People who have hip pain or stiffness may find it hard to exercise, walk, or bend over. A hip replacement surgery can help them do all of these things, relieve pain, and improve their quality of life.
The hip joint is a ball-and-socket joint. The ball, at the top of the femur (thighbone) is called the femoral head. The socket, called the acetabulum, is a part of the pelvis. The ball rotates in the socket, allowing the leg to move forward, backward, and sideways.
Cartilage, a soft connective tissue, covers the ball and the socket to help them glide together smoothly. If this cartilage wears down or gets damaged, the bones scrape together and become rough. This causes pain and can make it difficult to move the leg.
The most common replacement surgery is called a total hip replacement. (Doctors call this procedure a hip arthroplasty.) In this surgery, worn-out or damaged sections of the hip are replaced with artificial implants. The socket is replaced with a titanium metal shell and a ceramic or plastic liner. The femoral head and upper section of the upper femur are removed, and a new ball, made from a metal alloy, is attached to a metal stem that is inserted into in the top of the femur. (Learn more about the types of hip implants.) After 15-20 years, it may be necessary to replace some of the implants. This is called hip revision surgery.
To begin the operation, the hip replacement surgeon will make incisions (cuts) on the back or side of the hip, or on the front of the thigh.
Accessing the hip joint from the back of the hip is called the posterior approach. This is most common method used in the United States. In recent years, HSS surgeons pioneered a modified version of the posterior approach called minimally invasive hip replacement. This method uses smaller incisions to shorten healing and recovery. Special surgical tools and training for the surgeon are required. It is not appropriate for all patients, but it is highly successful.
Accessing the hip joint from the front of the thigh is called the anterior approach. Anterior hip replacement surgery does not require the surgeon to cut thigh muscle. For this reason, it can reduce pain and offer even shorter recovery times. It also requires special tools and training, and is not suitable for all patients. Surgeons sometimes make a slight variation to either of these approaches, by making the incisions closer to the side of the hip.
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