Everything you need to know about the hip prosthesis

Hip arthroplasty is an orthopedic surgery used to replace the hip joint with a metal, polyethylene or ceramic prosthesis.

This surgery is more common and elderly, from 68 years old, and can be performed in two ways: partial or total. In addition, it can be made with different materials, such as metal, polyethylene and ceramics, and all these choices must be made by the orthopedic doctor who will perform the surgery.

When to place a hip prosthesis

Generally, hip arthroplasty is used in elderly people with joint wear due to arthrosis, rheumatoid arthritis or ankylosing spondylitis, however, it can also be used in young patients, in case of fracture of the femoral neck, for example. Basically there is an indication for surgery in case of joint wear, chronic pain or inability to walk, up and down stairs, or to get in the car, for example.

How is the surgery done

Hip arthroplasty is performed under anesthesia in the operating room, which can be a regional block or general anesthesia. The surgeon makes a cut on the front of the thigh, the back or on the side of the thigh, depending on your choice, and removes the parts worn by the arthrosis and places the prosthesis.

The duration of the surgery is approximately 2.5 hours, but it may be longer, depending on the patient's condition. The length of hospital stay can vary between 3-5 days and physical therapy should be started right after the operation.

The surgeon usually prescribes painkillers and anti-inflammatory drugs, such as Paracetamol or Ibuprofen, after surgery and while the patient is in pain, requiring physical therapy for 6 months to 1 year.

X-ray of the hip prosthesis

Care after hip prosthesis placement

The recovery from hip arthroplasty takes about 6 months and during this period the patient must take some precautions, such as:

Lie on your back with your legs spread. It may be useful to place a pillow between your legs; Do not cross your legs to avoid displacing the prosthesis; Avoid turning the operated leg inward or outward on itself; Do not sit in very low places: always place seats to raise the toilet and chairs; Avoid lying on your side on the operated leg, especially in the first month after surgery; When climbing steps, first place the non-operated leg and then the operated leg. To descend, the operated leg goes first and then the non-operated leg; Practice light activities, such as walking in the first weeks, but activities such as dancing, only after 2 months of recovery and under the guidance of the doctor or physiotherapist.

Find out more details on How to speed recovery after hip replacement.

After the first review visit, the patient must return to the doctor every 2 years to have an X-ray to assess the positioning and wear of the prosthesis.

Physiotherapy after hip prosthesis

Physiotherapy for hip arthroplasty should start on the first day after surgery, being important to relieve pain, reduce swelling, improve hip movements and strengthen muscles.

Normally, the physiotherapy program should be guided by a physical therapist and includes guidelines for walking, sitting, getting up, how to use the walker, as well as exercises to learn to walk with the prosthesis, to strengthen the muscles and to develop balance. See how to do some exercises in: Physiotherapy after hip prosthesis.

After discharge from the hospital, the patient must maintain physical therapy for at least 6 months after hip arthroplasty. Also indicated are the electrical devices for muscle activation, and balance exercises that can be performed in the water, in the pool. The physiotherapeutic treatment varies according to the type of prosthesis and the surgical approach, so the physiotherapist must indicate the best treatment for each case.

Possible complications

Complications of arthroplasty are rare, especially when the patient follows the guidelines and appropriate care in the postoperative period of surgery. However, some complications can be:

Deep venous thrombosis; Pulmonary embolism; Prosthesis dislocation; Bone fracture.

Generally, the patient should go to a revision consultation 7-10 days after the surgery to remove the stitches and avoid some complications, such as disengagement of the prosthesis or infection. When complications are suspected, consult the orthopedist or go to the emergency room to start the appropriate treatment.

Most common questions about hip prosthesis

Does the hip prosthesis move?

Yes. It is possible for the prosthesis to move if the patient feels in very low places, cross his legs or turn his legs in or out, before the doctor or physiotherapist is allowed to perform these activities.