How Long Are Recovery and Rehabilitation?
Usually, people do not spend more than 3 to 5 days in the hospital after hip replacement surgery. Full recovery from the surgery takes about 3 to 6 months, depending on the type of surgery, your overall health, and the success of your rehabilitation.
What Are Possible Complications of Hip Replacement Surgery?
According to the American Academy of Orthopaedic Surgeons, more than 193,000 total hip replacements are performed each year in the United States and more than 90 percent of these do not require revision.
New technology and advances in surgical techniques have greatly reduced the risks involved with hip replacements.
The most common problem that may arise soon after hip replacement surgery is hip dislocation. Because the artificial ball and socket are smaller than the normal ones, the ball can become dislodged from the socket if the hip is placed in certain positions. The most dangerous position usually is pulling the knees up to the chest.
The most common later complication of hip replacement surgery is an inflammatory reaction to tiny particles that gradually wear off of the artificial joint surfaces and are absorbed by the surrounding tissues. The inflammation may trigger the action of special cells that eat away some of the bone, causing the implant to loosen. To treat this complication, the doctor may use anti-inflammatory medications or recommend revision surgery (replacement of an artificial joint). Medical scientists are experimenting with new materials that last longer and cause less inflammation. Less common complications of hip replacement surgery include infection, blood clots, and heterotopic bone formation (bone growth beyond the normal edges of bone). Studies are also looking at the use of bisphosphonates, ciprofloxacin, pentoxifylline, and other medications to prevent this bone resorption around the implants.
When Is Revision Surgery Necessary?
Hip replacement is one of the most successful orthopaedic surgeries performed. Studies have shown that more than 90 percent of people who have hip replacement surgery will never need to replace an artificial joint. However, because more people are having hip replacements at a younger age, and wearing away of the joint surface becomes a problem after 15 to 20 years, replacement of an artificial joint, which is also known as revision surgery, is becoming more common. It is more difficult than first-time hip replacement surgery, and the outcome is generally not as good, so it is important to explore all available options before having additional surgery.
Doctors consider revision surgery for two reasons: if medication and lifestyle changes do not relieve pain and disability, or if x-rays of the hip show damage to the bone around the artificial hip that must be corrected before it is too late for a successful revision. This surgery is usually considered only when bone loss, wearing of the joint surfaces, or joint loosening shows up on an x-ray. Other possible reasons for revision surgery include fracture, dislocation of the artificial parts, and infection.
What Types of Exercise Are Most Suitable for Someone With a Total Hip Replacement?
Proper exercise can reduce stiffness and increase flexibility and muscle strength. People who have an artificial hip should talk to their doctor or physical therapist about developing an appropriate exercise program. Most of these programs begin with safe range-of-motion activities and muscle-strengthening exercises. The doctor or therapist will decide when you can move on to more demanding activities. Many doctors recommend avoiding high-impact activities, such as basketball, jogging, and tennis. These activities can damage the new hip or cause loosening of its parts. Some recommended exercises are walking, stationary bicycling, swimming, and cross-country skiing. These exercises can increase muscle strength and cardiovascular fitness without injuring the new hip.
What Hip Replacement Research Is Being Done?
To increase the chance of surgical success and decrease the risk of complications and prosthesis failure, researchers are working to develop new surgical techniques, more stress-resistant materials, and improved prosthesis designs. They are also studying ways to reduce the body's inflammatory response to the artificial joint components.
Researchers are also studying gender and ethnic discrepancies in those who have the procedure, and characteristics that make some people more likely to have successful surgery.
Other areas of research address issues of recovery and rehabilitation, such as appropriate postsurgical analgesia for older people, and home-health and outpatient programs.
The National Institute of Arthritis and Musculoskeletal and Skin Diseases, one of the 27 Institutes and Centers of the National Institute of Health (NIH), supports research into the causes, treatment, and prevention of arthritis and musculoskeletal and skin diseases, the training of basic and clinical scientists to carry out this research, and the dissemination of information on research progress in these diseases.