Your hip is a ball-and-socket joint. The top of your thigh bone fits into the socket in your pelvis. Cartilage cushions the bones of the joint, so it rotates smoothly.

Over your lifetime, this joint moves thousands and thousands of times. With age, the joint can wear out, eroding the cartilage. Injury, like a fracture, can also damage the joint.

Hip replacement surgery means removing a damaged or worn-out hip joint and replacing it with an artificial one. Your new hip joint can be metal, plastic or ceramic.

Also called total hip arthroplasty, hip replacement helps your hip move like a normal hip. After recovering from the surgery, most people have much less pain and much better mobility.

Conditions hip replacement treats

• Hip osteoarthritis: Age-related wear-and-tear arthritis
• Hip dysplasia: When the hip bones don’t fit together as they should
• Hip osteonecrosis: When there isn’t enough blood supply to the hip, the bone dies (also called avascular necrosis)
• Hip injuries: For example, orthopaedic trauma from falling

What is an anterior approach to hip replacement?

The surgeon can get to your hip joint from the back (posterior), side (lateral) or front (anterior) of the hip.

For a long time, most surgeons used the posterior approach. Depending on your anatomy, it’s sometimes still the best approach.

However, anterior hip replacement has become more popular in recent years. There is less tissue damage therefore less pain and quicker healing.

Not all hip surgeons perform the anterior approach because it takes special training. Carilion surgeons have been performing the anterior approach since 2009. We were the first in the area to do so.

Osteoarthritis is the most common reason that people seek hip replacement. Because it’s a “wear and tear” condition, it worsens over time. Not everyone with arthritis in their hip will need a hip replacement. 

To treat your hip pain, you and your orthopaedic doctor will try other treatments first, including: 

• Medicines: These include over-the-counter and prescription anti-inflammatories and medicines to manage hip pain
• Pain injections: Steroid injections into your hip joint can help you manage pain for months
• Physical therapy (PT): PT can help stretch and strengthen the muscles that stabilize your hip

You might be a good candidate for hip replacement if you’ve tried these treatments and still have: 

• Severe hip pain that limits your everyday movement, for example, if you can’t walk more than a few minutes or climb stairs without pain
• Hip stiffness that makes it hard to move or lift your leg
• Hip pain that happens while resting, including at night when trying to sleep

Hip preservation and prolong hip replacement

Most people who get hip replacements are over the age of 50. But hip pain can strike younger people, too.

Athletes and active people often have hip problems related to the repetitive motions of their sport. The shape of their bones can also be a factor. Common athletic hip injuries include hip labral tears and hip impingement.

We try to preserve your hip joint for as long as possible, so you don’t need hip replacement at a young age. At Carilion, we offer a range of hip preservation surgeries to fix labral tears, reshape bones and improve pain and mobility.

Once you decide to have hip replacement surgery, you’ll attend Joint Academy at Carilion. This class helps you prepare for surgery and know what to expect.

The healthier and stronger you are before surgery, the easier your recovery will be. In the class, you’ll learn things like:

• Foods you should eat before surgery and during recovery
• “Pre-hab” exercises to do before surgery
• What to expect with physical therapy after surgery
• Tests you need before surgery
• How to set up your home for success after surgery

Day of surgery

For hip replacement, you’ll either have general anesthesia (asleep) or regional light sedation. Your surgical team will talk to you about which is best for you.

Hip replacement surgery usually takes 1 to 2 hours.

You might be a candidate for same-day hip replacement surgery, where you go home the same day as your surgery and start your recovery there. You’ll need someone with you who can take you home.

Your team will make sure you have what you need to manage your pain after surgery. You’ll need someone at home to help care for you for at least the first week after surgery.

Recovery

Whether you're going home or spending the night after surgery, your care team will get you up and moving shortly after your operation. You’ll learn specific physical therapy exercises to do right away.

Your doctor will give you a set of post-surgery instructions to follow. This will cover how to care for your incision and any warning signs to look for.

You’ll also work with a physical therapist in a rehab program. You’ll have PT at home for the first few days. Then, you’ll go to an outpatient PT location.

As for hip replacement recovery time, you should be able to get back to many activities of daily living 3 to 6 weeks after surgery. Your PT will work with you to build your strength and slowly increase your mobility.

All surgeries come with risks. For joint replacement, the ones we’re most concerned about are: 

• Infection: If bacteria settle on your artificial hip joint, it can become infected. The replacement parts can’t fight off germs the way your body parts can. You may need to take antibiotics after surgery. Fever, chills, increasing redness or swelling around the joint are all signs of infection.
• Blood clots: A blood clot in your leg can break off and travel to your lungs. This is a life-threatening condition. It’s why your doctor will likely have you take blood-thinning medicine after hip surgery.
• Falls after surgery: A fall in the weeks after surgery can delay your recovery and even cause you to need another surgery. Your care team will talk to you about preventing falls after hip surgery.