What to know before getting a hip replacement

More than 500,000 hip replacements are performed each year in the United States, according to the American College of Rheumatology. “It's actually one of the surgeries that we do that has the best overall outcomes and success as far as patient happiness and patient's return to activity,” says Thad Dean, DO, an orthopedic surgeon in Fort Worth, Texas.

Hip replacements are performed in people who have damaged the ball and socket joint of the hip and experience pain or limited activity despite other treatments. The most common cause of damage is osteoarthritis, which causes pain, swelling, and limited motion in the joints. People with hip injuries or health conditions that affect joints—like rheumatoid arthritis—may also be good candidates for a replacement.

What happens during hip replacement surgery

During the procedure, damaged cartilage and bone from the hip are removed and replaced with man-made prostheses. The prostheses are typically made of metal, plastic, and ceramic, based on the surgeon’s preference and how long the implants need to last. Hip replacement surgery is usually a one-time procedure for older people, but younger people may need more than one surgery. “Whenever [hip replacements are] done in younger patients, there's a possibility that the patient will outlive the implant,” says Dean.

Surgery typically takes one to two hours. During the procedure, a 6- to 12-inch incision is made over the side of the hip, through the muscle. There, the damaged cartilage and bone is removed and replaced with the prosthesis. Minimally invasive surgery, which is also used for hip replacements, requires smaller incisions and a shorter recovery period.

Evidence suggests candidates who are younger than 50 years old, are relatively thin, and lack bone and joint deformity have the best success with mini-incision hip replacement surgery. People who are very muscular or have medical conditions that may slow the healing process may be riskier candidates for the minimally invasive surgery.

Risks of hip replacement

A hip replacement can relieve pain, improve walking and range of motion, and help the hip joint function more efficiently. But like any major surgery, hip replacements have some risks, such as infection. “We treat folks with antibiotics to try to prevent infection, but it's probably the biggest risk that's associated with the surgery,” says Dean. Signs of infection include pain, discoloration and swelling of the joint, and fever.

Another potential problem following surgery is hip dislocation. Dislocation occurs when the ball (rounded top of the femur bone) pops out of the hip socket. Relatively uncommon, it can often be fixed without additional surgery, though sometimes another procedure is needed.

Other potential issues include blood clots and inflammation, which can cause deterioration of bone. Some patients’ legs may also be slightly different lengths following their surgery.

Recovering from a hip replacement

The rate of recovery and success of hip replacement surgery is determined by activity level, health, age, degree of joint deterioration, and risk of infection. After surgery, patients should expect to spend a few days in the hospital and meet with a physical therapist.

Typically, people can return to normal activity two or three months after their hip replacement surgery, but individuals with prosthetic hips are usually encouraged to avoid high-impact activity, like running and jumping.