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Hip Replacement: Procedure, Recovery, Cost and Is It Safe?

Last Updated: Dec 23, 2022

What is Hip replacement and why is it useful?

The hip joint is a spheroidal joint that often gets damaged easily. Sometimes, one experiences immense and recurring pain in the hip region due to a damaged hip socket or the femoral head of the thighbone due to several reasons.

Hip replacement treatment is utilized to replace the damaged ball and socket joint with artificial ones. It lasts for years and is often advised for adults. Durable and safe synthetic parts are constructed to imitate the natural ball and socket joint. Hip replacement is advised only when other methods like medications, physiotherapy, or braces do not work properly.

Summary: Hip replacement procedure refers to the replacement of a damaged ball and socket joint to alleviate pain and other symptoms. It can be attained by different procedures.

Who can benefit from a hip replacement?

American Academy of Orthopaedic Surgeons (AAOS)’s members and experts say that most people undergoing hip replacement age between 50 and 80. The primary reason is hip arthritis which breaks down the cartilage.

Cartilage cushions bones to withstand pain and prevent decay. The absence of cartilage leads to the bones rubbing with each other. Rubbing the bones can provoke severe pain. Some typical conditions that lead to hip replacement include:-

  • Osteonecrosis (avascular necrosis)
  • Rheumatoid arthritis
  • Osteoarthritis
  • Traumatic arthritis
  • Psoriatic arthritis
  • Femoroacetabular impingement syndrome
  • Hip dislocation or fracture
  • Developmental hip dysplasia
  • Neoplasms
  • Tumors in and around the hip joint
Hip replacement is considered an option only when:
  • Medication does not help alleviate hip pain
  • One experiences pain when walking even with a cane or walker
  • Hip pain affects the ability to climb up or down the stairs
  • One cannot sleep with the excessive pain
  • Standing from a seated position is painful
Summary: People who suffer from immense pain and discomfort in the hip area due to several causes and medications are not able to provide them relief must go for hip replacement surgery.

Different Types of Hip Replacement Surgery

Not every case is the same and the type of hip replacement surgery needed depends on a lot of factors. Your condition needs to be scrutinized by your medical advisor before any diagnosis plan. The common types of hip replacement surgery based on the parts to be replaced are:-

  • Total Hip Replacement - The complete ball and socket are replaced in total hip replacement surgery.
  • Partial Hip Replacement - In partial hip replacement surgery, only the ball is substituted.

A hip replacement surgery can also be categorized based on how the surgeon accesses the hip:

  • Anterior approach to hip replacement
  • Lateral approach to hip replacement
  • Posterior approach to hip replacement
Summary: Hip replacement surgery is categorized into some groups to meet the demands of several patients. The above-stated types are crucial ones.

How to comprehend whether I require a hip replacement?

If hip pain affects your lifestyle, you should consider hip replacement surgery. However, doctors will try to approach the problem using medicines, braces, physiotherapy, and methods other than surgery.

Only if these methods do not work, does the doctor consider hip replacement surgery. If your hip pain affects your life and shows the following complications, make sure to consult your doctor:

  • Disruption in sleep due to hip pain
  • Inability to climb up and down stairs
  • Difficulty in participating in daily activities
Summary: We can take this decision after consulting with a doctor. We should discuss our pain and discomfort with the doctor.
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When should you see a doctor for Hip Replacement?

As discussed, if your hip pain affects the quality of your life, you should see a doctor. The doctor might not immediately ask you to undergo hip replacement surgery. Your medical health provider will prescribe some medications to manage the situation. However, if these do not work, they will go ahead with a hip replacement.

Summary: If we find difficulty in carrying out a normal lifestyle due to continuous pain then we must consult a doctor.

When is Hip Replacement Surgery necessary?

A hip replacement surgery is necessary when the ball and socket joint is damaged. It might also happen due to the breaking down of cartilage, which might cause the bones to wear out. If your hip mobility is reduced and you’re in pain even when resting, doctors consider and choose to go with hip replacement.

Summary: If a person is suffering from recurring pain and discomfort in the hip area while moving around, must need hip replacement surgery. There are several possible causes for it to happen.

