Hip Replacement

Total Hip Replacement
In total hip replacement surgery, the surgeon removes both the ball and socket of the damaged hip joint and replaces them with prosthetic components made of metal, plastic, or ceramic. This can be performed using a traditional anterior approach (through the front of the hip) or a posterior approach (through the back of the joint), with the posterior approach being the more conventional method.

Partial Hip Replacement
Partial hip replacement, also called hemiarthroplasty, involves replacing only the ball of the hip joint while leaving the socket intact. This procedure is commonly recommended for fractures or traumatic hip injuries where the femoral head is damaged beyond repair. It is not usually indicated for degenerative conditions affecting both the ball and socket.

Hip Resurfacing
Hip resurfacing preserves most of the natural hip joint. The damaged surface of the femoral head is capped with a thin metal shell, allowing the joint to maintain more of its original bone structure. This procedure carries a lower risk of dislocation and may allow patients to return to normal physical activity more quickly once healed.

Diagnosis Before Hip Replacement Surgery

• Medical History: The surgeon reviews your overall health and asks about the severity of your hip pain and its impact on daily activities.
• Physical Examination: Assessing hip strength, mobility, and alignment.
• X-rays: Imaging to evaluate the extent of joint damage or deformity.
• Other Tests: MRI or other imaging may be required to assess soft tissue and bone health.

Procedure of Hip Replacement Surgery

During total hip replacement, the damaged hip joint is removed and replaced with prosthetic components:

1. Femoral Component: The head of the thigh bone (femur) is removed and replaced with a metal stem inserted into the hollow center of the femur. The stem may be cemented or press-fit into the bone. A metal or ceramic ball is then placed on top of the stem.
2. Acetabular Component: The damaged socket (acetabulum) is replaced with a metal cup, which may be secured with screws or cement. A plastic, ceramic, or metal spacer is placed between the new ball and socket for smooth movement.

There are two main approaches to hip replacement surgery:

Traditional Hip Replacement Surgery
A 10- to 12-inch incision is made on the side of the hip, and surrounding muscles may be split or detached for full access to the joint. The damaged femoral head and acetabulum are removed, and the prosthetic components are placed as described above. Muscles and tissues are then repaired, and the hip is closed and dressed.

Minimally Invasive Hip Replacement Surgery
Minimally invasive surgery uses smaller incisions and causes less tissue disruption. The same implants as traditional surgery are used, but specialized instruments allow placement through one or two small incisions:

• Single Incision Surgery: A 3–6 inch incision is made, usually on the side or back of the hip, with limited detachment of muscles and tendons. The muscles are repaired after implant placement to support healing and reduce dislocation risk.
• Multiple Incision Surgery: Two small incisions are used—one to access the socket (pelvis) and one for the femur (thigh bone). This approach minimizes tissue disruption compared to a single incision.

X-ray guidance is often used during minimally invasive procedures to ensure accurate placement of the implants.