How Hip Replacement Surgery Is Done

The first total hip replacement surgery was performed in the United States in 1969. Since that time, the growing number of active older Americans and improvements in technology have made the procedure more common.

Hip replacements offer a reduction in pain, improved mobility and the opportunity for patients to regain the quality of life they previously enjoyed.

Who undergoes hip replacement surgery in the U.S.?

Statistics provided by the U.S. Agency for Healthcare Research and Quality show that more than 350,000 hip replacement surgeries are performed nationwide each year. Although the prevalence does increase with age, patients who receive artificial hips come from all races and backgrounds.

Research presented at the American Academy of Orthopedic Surgeons (AAOS) annual meeting in 2014 shows the number of people in the U.S. living with an artifical hip to be in the range of 2.5 million. This includes about 1.4 million women and 1.1 million men.

Patients age 45 and over receive 95 percent of the artificial hips implanted each year, with about 6 percent of the population having a total hip replacement by their mid-80s.

Chart of the average age of hip and knee replacement in the US

Chart of the average age of hip and knee replacement in the US

Why are hip replacements necessary?

The hip is a ball-and-socket joint, made of a femoral head at the end of the leg that fits within the acetabulum on the pelvis. Under normal conditions, this allows a smooth, pain-free range of motion. When either of these structures are damaged, the result is often loss of function and debilitating pain.

Most hip replacements are necessitated by normal wear-and-tear that then led to osteoarthritis in the joint. Other common reasons a person may need hip replacement surgery include trauma, developmental dysplasia, reduced blood flow to the joint, abnormal growths and childhood hip disorders that cause excessive wear-and-tear.

How are a hip replacement and partial hip replacement surgery performed?

In general, there are three primary procedures known as “hip replacement.” During a total hip replacement surgery, both the femoral head and the socket it fits into are removed and replaced with an artificial joint. Partial hip replacement surgery removes the femoral head and stem while hip resurfacing replaces the socket.

Hip replacement set up

Hip replacement set up

How common are complications after a hip replacement?

No surgery comes without the risk of complications, and hip replacements are no different. Complications after a hip replacement procedures may lead to symptoms including:

  • Joint pain
  • Decreased range of motion
  • Implant loosening
  • Tissue death
  • Bone deterioration
  • Implant failure

About half of all patients who undergo a hip replacement experience heterotopic ossification, a hardening of the tissue around the implant. Luckily, though, this causes symptoms in only about 10 percent of those affected.

Almost three out of every four hip implant failures can be traced back to deterioration of the bone around the implant. Bone breaks around the implant, known as periprosthetic fractures, and implant loosening can also cause failure of the artificial joint.

Set up hip replacement

Set up hip replacement

Hip dislocations are rare following initial hip replacement surgeries, occurring in less than 5 percent of all cases. Following revision surgery, however, the risk rises to almost 20 percent. Dislocation is most common in the first few months following surgery.

Infections are also uncommon, occurring in only about 1 percent of patients. In some cases, the surgeon may open the surgical site to clean the infected area. For other patients, the artificial hip may need to be removed and another implant procedure scheduled for a later date.

While complications can occur after a hip replacement procedure, this surgery has allowed millions of people to regain mobility and live without debilitating pain. Whether used to treat arthritis or to help heal a hip fracture, artificial hip replacements have given many Americans an opportunity to reclaim a better quality of life.

Abstracts online

US National Library of Medicine 

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