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Hip Replacement

Introduction

Hip replacement surgery, also called total hip arthroplasty, involves removing a diseased hip joint and replacing it with an artificial joint, called a prosthesis.  Hip replacement surgery can be performed as a total replacement or a hemi (half) replacement.

Anatomy

Hip prostheses consist of a ball component, made of metal or ceramic, and a socket, which has an insert made of plastic, ceramic or metal.  The implants used in hip replacement are biocompatible, which means they’re designed to be accepted by the body, and made to resist corrosion, degradation and wear.

Causes

Hip replacement is typically used for people with hip joint damage from arthritis or an injury.  Followed by rehabilitation, hip replacement can relieve pain and restore range of motion and function of your hip joint.

Symptoms

The most noticeable symptom of hip arthritis, which is the most common reason to need a hip replacement, is pain that can be either dull or aching, and can be either intermittent or constant.  It will usually worsen with time or with higher activity levels, and can interfere with a person’s sleep.  Many also suffer from some form of mobility problems.  This can include needing to use a cane, crutch, or walker, it can mean that climbing stairs can be difficult or unmanageable, or just walking certain distances may cause a limp.

Diagnosis

Your doctor will assess the damage to the hip through a series of tests to determine whether a hip replacement is the best choice for you.  Evaluating the pain in the hip usually starts with X-rays.  An X-ray helps doctors see how your joints come together, reveals any bony defects or deformity and provides information about bone strength.  When the X-ray shows wear in the hip, a MRI is usually performed.  The MRI provides a clearer picture of the extent of the wear and how it is affecting the rest of the hip.

Treatment

After a total hip replacement, patients often start physical therapy immediately.  On the first day after surgery, it is common to begin some minor physical therapy while sitting in a chair.  Eventually, rehabilitation incorporates stepping, walking, and climbing.  Initially, supportive devices such as a walker or crutches are used.  Some degree of discomfort is normal.  The goals of physical therapy are to prevent contractures (shortening or hardening of muscles or tendons), improve patient education, and strengthen muscles around the hip joint through controlled exercises.  Contractures can cause limitation of joint motion result from scarring of the tissues around the joint.  Contractures do not permit full range of motion and therefore impede mobility of the replaced joint.  Patients are given home exercise programs to strengthen the muscles around the buttock and thigh.

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