Hip replacement, or total hip arthroplasty, is a type of surgery to replace a worn-out or damaged hip joint. According to the Agency for Healthcare Research and Quality, more than 450,000 total hip replacements are performed in the United States each year.

Total hip replacements are typically performed on patients between the ages of 50 and 80 years old, though there are actually no age limits. Even young teenagers and seniors over the age of 80 have benefitted from having a successful total hip replacement.

During the procedure, the damaged femoral head, the top of the thigh bone, is removed and replaced with a metal stem that is placed into the hollow center of the femur. A metal or ceramic ball is placed on the upper part of the stem. This ball replaces the damaged femoral head that was removed. The acetabulum’s damaged cartilage surface, the socket, is removed and replaced with a metal socket. Screws or cement are sometimes used to hold the socket in place. A plastic, ceramic, or metal spacer is inserted between the new ball and the socket to allow for a smooth surface.

Patients may choose to have a hip replacement because of a hip fracture or for severe pain because of arthritis. According to the Academy of Orthopaedic Surgeons, five common causes of hip pain are osteoarthritis, rheumatoid arthritis, post-traumatic arthritis, osteonecrosis, and a childhood hip disease.

Osteoarthritis, the most common reason for hip replacement surgery, is a degenerative joint disease that affects mostly middle-aged and older adults. It may cause the breakdown of joint cartilage and bones.

Rheumatoid arthritis causes inflammation of the lining of the joint and causes extra synovial fluid production, which is the fluid that reduces friction inside the joint. It may lead to severe pain and stiffness.

Post-traumatic arthritis is caused by an injury and may include damage to cartilage as well as bone.

Osteonecrosis is sometimes caused by an injury to the hip, such as a dislocation or fracture, which may limit the blood supply to the femoral head. The lack of blood may cause the surface of the bone to deteriorate, and arthritis will result. Some diseases can also cause osteonecrosis.
Childhood hip disease:

Some infants and children have hip problems which, even if they are successfully treated, may cause arthritis later on in life. This happens because the hip may grow abnormally and affect the joint surfaces.

The goal of hip replacement surgery is to replace the parts of the hip joint that have been damaged and relieve hip pain that cannot be controlled by other treatments such as therapy or medication. People with severe pain from arthritis may not be able to perform normal activities such as walking or sitting that involve bending at the hip. Patients having a total hip replacement are often admitted to the hospital for one to three days, although some health systems are currently performing hip replacements as same-day surgeries.

Any surgery can have complications such as bleeding, infection, blood clots, dislocation, the need for an additional surgery, or nerve injury. Some people may have additional risks depending upon their overall health or other conditions.

Once home, it is important to keep the surgical area clean and dry. Your healthcare team will give you specific bathing instructions. The stitches or surgical staples will be removed during a follow-up office visit. Your physician will also prescribe physical therapy, a pain reliever for soreness, and possibly even blood thinners to prevent clots.

Full recovery from a total hip replacement can take months, and initially, you will not be able to drive. Other activities may also be limited. It is important that you work closely with your surgeon, physical therapists, and the rest of your care team for the best post-surgery results to ensure a quick return to the activities you enjoy.