About Total Hip Replacement Surgery
Total hip replacement surgery involves both replacing the ball and modifying the socket of the hip joint.
The misshapen ball or femoral head is replaced with a perfectly round artificial ball, which is usually ceramic but is sometimes made of metal. The ball is attached to the thigh bone (femur) with either a titanium stem that is press-fit into the bone (the method most commonly used with younger, more active patients) or an alloy material that is attached with an acrylic bone cement.
A titanium cup is press-fit into the socket in the pelvis, and a surface commonly made of polyethylene is applied over it to allow for fluid movement.
Total hip replacement surgery has a high success rate. Both the procedure and the pain management strategies available after surgery are simple and straightforward, and both rapid recovery and return to near-full activity are the norm.
How the Hip Joint Works
The hip joint is the moving or articulating juncture between the pelvis and the thigh bone or femur. It is a ball-and-socket joint; a ball (called the femoral head) moves within a socket (called the acetabulum). In a properly functioning hip joint, a fluid motion of the ball in the socket allows the joint to rotate and flex the thigh in relation to the pelvis and upper body, making it possible to bend and rotate and bear weight so a person can sit, stand up and walk.
Causes of Hip Deterioration
A number of conditions can cause the hip joint to deteriorate, including:
- Arthritis resulting from wear and tear as the body ages
- A congenital or hereditary deformity such as dysplasia or impingement
- An injury or trauma such as a labral tear or osteonecrosis (also called avascular necrosis)
With any one of these, the ball and socket become misshapen and no longer fit together properly. The ball can become flattened, mushroom-shaped or even cone-shaped, making the joint operate like “a square peg in a round hole.” When the socket becomes misshapen, the result is like “a square peg in a square hole.” Either way, the result is pain and difficulty with movement, causing you to have a "bad hip".
Symptoms of Hip Deterioration
Patients with bad hips typically have trouble with common activities such as putting on shoes and socks, getting in and out of a vehicle, or getting up and down from a low chair or toilet seat. They may also experience pain while trying to lay the leg flat. Whether moving or lying still, they may experience pain radiating from the hip into the groin area.
Often patients delay seeing a doctor about their hips because the pain they experience feels more like pulling a groin muscle. This pain, which can come on suddenly, is almost always located in the front of the hip joint, rather than in the back or side where people assume they would feel hip pain.
Regardless of the location or severity of pain, anyone experiencing mild to moderate pain and/or difficulties with fundamental activities of daily life described above should see an orthopaedic surgeon for an evaluation. Hip replacement surgery has a high rate of success in resolving these issues.
Arriving at a Diagnosis
While insurance policies differ, most require that you first see your primary care physician (PCP) for a referral to an orthopaedic surgeon. Your PCP will conduct a physical examination and likely order an initial X-ray of your pelvis.
Typically, an initial appointment with an orthopaedic surgeon will include a review of your health history and symptoms, a confirming physical exam and the review of the X-ray. With this information, a surgeon can usually confirm the diagnosis. However, in some cases, he or she may also order additional tests such as an MRI, CT scan or blood tests to rule out a fracture or other conditions that may be contributing to your pain.
Options to Try Before Surgery
Before undergoing surgery, your doctor may encourage you to lose weight (to put less weight on the hip), and to use non-steroidal medications such as ibuprofen or acetaminophen to reduce swelling and pain. Steroid injections may also be helpful. But these steps often provide only temporary relief. Once the joint has deteriorated to a certain point, surgery is the only option offering long-term relief.
For more information about Total Hip Replacement, visit our Frequently Asked Questions About Total Hip Replacement page.
Why Choose Michigan Medicine for Your Hip Replacement
Both Michigan Medicine and its Orthopaedic Surgery program are nationally ranked, according to U.S. News and World Report.
Our Department of Orthopaedic Surgery has been a high-volume provider and a pioneer in surgical care, education and research since 1930. We are at the forefront of developing and using new, stronger joint replacement materials, and we specialize in hip replacement procedures that are less invasive and require less recovery time.
Contact Us / Make an Appointment
Determining whether and where to have joint surgery are important decisions. Because we are highly experienced in total hip replacement, we can help you explore your options.
Call 734-936-5780 to speak with a representative in our Orthopaedic Surgery Call Center to learn more or make an appointment for a consultation.