Reasons for Hip Replacement Surgery

Your doctor will recommend hip replacement surgery when medications do not work and your hip pain keeps on hampering your daily lifestyle. Some common hip replacement symptoms that you should look out for include:-

  • Pain in your groin or front hip area

  • Pain even when resting

  • Pain during climbing up or down the stairs

  • Pain in the hindquarters and trochanteric region

  • Reduced range of hip movements

  • Difficulty in sleeping

  • Difficulty when bending to tie shoes, wear socks, or other regular movements

Summary: There are various reasons lying behind hip replacement surgery. Pain and discomfort are some of the common causes.

How is Hip Replacement Surgery done?

The standard cause of the surgery is an injury to the spheroid joint. It is recommended only when other methods to control the condition do not work. Generally, the surgery is performed under spinal (you’re awake but your lower body has no sensations) or general anesthesia (you will be asleep).

Your doctor might give you an epidural which is very similar to spinal anesthesia. Once the anesthesia is complete, the doctor will make an incision of up to 30 cm over your hip side. Then, your femur's upper part is removed and the natural head socket is hollowed out.

The surgeon proceeds to fit a socket into the pelvic hollow and a metal shaft with a smooth ball on the upper end is placed into the femur hollow. It is fixed using a bone ‘cement’ and is used to replicate the bone and socket structure of the original hip joint.

Summary: Doctors follow specified methods for surgery. It starts with administering anesthesia then the incision is done and after applying various steps doctors complete the surgery.

What does Hip Replacement Surgery involve?

A hip replacement surgery is a minimally invasive procedure to eliminate the pain caused by damage or injury to the hip joint. The destroyed parts of the hip joint and substituted with manufactured ones by the surgeon. The artificial implants are constructed with metal, ceramic, hard plastic, and other durable materials.

Before the procedure:

Before you undergo hip replacement surgery, you need to mind certain regulations to equip for it. You should plan several appointments with your medical representative /to scrutinize your condition. It will help plan for the best course of action including the type of surgery.

Different studies like urine analysis, an EKG, X-rays, and other lab tests need to be performed. These are necessary to determine whether you should be cleared for surgery or not. Your medical history and other complications will be considered to ensure you are not at risk of further complications. Other than that, some other actions your healthcare provider will take include:-

  • Testing the strength of your muscles like hip flexors and abductors

  • Sensory examination and other tests to check the status of nerves and blood vessels

  • Palpitation testing to determine whether the hip pain is due to the joint or not

  • General body examination to detect other surgical incisions, discoloration, or swelling

  • Range of motion to determine whether hip pain has hampered it or not

  • The length of the leg is measured for the surgery

  • Testing the strength and functioning of the hip abductor muscles

We recommend you ask any questions that you might have about the procedure. It will help you relax and decide with a clear head. If you are under any other treatment process, clarifying which medicines you should discontinue can help.

Experts also recommend preparing for a safe recovery to reduce any surgical risk. You should also talk to your friends and family or have a good support system to help you through the process.

During the procedure:

After you check in for your surgery, the hospital will ask you to undress and wear a hospital gown instead. It allows greater accessibility and allows you to be comfortable during the process. Your surgeon will give you a general anesthetic to put you to sleep.

Alternatively, they might inject you with a spinal anesthetic or epidural to numb your lower body. A surgeon conducts hip replacement surgery in the subsequent steps:

  • The surgeon cuts the hip, through the layers of the body matter.

  • The damaged and injured cartilage and tissue are removed to retain the healthy parts of the bone.

  • A replacement socket is inserted into the pelvic bone.

  • A replacement ball with a metal step on one end is introduced into the femoral head.

After the surgery:

The patient is moved to the recovery area of the hospital after the operation is complete. The anesthesia will start wearing off after some time. The hospital's medical staff will keep you under scrutiny. Your alertness, pain, blood pressure, pulse, pain, and comfort levels will be monitored to keep you safe.

The approximate time required for a hip replacement surgery is 2 hours. Most people are allowed to go home on the same day, but everyone's case is unique.

Summary: Different steps are specified to be followed in several procedures pre and post-surgery. It takes almost 2-3 hours to complete.

What are the constituents of hip replacement implants?

