Total Hip Replacement (THR) is necessary when none of the other methods to correct a damaged hip is effective. In this operation the surgeon replaces the ball and the socket with metallic replacements and the cartilage with artificial joint material. Usually THR is done under general anesthesia, it can be also performed under spinal or epidural anesthesia where the anesthetic medicine is injected into a space between the vertebrae in order to numb the legs during the operation without making one lose consciousness.
- During the operation an incision will be made on the affected hip joint and the affected portions of the hip bone and the femur will be sawed off.
- The new prosthetic parts will be attached to the bone with the use of bone cement. Once both the ball and the socket are in placed the damage cartilage is also replaced between the prosthetics. A test motion is usually done to check the proper placement of the prosthetics.
- You may need a blood transfusion at this stage if you have lost a lot of blood during the operation. A drain may be put to drain off the excess fluids from the operative site.
- The muscles and skin are then sutured back using sutures or staples. The wound is bandaged.
After the surgery you will be transferred to the bed with a splint to hold the joint in place and avoid immediate movement. You will have to stay in bed with a wedge shaped cushion to keep the hip joint in alignment. Fluids, pain relievers and antibiotics may be given intravenously for a day or two before you can start on a normal diet and take the medications orally.
Early physiotherapy ensures early mobility and rapid recovery. Within a day or two you will be encouraged to walk with the help of crutches, walker or a cane. You may be released from the hospital in a few days to a week.
The benefits offered by this operation are remarkable in terms of reduction of pain and thus improvement of sleep, improvement of range of motion, physical capabilities and quality of life.
Are there any alternatives to THR?
There are several surgical and non-surgical alternatives. Pain relievers can be used. In addition regular physiotherapy is an option that can relive the pain and improve range of motion of the affected hip. Sometimes cortisone injections may also be given directly into the joint to relieve the pain and stiffness of the joint. Other surgical processes like hip resurfacing may also be tried. Here the implant is smaller and less of the bone is removed.