How the Normal Hip Works
- The hip is one of your body's largest weight-bearing joints.
- It consists of two main parts: a ball (femoral head) at the top of your thighbone (femur) that fits into a rounded socket (acetabulum) in your pelvis.
- Bands of tissue called ligaments (hip capsule) connect the ball to the socket and provide stability to the hip joint.
- The bone surfaces of your ball and socket have a smooth durable cover of articular cartilage that cushions the ends of the bones and enables them to move easily.
- A thin, smooth tissue called synovial membrane covers all remaining surfaces of the hip joint. In a healthy hip, this membrane makes a small amount of fluid that lubricates and almost eliminates friction in your hip joint.
- Normally, all of these parts of your hip work in harmony, allowing you to move easily and without pain.
Common Causes of Hip Pain and Loss of Hip Mobility
- The most common cause of chronic hip pain and hip disability is arthritis. Osteoarthritis, rheumatoid arthritis, and traumatic arthritis are the most common forms of this disease.
- Osteoarthritis usually occurs after age 50 and often in an individual with a family history of arthritis. It may be caused or accelerated by subtle irregularities in how the hip developed. In this form of the disease, the articular cartilage cushioning the bones of the hip wears away. The bones then rub against each other, causing hip pain and stiffness.
- Rheumatoid Arthritis is an autoimmune disease in which the synovial membrane becomes inflamed, produces tomuch synovial fluid, and damages the articular cartilage of the hip, leading to pain and stiffness.
- Traumatic Arthritis can follow a serious hip injury or hip fracture. A hip fracture can cause a condition known as avascular necrosis. The articular cartilage becomes damaged and, over time, causes hip pain and stiffness.
Realistic Expectations about Hip Replacement Surgery
- An important factor in deciding whether to have total hip replacement surgery is understanding what the procedure can and can't do.
- More than 90 percent of individuals who undergo total hip replacement experience a dramatic reduction of pain and a significant improvement in the ability to perform common activities of daily living. But total hip replacement won't make you a super-athlete or allow you to do more than you could before you developed arthritis.
- Following surgery, you will be advised to avoid some types of activity, including jogging and high impact sports, for the rest of your life.
- With normal use and activity, every hip replacement develops some wear in its plastic cushion. Excessive activity or weight may accelerate this normal wear and cause the hip replacement to loosen and become painful. With appropriate activity modification, hip replacements can last for many years.
Hip Surgical Procedure
- The surgical procedure takes a few hours. Your orthopaedic surgeon will remove the damaged hip cartilage and bone, then position new metal, plastic or ceramic joint surfaces to restore the alignment and function of your hip.
- Many different types of designs and materials are currently used in artificial hip joints. All of them consist of two basic components: the ball component (made of a highly polished strong metal or ceramic material) and the socket component (a durable cup of plastic, ceramic or metal, which may have an outer metal shell). These will create the new hip joint.
- Special surgical cement may be used to fill the gap between the prosthesis and remaining natural bone to secure the artificial hip joint.
- A non-cemented prosthesis has also been developed which is used most often in younger, more active patients with strong bones. The prosthesis may be coated with textured metal or a special bone-like substance, which allows bone surrounding the hip joint to grow into the prosthesis.
- A combination of a cemented ball and a non-cemented hip socket may be used.
- Your orthopaedic surgeon will choose the type of prosthesis that best meets your needs for your individual hip replacement.
- After your hip replacement surgery, you will be moved to the recovery room where you will remain for one to two hours while your recovery from anesthesia is monitored. After you awaken fully, you will be taken to your hospital room to begin recovery with your new hip.