Total Hip Replacement Surgery

If you and your surgeon have exhausted all conservative measures for treating your hip arthritis, you may be a candidate for total hip replacement surgery.  This procedure is often the only option for reducing pain and restoring an active, pain-free life. If your doctor decides a total hip replacement is right for you, the following information will give you an understanding about what to expect.

Total hip replacement is a surgical procedure for replacing the hip joint. During the procedure, the two parts of the hip joint, the hip socket (acetabulum) and the ball (femoral head), are removed and replaced with smooth artificial surfaces.

The artificial socket is commonly made of metal with a high density plastic liner, and the artificial ball is made out of metal or ceramic.

Implant Components

In total hip replacement surgery, the prosthesis or implant, is made up of three components. The femoral stem is made out of a metal, such as titanium, and is implanted down the shaft of the thigh bone or femur. The ball, or femoral head, is attached to the stem and is designed to replace the arthritic femoral head. The third part, the acetabular component, is a metal shell with a plastic inner socket liner.  These components are implanted into the pelvis and thigh bone, and are designed to closely approximate the mobility of the natural hip joint.

The Procedure

Before you are taken to the operating room, your anesthesiologist will talk with you about the medications used during the procedure and will administer medication to help you relax.  Next, the surgeon will make an incision in your leg to access the hip joint. Your surgeon will select the appropriate incision length and approach that is best for your case.

After the incision is made and exposure is adequate, the ligaments and muscles are separated to allow access to the bones of the hip joint. The femoral head is then dislocated from the hip joint and removed at the level of the femoral neck. After the femoral head is removed, the cartilage of the acetabulum is removed using a special reamer that forms a hemispherical shape. The remaining shape will allow for a proper fit of the metal shell. A trial component is placed in the reamed area to determine the proper size and fit. Once your surgeon is satisfied with the size and positioning of the trials, he will implant the metal shell.  The next step involves preparing the femoral canal to accept the femoral stem implant. Special instruments are used to

hollow out the femur to match the shape of the metal stem of the femoral component. Trial components of the femoral stem, femoral head and acetabular shell are temporarily implanted to ensure the proper size and fit of the final implants.

At this stage, the surgeon will move your hip in all directions to make sure the trial components are implanted appropriately.

Once he is satisfied with the placement of the implant trials, he will insert the final components. For some patients, a special type of acrylic cement, which is well-tolerated by the body, is used to fix the components to the underlying bone.

For other patients, the implants are fixed to the bones without cement. In these cases, the implants are coated with a special porous surface that allows the living bone tissue to adhere to the implant.

Finally, the wound is closed, an external dressing is applied to the incision, and you will be taken to the recovery room.  In the recovery room, the staff will monitor your vital signs until you are transferred to your hospital room.

©2003 Smith & Nephew, Inc.    Used with permission.