FAQs on Total Hip Replacement Surgery

What is a total hip replacement?
A total hip replacement surgery or THR (also known as total hip arthroplasty, full hip replacement and complete hip replacement) is a procedure performed in order to treat:
• osteoarthritis of the hip joint (bone on bone)
• severe pain in hip joint
• loss of motion in hip joint
• deformity of the hip joint
• hip injuries
• rheumatoid arthritis
• bone tumor
• bone loss due to insufficient blood supply (avascular necrosis - AVN)


What are the components of a hip implant in a total hip replacement?
In a total hip replacement surgery, the painful parts of the damaged hip are replaced with artificial hip parts called a prosthesis, a device that substitutes or supplements a joint. The prosthesis consists of steel components: a socket, ball, and stem.

The outer shell of the socket is usually made of metal and the inner shell consists of plastic, or the entire socket may be plastic. When the metal ball is joined with the socket, the new hip can allow for smooth, nearly frictionless movement.


What are the different hip replacement implant options available?
The materials used in the implant depend on several factors, including the age of the patient, the activity level of the patient, and the surgeon's preference.
Below are brief generic descriptions of some of the most commonly used hip replacement implants.

• Metal and Plastic Implant
These are the most commonly used hip replacement implants. Both the ball and the socket of the hip joint are replaced with a metal prosthesis, and a plastic spacer is placed in between. The metals used include titanium, stainless steel, and cobalt chrome. The plastic is called polyethylene.

• Metal-on-Metal Implant
In this case there is no plastic piece inserted in between. Metal-on-metal implants do not wear out as quickly as the metal and plastic materials.

• Ceramic-on-Ceramic Implant
Ceramic bearings are available in 2 configurations: a ceramic femoral head (ball) with a polyethylene liner, or a ceramic femoral head (ball) with a ceramic liner. These are designed to be the most resistant to wear of all available hip replacement implants and they wear even less than the metal-on-metal implants. Ceramics are more scratch resistant and smoother than any of these other implant materials.

• Metal and Highly Crosslinked Polyethylene
One of the more commonly used implants are new types of plastic that are designed to be more resistant to wearing out. These so-called highly crosslinked plastics are manufactured in a way that they wear out less quickly than the traditional plastics. However, since these implants have been available only for a few years, no long-term data is present to establish how well they work compared to the traditional plastic implants.


How is the implant affixed in the body?
This is achieved in one of three ways:
• Bone Cement: A special type of bone acrylic cement may be used to secure some or all of the implant components to the bone. If used, the bone cement takes about 15 minutes to set.
• Press-Fit or Cementless: The implants may be "press-fit" into the bone. Press-fit components may have a special porous coating that allows bone tissue to grow up to it for fixation.
• Combination: Depending upon the implant components and condition of the pelvic and thigh bone, a combination of cement and press-fit attachment may be used.


Who are some of the hip replacement implant manufacturers?
Some of the hip replacement implants manufacturers are:
• Johnson & Johnson DePuy
• Stryker
• Biomet
• Zimmer
• Smith & Nephew


What activities can I do or not do after receiving a hip joint replacement?
• Typically, patients are advised to avoid high impact sports such as jogging, basketball, racquetball, gymnastics, etc.
• Safer activities may include walking, golf, swimming, and bicycling.


What is the MIS (minimally invasive surgery) approach in total hip replacement surgery? What are its benefits?
The MIS approach (also known as "keyhole surgery") in total hip replacement (THR) is an alternative to the traditional total hip replacement surgery. Traditional surgery involves a long incision and the surgeon has to cut muscles, tendons and ligaments to access the hip joint. The more tissues that are cut, the longer it usually takes patients to heal. The MIS approach is a less invasive approach of doing a hip replacement surgery in which the size of the cut is reduced. Newer surgical techniques and tools allow MIS surgeons to place the same hip implant in a manner that allows muscles and tendons to be avoided or separated, rather than cut. This makes rehabilitation faster and less painful and causes less scarring.

Some of the potential patient benefits of the MIS procedure are:
• A single, smaller incision
• Less tissue trauma
• Spares muscles and tendons, allowing for the possibility of a faster recovery
• Faster and less painful rehabilitation
• Shorter hospital stay
• Smaller scar
• Reduced blood loss and less need for pre-surgery blood donation
• Faster return to work and daily activities


Is there an alternative to total hip replacement?
Hip replacement is usually considered for patients who are older than 60. For younger active patients, a different surgery called Birmingham hip resurfacing is a better alternative. Compare hip replacement with hip resurfacing.


How much does a total hip replacement surgery cost?
Check out:
• Hip replacement in India
• Hip replacement in Belgium
• Hip replacement in Mexico


Who are some of the well-known surgeons who perform the hip replacement surgery?
• Dr. Vijay C. Bose
• Dr. Kaushal Malhan
• Dr. Yash Gulati
• Dr. Raju Vaishya
• Dr. Sanjiv KS Marya
• Dr. Koen De Smet
• Dr. Dario Garin


Check out patient stories here.


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