Total Hip Replacement - A brief introduction.

  • Author:

    Dr Sreenath Shankar

Joint Replacement Surgery: Joint replacement surgery is one of the most successful advance in the history of medicine. This field combines the knowledge and skills of modern medicine, metallurgy,implant design and newer bearings.

Hip movement is needed for daily activities and in various conditions causing arthritis or loss of cartilage and hhip is extrememly painful.at this stage total hip replacement is performed whereby the acetabular cup (socket)and head of femur(ball) is replacement..this is a noint with following advantage.this new joint is painfree ,stable and mob ile and drable.with modern implants upto 30 yr can be obtained

Common Causes of Hip Pain!

  • Osteoarthritis: This is an age-related "wear and tear" type of arthritis. It usually occurs in people 50 years of age and older and often in individuals with a family history of arthritis. The cartilage cushioning the bones of the hip wears away. The bones then rub against each other, causing hip pain and stiffness. Osteoarthritis may also be caused or accelerated by subtle irregularities in how the hip developed in childhood.
  • Rheumatoid arthritis: This is an autoimmune disease in which the synovial membrane becomes inflamed and thickened. This chronic inflammation can damage the cartilage, leading to pain and stiffness. Rheumatoid arthritis is the most common type of a group of disorders termed "inflammatory arthritis."
  • Post-traumatic arthritis: This can follow a serious hip injury or fracture. The cartilage may become damaged and lead to hip pain and stiffness over time.
  • Avascular necrosis: An injury to the hip, such as a dislocation or fracture, may limit the blood supply to the femoral head. This is called avascular necrosis. The lack of blood may cause the surface of the bone to collapse, and arthritis will result. Some diseases can also cause avascular necrosis.
  • Childhood hip disease: Some infants and children have hip problems. Even though the problems are successfully treated during childhood, they may still cause arthritis later on in life. This happens because the hip may not grow normally, and the joint surfaces are affected.

Who can have a hip replacement?

There are no absolute age or weight restrictions for total hip replacements.Recommendations for surgery are based on a patient's pain and disability, not age. Most patients who undergo total hip replacement are age 50 to 80, but orthopaedic surgeons evaluate patients individually. Total hip replacements have been performed successfully at all ages, from the young teenager with juvenile arthritis to the elderly patient with degenerative arthritis. There are several reasons why your doctor may recommend hip replacement surgery. People who benefit from hip replacement surgery often have:

  • Hip pain that limits everyday activities, such as walking or bending
  • Hip pain that continues while resting, either day or night
  • Stiffness in a hip that limits the ability to move or lift the leg
  • Inadequate pain relief from anti-inflammatory drugs, physical therapy, or walking supports

What exactly is done during hip replacement?

In a total hip replacement (also called total hip arthroplasty), the damaged bone and cartilage is removed and replaced with prosthetic components.

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


The complication rate following hip replacement surgery is low. Serious complications, such as joint infection, occur in less than 2% of patients. Major medical complications, such as heart attack or stroke, occur even less frequently. However, chronic illnesses may increase the potential for complications. Although uncommon, when these complications occur they can prolong or limit full recovery.

  • Infection
  • Blood clots
  • Leg-length Inequality : Sometimes after a hip replacement, one leg may feel longer or shorter than the other.
  • Dislocation : This occurs when the ball comes out of the socket. The risk for dislocation is greatest in the first few months after surgery while the tissues are healing. Dislocation is uncommon.
  • Loosening and Implant Wear
  • Other complications : Nerve and blood vessel injury, bleeding, fracture, and stiffness can occur. In a small number of patients, some pain can continue or new pain can occur after surgery.


Anaesthetics are extremely safe, but they do carry a risk of minor side effects such as nausea (usually temporary), and also a slight risk of serious complications as in any other surgery.

Hip replacement surgery offers a number of benefits:

  • Reduced hip pain.
  • Increased mobility and movement.
  • Correction of deformity.
  • Equalization of leg length.
  • Increased leg strength.
  • Improved quality of life, ability to return to normal activities.
  • Enables you to sleep without pain.

For people who wish to Add life to years rather than years to life ,who want a painfree independent life total hip replacement has opened up great opportunity .The success of the surgery depends to a large extent on the quality of the implants as well. so always opt for better implants and undergo the surgery at institutions where it is done routinely with all full fledged operating room facilities. For further information : www.aaos.org

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Dr. Sreenath Shanker

Dr.Sreenath is a leading joint replacement and arthrocopic suregon in Kerala, India.Get to know him and and what he has to share via his online portal DrSreenath.com, delievering various services including online appointment booking.


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