain and stiffness and restore mobility. Total hip replacement is the replacement of the ball and socket of the hip joint with implants. There are two main components used in total hip replacement. The acetabular shell replaces the hip socket. The femoral stem replaces the worn-out top of the femur. These components may be made of any number of materials, including metal, ceramic and/or polyethylene (medicalgrade plastic). During surgery, the head of the femur (thigh bone) is removed and replaced with both a stem and socket, mimicking your existing anatomy.

Hip Surgery

To prepare yourself for surgery, you may be asked to do a number of things, including lose weight and/or stop smoking (if applicable). It is essential that you tell your surgeon about any medications or supplements you are taking. Bring a list of all medications and dosages, including over-the-counter medicines. Your doctor may want you to donate your own blood ahead of time for a possible transfusion during surgery. It is normal to feel Surgery pain and discomfort after surgery. Be sure to let the nurse know if you are in pain. The usual hospital stay for hip replacement is three to five days. To protect your hip, you will be asked not to sit up beyond a 90- degree angle. Whatever assistive devices you need will be provided. After 24 hours, you should begin to eat and drink regularly, according to your surgeon’s direction.


The therapist will teach you how to dress, get out of bed without help and use a walker or crutches. You will continue to work to strengthen yourself in preparation for your return home. It is important for you to follow your surgeon’s directions and Progress proper positioning techniques throughout your rehabilitation. By the time you leave the hospital, you should be progressing well in regaining your mobility and stability. When your sutures or clips have to be removed, you will be told who will remove them and where this will be done. It is not uncommon to still experience some pain. Remember that full recovery typically takes three to six months.

Do’s and Don’ts

  • To avoid hip dislocation

  • Use 2-3 pillows between your legs when sleeping (roll onto your ‘good side’)

  • Do not cross your legs

  • Use chairs with armrest

  • Do not bend forward past 90 degrees

  • Use a high-rise toilet seat if necessary

  • Avoid pronation of the legs

  • To avoid stairs, sleep in the living room

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