In a routine total hip replacement surgery, an incision will be made in the area while a patient is under general anesthestia. The tissue is then divided so the arthritic joint can be removed. If there are bone spurs, they will be shaved down, as well since these, too, can cause pain. How the prosthetic is inserted depends on the doctor’s approach, but in most cases the incision location is decided strategically on a case-by-case basis in order to create the most pain-free outcome for the patient. When the final implant has been inserted, the patient is reassessed, washed and the tissue is sewn up before they are wheeled into recovery.
Following a total hip replacement surgery, the goal is to get the patient on their feet as soon as possible. By doing this, post-operative complications can be reduced and recovery is typically faster and less painful. Recent protocols also call for a reduction in the narcotics given post-operatively. The idea is that by avoiding heavy drugs, patients can get up and moving sooner, which results in a faster recovery and less issues such as blood clots, which often occur when a patient is bed-ridden. A patient usually will not recover full range of motion after a total hip replacement, even after physical therapy (although it is possible), but motion does improve significantly as pain is eliminated or decreased. It can take a full year for the joint to rebuild its strength and for the full benefits of the surgery to be realized.
The purpose of a total hip replacement surgery is to eliminate or greatly reduce pain, remove arthritic joints and allow a patient to live a fuller, happier life where daily activities are easier to manage and done with the use of assistive devices such as a walker.
The biggest benefit of a total hip replacement procedure is reduced or eliminated pain. In most cases, patients experience a reduction in pain or complete relief from pain immediately following the surgery. Much of this is achieved by removing bone on bone contact, which is extremely painful in the hip joint. Patients who undergo total hip replacements are typically walking without a walker or other assistive device within three weeks of surgery and are able to drive shortly after that.
There are risks involved with every surgery. With total hip replacements, certain modalities put patients at risk. For example, a patient who is obese is at a higher risk of suffering complications during surgery, and their weight could make their recovery more difficult. A history of heart disease, diabetes or depression can also affect how well a person fairs during surgery and recovery. Mostly these conditions extend the healing process but they do also increase the risk of surgery itself. If you have underlying disease, talk it over with your doctor. If the procedure is too risky, they’ll advise against it, however, in many cases, steps can be taken beforehand to reduce risk, such as losing weight.
Hip replacements do include some specific risks such as infection (either at the incision or in the deeper tissues of the hip), blood clots that form in the body’s deep veins, fracture, dislocation, loosening or a change in leg length. For the most part complications during hip replacement surgery and recovery are rare and the mortality rate is low.
A total hip replacement is targeting pain. In most cases, total pain relief or at least a significant decrease in pain is experienced immediately following the surgery. A little post-operative pain due to the incision and the procedure is normal, but most patients express feeling a difference in pain immediately. Those undergoing a total hip replacement surgery are typically experiencing pain throughout their day—making it difficult to get up and down, walk, sleep or even rest comfortably. In most cases, sitting, standing and lying down are all painful, so the decrease in pain is making all of the difference.
Those who are candidates for total hip replacement surgery have likely already undergone several other treatment options including managing pain with medication, assistive walking devices and therapy programs. The first two are really more like bandages anyway. The other alternative to a total hip replacement would be a hemi hip replacement, which refers to replacing only part of the joint as opposed to the whole thing. A doctor will be able to tell you if you are a candidate for a hemi replacement instead of a total replacement.
For those who do not have health insurance, a total hip replacement is pricey. The price tag usually runs anywhere from $30,000 to $45,000 in the United States with various factors such as location, equipment needed and doctor affecting total cost. Luckily, insurance will often cover all or part of a total hip replacement, lowering the out of pocket costs for patients.
“How Much Does Hip Replacement Cost? – CostHelper.com.” CostHelper. Accessed April 23, 2018.http://health.costhelper.com/hip-replacement.html.
“Hip Replacement.” Mayo Clinic. December 28, 2017. Accessed April 23, 2018. https://www.mayoclinic.org/tests-procedures/hip-replacement/about/pac-20385042.