What Should I Expect with a Total Hip Replacement?
A total hip replacement (THR) is also known as a total hip arthroplasty (THA). During this process the damaged bone and cartilage is removed from your hip joint and an artificial joint is implanted. There are many possible causes of hip pain that result in a THA – Osteoarthritis (shown in the figure above), fracture, Rheumatoid Arthritis or Avascular Necrosis. Osteoarthritis (OA) is known as a breakdown of cartilage between your joints leading to bone-on-bone contact. OA can occur as a result of genetics, age or obesity. Rheumatoid Arthritis (RA) is defined as an autoimmune disease that causes inflammation of the synovial lining of your joints. This disease leads to pain and stiffness. Lastly, avascular necrosis can occur as a result of a dislocation or fracture at the hip that limits blood supply to your joint. As a result of a lack of blood supply your joint surfaces can collapse causing significant degenerative changes in the joint.
Surgery to replace your hip joint will be recommended if you experience the following symptoms:
- Significant pain in your hip that limits activities such as walking or bending.
- Hip pain that is persistent at rest.
- Overall hip stiffness leading to decreased movement.
- Lack of pain relief from conservative treatments such as medications and physical therapy care.
A THA will focus on the removal of the damaged part of your hip joint and replacing it with an artificial object. The surgeon will make an incision on the front, side or back of your hip. The precautions you are given after the procedure will depend on the type of surgery performed. For examples of precautions see the image below:
The artificial hip joint consists of a metal stem, ceramic or metal ball and a socket, a spacer is also added to allow your joint to move naturally. The femoral head (shown in the figure above) is removed and replaced with a femoral stem made of metal. The metal or ceramic ball is then added to recreate the femoral head aspect of your hip joint. A metal socket for the femoral head to fit into is then created to complete the joint. Lastly, a spacer is added which is made of plastic, ceramic or metal. This component is placed between the femoral head component and the socket.
After receiving a total hip replacement you should expect a significant reduction of pain and an increased abilities to perform day-to-day activities. You will be in the hospital for a few days and physical therapy will begin very soon after your surgery. Early mobilization is a critical process in order to achieve the best recovery. When returning home, home modifications should be in place to allow for easy navigation – grab bars, handrails, raised toilet seat, a caretaker and more.
However, your doctor may advise you to avoid high intensity activities such a jogging, running and jumping to avoid breakdown of the artificial hip joint. Precautions are generally lifted after 6 weeks based on physician preference. Certain movements that you should avoid will also be given to you by your doctor to keep your new joint as healthy as possible. Physical therapy care is a vital part of your recovery and should be set up as soon as possible to maximize your overall recovery. Physical therapy treatment will focus on restoring your movement ability and strength in your hip. It is critical that you work to recover both your motion through range of motion exercises and strengthening exercises. Your physical therapist will help you regain the motion with manual therapy and appropriate range of motion.
Restoration of your strength is extremely important to your recovery process due to the likely low level of strength prior to a hip replacement. Hip disease is often exists for many years prior to receiving a THA. As a result, the strength in your leg is substantially lower. The rebuilding of strength is essential help you to return to your prior level of function. Your PT will provide you with a guided exercise program to allow you to return to your desired activities. Following the rehabilitation of your THA you will have restored mobility, strength and be able to return to your everyday activities!
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Contact Sacred Heart University Physical Therapy Specialists today to schedule your appointment: (203) 396-8181.