Total Hip Replacement or THR is an open surgical procedure that allows us to replace the damaged or arthritic hip joint with a resurfacing of the thigh bone(femur) and pelvis (acetabulum) with metal, plastic or ceramic surfaces. I approach the hip through an anterior approach allowing for preservation of the muscles and tendons with a minimally invasive approach. This also preserves the tissues in the back of the hip and allows for fewer restrictions on activities than with the more traditional posterior approach. On the cup side (acetabulum) a metal cup, that allows for bony ingrowth, is placed. A liner or polyethylene (plastic) is inserted into the metal cup to produce the new surface for the femoral head. A short metal stem is placed in the femur with a metal or ceramic head. This allows for smooth range of motion. The new design that we use is the DJO Taperfill for total hip replacement.
This hip replacement is a special design that allows for insertion through a minimal incision muscle sparing approach. This advanced prosthesis is designed for more normal activities and longer lifespan. A recent article in the New York Times discusses this approach. Now the hip replacement surgery is guided with the use of state of the art computer navigation. Computer assisted surgery allows for more precise placement of the hip components and restoration of leg length. It is the newest addition to our state of the art care.
Prior to surgery, you will meet with the total joint coordinator who will assist you in your preparation for surgery, monitor your recovery and transition to home. You will meet with a medical doctor to ensure that you are healthy and fit for surgery. You will meet with a physical therapist to understand the exercises before and after surgery.
On the day of surgery, the anesthesiologist will discuss with you the best anesthesia for you. You will then be taken to the operating suite where surgery will last approximately 2 hours. You will then be in the recovery room for approximately 40 minutes. You will then be transferred to your hospital room. The physical therapist will drop by that day to start some simple exercises.
We expect you to be hospitalized for 1-2 nights in which time you recover from surgery achieving good pain control, early motion, independence in daily activities, blood clot prevention, and early exercises including walking. After your discharge from the hospital you will attend physical therapy as an outpatient.
The suture repairing your skin wound is under the skin and will reabsorb. We then follow you in our office for an initial wound check and at monthly intervals to ensure a complication-free recovery from your surgery. Your initial recovery will last 3-4 months. We then allow you to be on an independent exercise and activity program. We follow you at yearly intervals to ensure with x-rays that the prostheses continues to function as expected. We recommend antibiotics for any invasive procedures for the first six months after surgery if your immune system is not compromised. We like to discuss future athletic endeavors and activities to ensure the long-lasting function of your new hip replacement.