Total Hip Arthroplasty – Replacement and Resurfacing

A total hip replacement (also called an Arthroplasty) is a surgical procedure that removes and replaces damaged bone and cartilage with prosthetic components.

• A metal stem is placed into the hollow center of the femur to replace the damaged femoral head. This stem is either cemented or “press fit” into the bone.
• A metal or ceramic ball on the upper part of the stem replaces the damaged femoral head that was removed.
• The cartilage surface of the socket (acetabulum) that is damaged is removed and replaced with a metal socket, with screws or cement used to hold the socket in place.
• A plastic, ceramic, or metal spacer goes between the new ball and socket for a smooth gliding surface.

Your surgeon may recommend hip arthroplasty if you have a painful condition that does not respond to nonsurgical treatment such as rest, physical therapy, and medications or injections that reduce inflammation. Inflammation is one of your body’s normal reaction to injury or disease. In an injured or diseased hip joint, inflammation causes swelling, pain, and stiffness.

Hip replacement surgeries are one of the most successful operations in all of medicine. First performed in the 1960s, improvements in surgical techniques and technology have greatly increased their effectiveness. More than 300,000 total hip replacements are performed each year in the United States, according to the Agency for Healthcare Research and Quality.

Common activities such as walking or getting in and out of a chair can be painful and difficult if your hip has been damaged by arthritis, a fracture, or other conditions. It may even feel uncomfortable while resting. If your hip is stiff, and it’s hard to put on your shoes and socks, you should talk with one of our doctors about hip replacement surgery. It’s a safe and effective procedure that relieves pain, increases motion, and helps you get back to enjoying normal, everyday activities.

COMMON CAUSES OF HIP PAIN

Arthritis is the most common cause of chronic hip pain and disability. The most common forms are osteoarthritis, rheumatoid arthritis, and traumatic arthritis.

• Osteoarthritis. Age-related, “wear and tear” type of arthritis that usually occurs in people 50 years and older. It is often seen in individuals that have a family history of arthritis. As the cartilage cushioning the bones of the hip wear away, the bones then rub against each other, causing pain and stiffness. Osteoarthritis is sometimes caused by how the hip’s childhood development.
• Rheumatoid arthritis. A chronic autoimmune disease where the synovial membrane (specialized connective tissue lining the inner surface) becomes inflamed and thickened. The inflammation damages the cartilage, resulting in pain and stiffness. Rheumatoid arthritis is the most common type of inflammatory arthritis.
• Post-traumatic arthritis. If cartilage is damaged following a serious hip injury or fracture, it can lead to hip pain and stiffness.
• Avascular necrosis. Dislocation or fracture injuries to the hip can limit the blood supply to the femoral head. The lack of blood (called avascular necrosis or osteonecrosis) can cause the surface of the bone to collapse, resulting in arthritis. Avascular necrosis can also be caused by some diseases.
• Childhood hip disease. Infants and children with hip problems may have arthritis later in life, even though the problems were successfully treated during childhood. If the hip doesn’t grow normally the joint surfaces are affected.

HIP REPLACEMENT PROCEDURES

Hip surgery replaces diseased and damaged portions of the hip with implants designed to restore function to your hip joint. The surgeons at Florida Orthopaedic Institute offer the most up-to-date replacement procedures including:

• Ceramic on Ceramic
• Direct Anterior Approach
• Margron
• Metal on Metal
• Metal on Metal with Liner
• Mis 2-Incision
• Resurfacing
• Resurfacing (Wright)
• Smith & Nephew

The term hip arthroplasty is used to describe two related but different procedures: 1. Hip replacement and 2. Hip resurfacing procedure.

Hip Replacement

In a standard hip replacement, your surgeon opens an incision along the side of your hip. The thighbone tendons are shifted to locate the ball of the hip. This ball is then detached with a surgical tool. To complete the procedure, an artificial joint is fastened using a clinical adhesive that enables the remaining bone to attach to the newly-created joint.

Hip Resurfacing

A hip resurfacing procedure replaces diseased and damaged portions of the hip with implants designed to restore function to the hip joint. As opposed to a total hip replacement, a hip resurfacing trims the thighbone top and caps it with a metal covering. A metal casing replaces the impaired bone and tendon, like a conventional hip replacement. To reach the hip joint, your surgeon opens a slit in your upper thigh. The top of the thighbone is removed from its socket, and its head is trimmed with specially designed surgical devices. A metal shell is attached to the trimmed head. The tendons that line the socket are removed. A cup is pressed into the socket and secured by friction between the bone and the metal. The top of the thighbone is then replaced back into its socket and the incision is sealed.

The board-certified and fellowship trained hip surgeons at Florida Orthopedic Institute are experienced and knowledgeable and invite you to consult with them about the differences and benefits of these procedures. Based on your individual medical needs, our surgeons will help you find the procedure that best suits your individual needs.

POST-OP

Your pre-op care includes a hospital stay of 4-6 days to ensure your new hip (or hip replacement parts) properly adhere in place. Upon healing, you will be encouraged to walk with assistance.

To further enhance your healing process, Florida Orthopaedic Institute provides you with in-house physical and occupational therapy services under the care of a knowledgeable and licensed therapist. Our goal is to offer immediate access to our therapy centers and to start treatment within 24-48 hours of your surgeon’s approval. This continuum of care give you seamless attention while allowing us to track the quality of your recovery to speed your healing.

Your physical therapist will also educate you with movements to avoid, as well as advise you on the appropriate equipment to support your daily routine.

ONE OF THE MOST SUCCESSFUL OPERATIONS IN ALL OF MEDICINE

Hip replacements have been performed since the early 1960s when an artificial joint lasted, on average, up to 10 years. Statistics now report that implants to the hip have an 85% endurance of 20 years or more. At Florida Orthopaedic Institute, our surgeons continuously stay educated on the latest techniques, as well as participating in the creation of new and innovative one, to advance procedures that will help you regain your active lifestyle.

If you are experiencing chronic pain that has not been alleviated by more conservative treatment methods, contact one of the Florida Orthopaedic Institute surgeons who make hip arthroscopy their expertise. Call to schedule an appointment at 813-978-9797 or use our online appointment request form.