The hip is a “ball-and-socket” joint where the “ball” at the top of the thigh bone (femur) fits inside the “socket” in the pelvis (acetabulum). A natural substance in the body called cartilage lubricates the joint. When the bone and/or cartilage of the hip becomes diseased or damaged from arthritis, hip fractures, bone death or other causes, the joint can stiffen and be very painful. A total hip replacement may be recommended for patients who experience severe hip pain and whose daily lives are affected by the pain.
In a total hip replacement, the diseased bone and cartilage are replaced with a metal ball and plastic cup. The artificial joint, called a prosthesis, may be cemented in place, may be cementless, or may be a hybrid of both. The surgery takes from two to four hours, followed by another few hours spent under observation in a recovery room. Patients usually enjoy immediate relief from joint pain after the surgery.
Physical therapy starts as soon as the first day after surgery with the goal of strengthening the muscles and preventing scarring (contracture). Therapy begins with the patient sitting in a chair and progresses to stepping, walking and climbing stairs, first with crutches or walkers and then without supportive devices. Occupational therapy and at-home exercises help patients learn how to use the prosthesis in everyday activities.
Total hip replacement is successful in over 95% of well-selected patients. On average, replacements last 15-20 years. Some patients enjoy full use of the prosthesis after 25 years or longer.