Partial Hip Replacement
A partial hip replacement removes and replaces the ball of the hip joint. It does not replace the socket. This surgery is most often done to repair certain types of hip fractures.
The ceramic or metal ball is attached to a metal stem. This is called a hip implant. The stem is set down into the core of the thighbone (femur). It is firmly fixed in the femur in one of two ways:
- Cemented to the bone.
- Uncemented. This kind of stem has a porous coating that the bone grows into.
Your doctor may use general anesthesia. This means you'll be asleep during the surgery. Or your doctor may use regional anesthesia. This means you can't feel the area of the surgery. You'll have medicine that makes you unaware and lightly asleep. Which type of anesthesia you get depends on your doctor and on your overall health. Your doctor might also ask what you prefer.
What To Expect
Right after surgery
When you wake up from surgery, your pain will be controlled with intravenous (IV) medicine. You will also likely have medicines to prevent infection, blood clots, and nausea. If you had regional anesthesia, expect to have little or no feeling below your waist for a while.
Coming out of surgery, you may have a cushion between your legs. This is to keep your new hip in the correct position. You may also have a catheter. It lets you empty your bladder without getting up. To help prevent blood clots, you'll likely be wearing compression stockings. And you may have compression sleeves on your legs. These squeeze and release your lower legs to help keep the blood moving.
As soon as possible, you will be taught how to move your body without dislocating your hip. Until your hip is fully healed, you will need to follow "hip precautions." Most often, this means that:
- You avoid twisting at the hips. You keep your shoulders, hips, knees, and feet facing forward.
- You do not let your affected leg cross the center of your body toward the other leg. Your therapist may suggest that you:
- Do not cross your legs or feet.
- Be very careful as you get in or out of bed or a car. Make sure your leg does not cross that imaginary line down the middle of your body.
- Keep a pillow between your knees when you are lying down. When you are on your back, the pillow rests under the affected leg and on top of the other leg. This helps you turn onto your side without twisting at the hips.
On the day of surgery or the day after, you'll get out of bed with help. You will learn how to walk with a walker or crutches. By the time you leave the hospital, you will be able to safely sit down and stand up, dress yourself, use the toilet, bathe, and use stairs.
Leaving the hospital
Your doctor will let you know if you will stay in the hospital or if you can go home the day of surgery. When you go home, you will need someone to help you for the next few weeks or until you have more energy and can move around better. Some people who need more extensive rehab may go to a specialized rehab center for more treatment.
During the first week or so after surgery, you will need less and less pain medicine. For a few weeks after surgery, you will likely take medicine to prevent blood clots.
You may need a walker, crutches, or a cane for a few weeks. As you get your energy back, work up to taking a short walk a few times each day. If you feel any soreness, try a cold pack on your hip.
Don't drive until:
- Your doctor says it is okay for you to drive.
- You're not taking an opioid pain medicine.
Complete recovery after a hip replacement can take at least 6 months. Keep up your walking and physical therapy exercises. They help speed your recovery.
For most people, it is safe to have sex about 4 to 6 weeks after a hip replacement. Talk to your doctor about when it is okay to have sex and what positions are safe for your hip.
Living with a hip replacement
Exercise (such as swimming and walking) is important for building your muscle strength. And it helps you feel better overall. Discuss with your doctor what type of exercise is best for you.
- You probably will be able to resume activities that you did before surgery, such as golfing, biking, swimming, or dancing.
- Your doctor may discourage you from running, playing tennis, and doing other things that put a lot of stress on the joint.
Your doctor will probably want to see you at least once every year to check your hip.
For at least 2 years after your surgery, your doctor may want you to take antibiotics before dental work or any invasive procedure. This is to help prevent infection around your hip implant. After 2 years, your doctor and dentist will decide if you still need to take antibiotics.
Why It Is Done
A partial hip replacement surgery is most often done to repair certain types of hip fractures. It is an option when the socket of the hip joint is healthy.
How Well It Works
Surgery usually works well. But recovery does take patience and time. Your hip will likely regain most, if not all, of what it used to do.
Because of the way the hip is structured, every added pound of body weight adds 3 pounds of stress to the hip. Controlling your weight will help your new hip joint last longer. Your hip should also last longer if you do not do hard physical work or play sports that stress the joint.
The risks of hip replacement surgery can be divided into two groups.
- Risks of the surgery and recovery period include:
- Blood clots. These can be dangerous if they block blood flow from the leg back to the heart, or if they move to the lungs.
- Infection. Infection in the wound is usually treated with antibiotics. Infection deep in the joint may need more surgery. In some cases, the hip implant has to be replaced with another one.
- Nerve injury. This is rare. It can cause tingling, numbness, or difficulty moving a muscle.
- Problems with wound healing.
- Problems with anesthesia.
- Hip dislocation after surgery.
- Difference in leg length. Any difference is usually very small and can be corrected by using a shoe insert.
- Long-term risks that may occur months to years after the surgery include:
- Loosening of the hip implant in the bone.
- Infection in the joint.
What To Think About
Some hip fractures are repaired by getting the bone lined up correctly (reduction) and stabilizing broken bones (internal fixation). This is often done on younger, active people. Hip replacement surgery often is done on older, less active adults. In deciding how to repair a hip fracture, your surgeon will look at the type of fracture, your age and activity level, and the possible trade-offs.