Hip replacement surgery implants and devices are made of different materials and bearing surfaces, such as:

  • Ceramic Ball and Socket with Metal Lining

  • Ceramic Ball and Socket with Ceramic Lining

  • Ceramic Ball and Socket with Plastic/Polyethylene Lining

  • Metal Ball and Socket with Plastic/Polyethylene Lining

Your surgeon will determine the type of implant based on your risk of future complications, medical history, and condition.

Summary: Metals, ceramics, plastic, etc. are some of the commonly used materials used for constructing surgical implants and devices

What is the best material for hip replacement transplants?

Hip replacement surgery focuses on eliminating hip pain and boosting the range of movements. The implant's bearing surface greatly affects the success of the surgery. Hence, one needs to consider the safety and durability of the available hip implants.

The common types of hip replacement implants available are detailed above. In recent years, ceramic balls and sockets with polyethylene lining have become the most commonly used materials for hip implants.Summary: Durable and safe materials are used for hip replacement surgeries. It includes various types like polyethene lining, ceramic balls, sockets, etc.

Types of Socket Implant Attachment

Hip replacement can be classified based on the types of socket implant attachment including

  • Uncemented prosthesis - The implants are attached with a permeable surface allowing the bone to develop over a period and hold it in position.

  • Cemented prosthesis - A material known as bone cement is utilized to connect the transplant to the bone.

Both cemented and uncemented approaches are viable and safe. In some cases, your surgeon might also combine these methods.

Summary: Different prostheses are employed in different hip replacement surgical procedures. It is categorized as cemented as well as uncemented prosthesis.

Is Hip Replacement painful?

Before hip replacement surgery is performed, the patients are put under anesthesia. It helps reduce the sensation of pain. One might experience some inflammation and pain that can be diminished with the help of treatments and restoratives.

Generally, surgical pain can persist between two to four weeks after the surgery. The time varies from person to person and depends on several exterior elements. You can speed up recovery by following some common precautionary methods.

Summary: Yes, hip replacement surgery is quite painful but it is reduced to a certain extent by anesthesia application. Pain is often felt during post-surgical duration too.

What are the possible difficulties of Hip Replacement?

A few possible immediate side-effects of hip replacement surgery include:-

  • Bleeding and Blood Clots - After surgery, one is at an increased risk of experiencing bleeding and blood clots. Clots can easily form in the leg veins which can be harmful. A portion of the clot might split and travel to organs like the brain, heart, or lungs. Ensure to avoid blood thinning medications to further reduce the risk of the same.

  • Infection - Infection at the site of the surgical incision and in deeper tissues near the hip is a possible complication. Antibiotics can easily treat the condition to avoid spreading the infection.

  • Fracture and Dislocation - Some healthy portions of the hip might fracture during surgery. Small fractures can be treated on their own, but larger fractures need to be stabilized medically. A large range of movement can cause the ball to come out and dislocate. Small dislocations can be corrected. However, if one experiences frequent dislocations, surgery is needed to stabilize the condition.

Summary: Hip replacement surgery may lead to some immediate complications. The above-stated issues are some of the common aftereffects.

How Safe Is Hip Replacement?

Hip replacement surgery is very safe but every surgical procedure involves certain risks. It is better to consult your surgeon to understand the risks the surgery would entail. The medical team at Pristyn Care will ensure their best to reduce complications (if any) and will help you make a quick recovery.

Summary: Hip replacement surgery is quite safe but we must get it done by an experienced or specialized doctor. We can also consult doctors prior to the surgery to ensure safety methods.

How long does one need to recover after Hip Replacement?

Most patients can be released on the same day as the procedure. However, your hospital might detain you for three to five days to monitor any changes. You can get back your full range of motion with the help of a physiotherapist and a strong support system.

Full recovery from a hip replacement surgery might take two to three months. Remember that indulging in high-impact activities can be very stressful.

Summary: The recovery period after hip replacement surgery is not the same for every patient. However, it may take three months to recover completely.

What is the success rate of Hip Replacement?

The success rate of hip replacement surgery is more than 95% which is why it is considered to be a safe procedure.

Summary: The success rate of hip replacement is considered quite good.

