Hip Replacement

If you have problems walking, your hip joint may be damaged to the point of needing a hip replacement in the form of a new, man-made joint. The hip is a ball and socket joint. The thighbone, or femur, ends in a rounded outcropping that comes off the bone at a little more than a 90-degree angle. This ball fits into an open compartment created by the pelvis.

Through the use of cartilage to cushion the joint, your body is able to take a great deal of stress and pounding during strenuous activities. This joint is responsible for moving your leg throughout the range of motion required for walking and running. Any breakdown of the bone, the joint cartilage, or the surrounding muscles and ligaments can land you in a world of pain.

Reasons for Replacement

You will likely need a hip replacement surgery if you sustain some damage to the protective cartilage in the joint or to the bones that make up the hip. Some common reasons for hip replacement are osteoarthritis, rheumatoid arthritis, a broken hip, a tumor on the bone, or a condition that causes necrosis of the joint. Other reasons may bring you to a hip replacement, but the most common reasons are fracture and arthritis.

You might experience symptoms that lead your doctors to believe you need a hip replacement. For instance, persistent pain in the hip joint despite pain medication is a good indicator of a need for the surgery. Pain when walking, even with a cane or other assistive device, is another good indicator. Pain that wakes you from sleep, gives you trouble with stairs, causes difficulty rising from a chair, and an inability to enjoy once pleasurable activities, are all signs that your hip joint is diseased. When all other treatment modalities and physical therapy fail to alleviate pain, it is likely time for a replacement joint.

The Procedure

Hip replacement surgery is a complex surgery that requires a skilled surgeon. The surgeon will make a long incision down the outside of the affected leg. Through this incision, he will remove the head of the femur and take off the ball portion of the joint, along with some of the neck. He will then place the metal or ceramic ball joint on top of the modified femur. This is usually done by driving the arm of the prosthetic into the top of the exposed bone of the femur.

The second part of the surgery involves placing a cup-like apparatus into the pelvis to accept the new ball of the hip replacement. Although these devices are put in securely, it sometimes takes time for the bone to grow around the replacement and cement it in place. That is why the physical therapy and recovery restrictions after hip replacement are so important.

Risks and Recovery

Blood clots are the number one risk after hip surgery, and you should follow your doctor’s recommendations for post-surgery exercises to keep the blood in your legs moving. You may have to wear special compression socks during your recovery to prevent this side effect. Infection is another risk of surgery.

The hip replacement itself can experience a number of side effects, depending on how you rehabilitate after the surgery. The hip replacement can fracture surrounding bones if healthy parts of the bone are weakened after surgery. Careful physical therapy sometimes prevents this. Dislocation of the hip joint is another possibility, and this is why your doctor will restrict you from crossing your legs or moving in certain positions to prevent the ball from slipping out of socket. Loosening and breakage of the device are rare complications with newer replacement joints. You may also experience a change in leg length and stiffening of the hip joint, especially if you do not perform your physical therapy. Finally, the joint will wear out over time, usually about 10 years, and may need to be replaced in your lifetime.


Mayo Clinic; Hip Replacement; April 2011