Hip arthritis typically occurs in adults aged 45 and older, when the cartilage that cushions the joint breaks down and eventually wears away. Characterized by pain and stiffness, severe cases can be profoundly debilitating.

If conservative treatments for hip joint pain fail to bring relief; if pain is impacting normal daily functioning and the ability to get a good night’s sleep, total hip replacement surgery (arthroplasty) may be recommended.

Surgeons approach the joint through an incision at the buttocks (posterior), the side of the leg (lateral) or through the front of the thing (anterior).  Surgeons consider many factors when anterior approach comparisondetermining which approach is the most appropriate for an individual patient.  For some patients, surgery can be safely performed under spinal anesthesia, however, minimal general anesthesia medication may be administered in consideration of a patient’s individual condition. 

During surgery, the surgeon removes damaged cartilage and bone, and implants the new prosthesis to reconstruct the joint.  The artificial joint has three main components: the socket (typically made of a metal alloy with a plastic insert [cushion]); the ball (which is typically made of ceramic); and a metal stem which is implanted into the upper portion of the femur and keeps the ball securely attached to the femur.  

The surfaces of the metal stem and socket are specially processed to encourage surrounding bone growth into and onto the metal. This provides long-term stability of the implants.  For some older patients with osteopenia/osteoporosis, the surgeon may use a special bone cement to attach the stem to the femur bone.

Hip Replacement SurgeryThe plastic insert is a high-density, highly cross-linked polyethylene.  The plastic is estimated to last more than 20 years.

DePuy – What to expect Before, During and After Hip Replacement

Total Hip Replacement overview by American Association of Orthopaedic Surgeons (AAOS)

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