How much is Hip Replacement cost?

Hip replacement surgery cost depends on several factors like the expertise of the medical team and the hospital's infrastructure. However, the average cost of hip replacement treatment in India is lower than that in the US and UK. The average cost is INR 2,50,000, whereas the minimum and maximum costs are INR 60,000 and INR 8,00,000, respectively.

Summary: The cost of hip-replacement surgery is quite high-priced. It may range from 50,000 to 3 lacks approximately.

What to eat after Hip Replacement?

You should include a healthy, balanced diet to ensure quick recovery after a surgical procedure. Some bone-healing foods that can help you recover after a hip replacement surgery include:-

  • Protein - At least 50% of our bone volume consists of protein making it a crucial element to include in our diet. Vegetarian sources of protein include - chia seeds, soybean, quinoa, spinach, beans, and lentils. Some non-vegetarian sources of protein include - poultry, egg and dairy products, meat, and seafood.

  • Calcium - Calcium boosts the bone formation and is another essential in a post-surgery recovery diet. Some common foods that have high calcium content include dairy products like yogurt and milk and dark leafy vegetables like spinach.

  • Vitamin D and Vitamin C - Vitamin D boosts the person's capability to absorb calcium. Some sources of Vitamin D include - dairy products, fatty fish, and salmon. Additionally, Vitamin C has great antioxidant properties that can help prevent infection. Foods that are rich in Vitamin C include - strawberries and other citrus foods.

Summary: While recovering from hip replacement surgery, we must watch what we eat. Eating strawberries, dairy products, lemon, salmon, etc, are good options.

What not to eat after Hip Replacement?

To help your body recover naturally and prevent any negative effects of bone-healing foods, some foods that you should avoid include -

  • Caffeine,
  • Alcohol,
  • Processed foods,
  • Excessive sugar, and salt.

These can slow down the healing capacity of your body and lead to the depletion of nutrients. Try to eat natural foods to acquire nutrients so that the body can efficiently absorb them.

Summary: Some foods like junk and processed foods, caffeine, and alcohol must be excluded from our diet. They act as a barrier in recovery processes.

How long do I need after hip surgery to walk normally?

Most patients can resume their daily lifestyle after about 3-6 weeks of the medical procedure. However, one needs to make sure that one shouldn’t perform high-impact exercises. Regular exercises that do not strain the surgery site and a balanced diet can help you make a quick recovery.

Summary: It may require almost 2 months to come back to a normal lifestyle. Regular exercise can help the patients to walk normally.

Are the results of the Hip Replacement permanent?

Studies suggest that over 90% of hip replacement implants work even after 10 to 15 years after the surgery. For exact facts and figures, refer to the points below:

  • 60% of hip replacement surgeries last over 25 years

  • 70% of surgeries last at least 20 years

  • 90% of hip replacement procedures last over 15 years

Summary: Hip replacement surgery usually provides permanent results. Nevertheless, it can change according to how severe the symptoms are.

What are the post-treatment guidelines for Hip Replacement?

Your doctor will create a detailed post-treatment recovery plan to help you get back to your day-to-day activities as fast as possible. Doctors will include rehabilitation and physical therapy immediately after surgery.

They will monitor your strength and flexibility to check whether the recovery is working for you or not. Your physical therapist will follow this recovery process to help you regain your strength and return to your daily lifestyle.

Summary: Post-treatment guidelines after hip replacement treatment often include physical therapy and some other methods. To speed up healing, these are crucial and must be followed.

What are the side effects of Hip Replacement?

Hip replacement surgery takes place under anesthesia which can have several risks and complications. These can happen immediately after surgery or several years later:

  • Bleeding and Blood Clots

  • Infection

  • Loosening and breakage of implants

  • Change in leg length

  • Weakness and fracture

  • Dislocation and stiffness

Summary: Apart from all benefits, hip replacement surgery causes some side effects too. They can be experienced sooner or later after the surgery.

What is Hip Replacement's outlook and prognosis?

Hip replacement surgeries are highly successful and reports suggest complete elimination of pain after a few years. Out of all complications mentioned, the most common is dislocation of the hip implants.

