The hip is one of the largest articulations in the human body. The joint is basically a ball inside a socket each covered with cartilage. When the cartilage wears out, the person has arthritis which can lead to disabling pain. The hip was one of the first joints to be studied for replacement.
Total hip replacements, sometimes called hip arthroplasty, have been done since 1960 and today more than one million hip replacements are performed each year in the US. The implants have significantly improved over the years. With most hip arthroplasties, the bone actually grows into the implant and cement is no longer needed to stabilize the components.
State of the art bearing surfaces have such low wear rates that modern hip replacements could a last lifetime. Dr Tenny frequently uses a direct anterior intermuscular approach to the hip, which is the least invasive way to replace a hip. No muscles are cut during the procedure and patient recovery is significantly faster.
Patient undergoing hip replacement are typically in the hospital for one day. Sometimes the procedure is performed as a day surgery. The procedure is performed the day of admission and therapy is started shortly after the procedure. Some people go to a rehabilitation center after discharge from the hospital while most go directly home.
Hip replacements are mechanical devices that can wear out with time. Our goal is to have the hip replacement last the rest of the patient's life. Avoiding high impact activities such as running and jumping as well as carrying excess body weight can help prolong the life of the implant.
Another cause of implant failure is infection. Our bodies are constantly bombarded with bacteria that our kidneys filter out or our immune system eliminate. If these bacteria settle on a foreign material in our body, such as a hip replacement, they can form a biofilm which is an extracellular matrix that antibiotics cannot penetrate. When this happens, the joint replacement usually needs to be removed to treat the infection.
In some cases our bodies can be exposed to high levels of bacteria, such as when we have an active infection or undergo a surgical procedure. Under these conditions, we may need to take an antibiotic that will cover the bacteria we might be exposed to. Current prophylatic antibiotic recommendations can be found at the The American Academy of Orthopedic Surgery web site.