When should I consider hip replacement surgery?

You should consider hip replacement surgery (also known as a hip arthroplasty) when you have severe hip joint damage that significantly impacts your quality of life, and your symptoms do not respond to other conservative treatments. The primary goal of this surgery is to relieve pain, improve joint function, and increase mobility [1].

This surgery is considered an effective treatment option when the pain caused by a damaged hip joint is severe and persistent, limiting your ability to perform daily activities such as walking or climbing stairs, and cannot be managed with medication, physical therapy, lifestyle changes, or the use of assistive devices such as crutches [1].

Common reasons for considering hip replacement surgery

There are several medical conditions that can lead to hip joint damage and warrant consideration of surgery:

• Arthritis: Osteoarthritis (degenerative arthritis) and rheumatoid arthritis are the primary causes of cartilage wear and joint damage, which cause pain, swelling, and reduced mobility [1] [3].
• Osteonecrosis: This occurs when parts of the bone die due to a lack of blood supply, leading to joint collapse [1].
• Injuries or fractures: Hip fractures resulting from falls or bone diseases may require joint replacement surgery, especially if the fracture affects the femoral head or the acetabulum (hip socket) [1].

Conservative treatments before surgery

Before recommending hip replacement surgery, your doctor may suggest trying other treatments aimed at relieving symptoms and improving joint function. These treatments may include [1]:

• Pain-relieving medications.
• Physical therapy programs and exercises to strengthen the muscles surrounding the joint.
• Modifying daily activities to reduce stress on the hip.
• Using assistive devices such as a cane, crutches, or a walker.

If these treatments do not provide sufficient relief and the pain continues to affect your activities, surgery may be the most appropriate option [1].

Preparing for hip replacement surgery

Good preparation before surgery can contribute to a better recovery and reduce the risk of complications. Preparation includes several aspects [1]:

• Medical consultation: Talk with your surgeon and healthcare team about what to expect from the surgery and recovery. Ask questions about the type of implants used, such as those with metal, ceramic, or plastic components [1]. In rare cases, surgeons may choose to avoid metal-on-metal artificial surfaces due to potential complications [1].
• Improving general health: If you smoke, try to quit or cut down. If you are overweight, losing weight may help reduce the risk of complications [1].
• Exercise: Ask your surgeon about exercises you can do to strengthen your core, upper body, and legs before surgery [1].
• Home arrangements: Prepare your home for recovery, such as arranging daily items within reach and preparing meals in advance. You may need to arrange for help at home for the first two weeks after returning [1].
• Assistive devices: Discuss with your healthcare team equipment that may help you with daily activities, such as safety bars in the bathroom, a shower seat, or mobility aids [1].

What happens during surgery?

Hip replacement surgery is performed under anesthesia, which may be regional anesthesia (numbing a specific part of the body) or general anesthesia (putting your whole body to sleep) [1]. The surgeon makes an incision over the hip to remove damaged bone tissue and cartilage from the joint. Afterward, the femoral head and the surface of the acetabulum are replaced with new artificial parts [1]. These parts can be fixed to the bone using a special adhesive (cemented) or with a porous design that allows natural bone to grow into them (uncemented) [1].

For more information on the details of the surgery and recovery, you can visit Hip replacement surgery: preparation, procedure, and full recovery (Arabic).

When to seek emergency help?

After hip replacement surgery, it is important to be alert for any abnormal symptoms. If you experience new or worsening pain, swelling, numbness, weakness, hear abnormal sounds (such as clicking, grinding, or squeaking) in the hip, or notice a change in your ability to walk, you should contact your orthopedic surgeon immediately [2].

If you have had a metal-on-metal hip replacement, it is important to inform your doctor of any new or worsening symptoms in any part of your body, including skin rashes, heart problems, neurological changes (such as hearing or vision loss), psychological changes, impaired kidney function, or thyroid disorders, as these symptoms may be related to metal ions released by the joint [2].

Medical references

• Hip Replacement Surgery
• Hip Replacement
• Metal-on-Metal Hip Implants: Information for Patients