However, new prosthetics are comparatively safer and the chances of riskier complications like blood clots are reduced. Ensure that you do not indulge in high-impact activities and keep obesity at bay to avoid excess pressure on the implants.

Summary: It is often observed that result of hip replacement surgery is very much successful. It helps to eradicate the pain and discomfort gradually.

What not to do after Hip replacement?

Some common tips to keep in mind after a hip replacement procedure comprise:-

  • Do not avoid moving and resting as per your physiotherapist's guidelines

  • Do not bend your upper body or at the waist (not more than 90 degrees)

  • Do not sit cross-legged or lift your knees up

  • Do not put stress on your hips by twisting or bending them

Summary: The above-stated points must be made after Hip replacement surgery. We must be careful about the affected area.

Hip Replacement - Outlook / Prognosis

Full recovery from hip replacement depends on a person's medical record and circumstances. A general duration is around three months after the surgery. However, most people can observe improvements in the first year. It will help reduce pain and increase the range of motion for better recovery

Summary: Depending on the patient's condition, complete healing and progress may take some time. However, the success rate of surgery is quite good.

Frequently Asked Questions (FAQs)

Can MRI be done with Hip replacement?

Some old MRI scan equipment is not compatible with hip replacement implants. However most MRI equipment today is safe and compatible with prosthetics. MRI scan of other body parts after a hip replacement surgery is safe.

Can you do squats after Hip replacement?

Moving your hips after a hip replacement surgery is risky, but with proper precautions, one can easily perform squats. Make sure to receive clearance from your physiotherapist and primary healthcare provider before attempting a squat after 8 weeks of the surgery.

How long will a stryker Hip replacement last?

You cannot expect an artificial prosthetic to last forever. However, the average life expectancy of a hip implant is around 15 to 20 years. Stryker was a popular choice for hip replacement up until some of its models were reclaimed by the FDA.

How successful are Hip replacements?

Hip replacement surgeries are regarded as a few of the most thriving medical operations. With over a 90% success rate, hip replacements are a safe procedure

How to massage after Hip replacement?

Massage therapy is important in the recovery process after hip replacement. However, attempting it by yourself can be harmful and might have a negative impact. We suggest you consult an expert physiotherapist after clearance from your regular healthcare provider to reap the benefits of a massage.

How to sit after Hip replacement?

After hip replacement, you need to move carefully for a safe recovery. Some steps to sitting down after surgery include:-
  • Move to the back of your chair or bed until the back of your knees touch them
  • Reach your hands back to touch the armrests and hold yourself still
  • Lower yourself to move to a seated position without bending forward at the trunk

Is Hip replacement covered under insurance?

Most health insurance plans do cover hip replacement surgeries to help you save money. However, it depends on the provider and the plan you are under. Hence, it is best to contact your insurance company for more details.

Is Hip replacement worth it?

Hip replacement has a success rate of over 90% and is considered one of the safest surgeries in the industry. With the least chance of future complications, experts suggest getting the surgery to relieve the pain. Moreover, your medical team of experts will ensure you do not face any complications and make a safe recovery.

Do you have a meniscus after the hip replacement surgery?

The meniscus is a rubber cartilage present between the thighbone and the shinbone. A torn meniscus needs surgery and is a form of a knee injury. It might also cause problems with the hip joint making hip replacement necessary.

How long does a titanium Hip implant last?

Hip replacements last for an average of 10 to 15 years, but modern implants might last longer. For example, a titanium hip replacement lasts over 15 years and is much more durable.

How much blood is lost during a hip replacement procedure?

Blood loss depends on several factors like the height and weight of the patient. A clinical test reported that blood transfusion was needed for about 74% of patients. However, the results might vary from clinic to clinic.

How to treat nerve pain after Hip replacement?

Nerve Pain after hip replacement occurs due to inflammation, but it can be healed easily. Continuous physical therapy can help you treat nerve pain within 12 weeks after hip replacement surgery.

Is Hip replacement considered major surgery?

Hip replacement is considered major surgery but the high success rate makes it a safe procedure.

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Written ByDr. Sidharth Verma PDCC - Pain Management,MD - Anaesthesiology,DNB Anaesthesiology,MBBSOrthopaedics
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