Understanding Hip Pain
Your hip is a simple ball and socket joint, where your thigh bone joins with your pelvis. Surrounded by cartilage, muscles, and ligaments, your hip is one of your largest weight bearing joints in your body. Smooth cartilage and bone help you walk easily and without pain.
In a healthy hip, smooth cartilage covers the ends of your hip bones allowing the ball to glide easily in the socket. Smooth weight bearing surfaces allow for painless movement.
In a problem hip, the cartilage wears away and the bones rub together, becoming rough and pitted. The ball grinds in the socket when you walk, resulting in pain and stiffness.
Your damaged hip joint can be replaced with new, smoothly surfaced components. A ball will replace the worn head of your thigh bone, with a stem inserted into the bone for stability. A cup will replace the worn socket. Like a healthy hip, your prosthesis has a smooth gliding surface that will allow you to move with ease and without pain. Unlike your healthy hip, however, your prosthesis has a limited range of motion, and will need your special care after surgery.
Hip replacement is usually performed to treat severe arthritic conditions. The operation is sometimes performed for other problems such as hip fractures or aseptic necrosis. Most patients who have artificial hips are over the age of 55, but the operation is occasionally performed on younger patents as well. Circumstances vary, but generally patients are considered for hip replacements if:
- Pain is severe enough to restrict work, recreation, and the ordinary daily activities.
- Pain is not relieved by anti-inflammatory medicine, the use of a cane, and other restricting devices.
- There is a significant stiffness of the hip.
- X-rays show advanced arthritis or other hip problems
When dealing with hip pain you would first start off with non-surgical procedures to help the pain. These normally don’t fix the problem but most likely with provide pain relief for a short period of time. Some non-surgical options are:
- Rest (Ice, Compression, Elevation, Braces)
- Physical Therapy
- Walking Aids
- Pain relievers
- Cortisone Shot
After attempting the non-surgical approach and if you have not experienced results you may want to ask your doctor about hip replacement.
Why BioPro Hip Implants?
BioPro offers a variety of different implant solutions for hip replacement. The implants were designed by Dr Charles Townley, following his principles of “Design by Reason”. BioPro hip stems all incorporate a collared design, which helps preserve bone quality around the implant.
What to expect during and after surgery
Hip replacement is one of the most common forms of total joint replacement. To begin the surgical procedure, the patient will be given an anesthetic (usually a spinal unless contraindicated). The surgeon will then make an incision and prepare the hip bone for implantation of the prostheses. The surgeon will remove the rough surfaces of the bone at the joint and replace them with new smoothly surfaced implants.
Like the human hip, this artificial joint is composed of three components that fit together to form a ball and socket joint. The components of the prosthesis are the ball, stem, and cup. The ball will replace the worn upper end of the femur, while the cup will replace the worn socket in the pelvis. The stem will be inserted into the bone for stability. These components are implanted separately and then brought together. In some cases, after the incision is closed, a small tube (called a hemovac) is inserted to help drain fluids from the hip joint area for the first day or so following surgery.
Complications of Hip Replacement Surgery
Most complications that occur after hip replacement are successfully treatable. Possible complications after knee replacement include:
Infections: Any infection in your body can spread to your joint replacement. Infections may occur while you are in the hospital of after you go home. Minor infections can be treated with antibiotics, while major infections may require surgery and removal of the prosthesis.
Blood Clots: If there is a severe pain and / or swelling that develops in your calf or thigh, you may have developed a blood clot. Blood clots result from several factors, including decreased mobility that causes slow movement of blood through your leg’s veins. Your doctor may take preventative action to reduce the possibility of blood clots, such as blood thinning medications, elastic stockings, exercises that increase the blood flow in the leg muscles, or plastic boots that inflate with air to compress the muscles in your legs.
Loosening: Loosening of the prosthesis within the bone may occur after hip replacement. If the loosening is significant and there is a large amount of pain, a revision surgery to correct the loosening may be necessary.
Dislocation: Occasionally, after total hip replacement, the ball can be dislodged from the socket. In most cases, the hip can be relocated without surgery. A brace may be worn for a period of time if a dislocation occurs.
Wear: Wear occurs in all joint replacements. However, excessive wear can lead to loosening and pain and may require revision surgery.
Prosthetic Breakage: Breakage of a hip replacement is extremely rare, but it can occur. If this case does occur, a revision surgery will be needed.
Nerve Injury: Nerves in the vicinity of the total joint replacement can be damaged during the total replacement surgery. This type of injury is not common and may often improve and/or completely recover after some time.
Notify your surgeon or nurse if you experience any of the following symptoms:
- Pain, soreness, swelling, or redness in the calf muscles of either leg.
- Unexplained, increased pain in the operative area.
- Redness, swelling, or puslike drainage from the area around the incision
- Cough, high fever, or chills.
- Chest pain, shortness of breath, or difficulty breathing.
What to expect after surgery
After surgery, you will be taken to the Recovery Room for a period of close observation. Your blood pressure, pulse, and temperature will be monitored and close attention will be paid to the circulation and sensation in your legs and feet. Post operatively, you may have temporary nausea and vomiting due to anesthesia or medications. (Anti-nausea medication may be given to you when you are in your room to minimize nausea and vomiting.) It is also important to tell your nurse if you experience any numbness, tingling, or extreme pain in your legs or feet. When your condition is stabilized, you will be transferred to your hospital room.
A tube (called a hemovac) that may have been placed in you during surgery will drain excess fluid to keep swelling down, while an intravenous (IV) line may be used to provide fluids for nourishment, medication to prevent blood clots, and antibiotics to prevent possible infection. You may also have a catheter placed to aid in urination. To relieve pain, you can be attached to a special device that will allow you to get pain medication when you feel it is necessary.
Despite the back discomfort that some patients experience after surgery (caused by the soreness of the hip area and prolonged lack of movement), you must remember a few precautions to prevent dislocations:
1) The head of your hospital bed should not be elevated more than 70 degrees during the first few days after surgery.
2) Use a high-rise toilet.
3) Use 2-3 pillows between your legs.
4) Do not cross your legs or bend them forward 90 degrees.
At first, you will be restricted to ice chips and clear liquids, but your diet will be allowed to progress as your condition permits. Meanwhile, the surgeon and physical therapist will work together to set movement guidelines for you. The physical therapist will continue to check the strength and flexibility in your leg and hip, and your ability to stand and sit. The physical therapist may also recommend some gentle exercises that will help strengthen and increase your new hip’s range of motion.
After total hip replacement surgery, it takes only a few months to regain strength and confidence in your new hip. With the help of your orthopedist and physical therapist, activities that you were not able to do before surgery can be enjoyable again.
Hospital Recovery and Rehabilitation After Hip Replacement
Exercises will begin as soon as possible to help strengthen your leg muscles and increase your ability to bend your knee. Your balance may seem unsteady at first, but will improve as you progress with walking.
During your recovery period in the hospital, your recovery team’s goals are to minimize any swelling or pain caused by the surgery, and to start your gentle physical therapy exercises. Your physical therapist will initially teach you exercises that will increase your circulation and will then continue to teach you exercises that will improve your strength and increase your endurance so you can recover more quickly. Your therapist will finally teach you how to properly get out of bed, stand, sit, and walk, so you will be able to do these activities safely on your own.