While hip replacement is a straightforward procedure, there arevariations in the techniques and artificial hip joint products used. Some of these options are advertised directly to consumers, claiming to be less invasive, better at preserving muscle tissue, requiring less recovery time or delivering an earlier return to a greater level of activity.
To help you make the best decisions about your hip replacement, we offer answers to the following frequently asked questions:
I’ve heard about two surgical approaches — Anterior and Posterior — which is better?
The Direct Anterior Approach (DAA) involves an incision through the front of the hip. In the Posterolateral Approach (PA), the incision is made through the back of the hip. Michigan Medicine researchers have analyzed a large volume of patient data on both approaches, and report no difference in the number of complications, hip dislocations or recovery time between the two. Read the Michigan Medicine researchers' report, "No Difference in Dislocation Seen in Anterior Vs Posterior Approach Total Hip Arthroplasty", on arthroplastyjournal.com.
What about hip resurfacing?
Marketed as a less invasive alternative to traditional hip replacement, hip resurfacing does not involve removing the end of the femur. Instead, the surgeon trims the end of the femur and covers it with a smooth metal cap and replaces the hip socket with a metal shell. Here too, researchers at top institutions like Michigan Medicine analyzing patient data have found that hip resurfacing has not performed as well as the conventional stemmed replacement.
How do I choose a surgeon for my hip replacement?
As with any surgery, the higher the volume of a specific procedure a surgeon and hospital perform, the better the patient outcomes. Seek out a surgeon who performs a high volume total hip replacements.
Also, there are a number of different types of artificial hip implants from a number of different manufacturers. Ask the surgeon which artificial implant(s) he or she uses, and how those implants perform over time.
Performance data about hip implants is collected and maintained in patient registries. Michigan Medicine is the Coordinating Center for the Michigan Arthroplasty Collaborative Quality Initiative (MARCQI), which tracks data about hip and knee replacements performed in the state of Michigan, including detailed performance information about each artificial implant.
In addition to asking about surgical volume and implant preferences, you should choose a surgeon with whom you can establish a good rapport, and one who participates in MARCQI.
How long does surgery take?
While the actual replacement procedure might take only an hour, there are numerous steps before and after surgery that can make the entire process take several hours.
Following surgery, a whole team will attend to your recovery, including helping control any post-operative pain.
Hip replacement does not usually require an overnight stay in the hospital. If your care team determines that you are able to perform certain post-operative physical movements (standing, walking, climbing a few steps) while maintaining a safe blood pressure, and if you are able to void or empty your bladder, you can usually return home within six to 12 hours of your surgery.
Patients with medical conditions such as heart disease or kidney failure, and those who are unable to empty their bladder may require spending more time in the hospital for additional monitoring.
What are the possible risks and side effects of hip replacement surgery?
While the risks are low, some complications can result from hip replacement:
- Less than one percent of patients undergoing any type of surgery will have some cardiovascular event such as a stroke or heart attackbrought on by the stress of the event.
- About 0.5 percent of patients develop an infection.
- About one percent of patients experience a dislocation of the hip.
- Depending on the type of implant, less than five percent of patients may need revision surgery because of a fracture.
Assuming none of these major events occurs, a patient may experience some muscle soreness when flexing or lifting the thigh, or the sensation that one leg is longer than the other. Despite these side effects, most patients report being very satisfied with the decision to have hip replacement surgery.
How long does it take to recover from surgery?
While the time it takes to fully recover can vary significantly based on the individual patient and the type of procedure, in general, recovering from hip replacement surgery is relatively quick. Most patients achieve immediate relief from their pain and mobility symptoms, with only minor soreness near the incision.
Patients are advised to take it easy in the days right after surgery. A cane is recommended for walking within the first few weeks, and they can begin walking or biking for a longer distance within four to six weeks.
Patients are advised to avoid high impact activities like running or basketball after hip replacement. On a case-by-case basis, however, some surgeons may allow patients to resume these high impact activities.
Within months, the vast majority of patients return to full activity with little to no pain.
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.