Total Hip Replacement (THR)
Total Hip Replacement (THR)
Total Hip Replacement (THR), also known as Total Hip Arthroplasty, is a major surgical procedure where a damaged or diseased hip joint is replaced with an artificial joint (prosthesis). It is most commonly performed to treat advanced osteoarthritis, rheumatoid arthritis, or hip fractures.
When You Should Consider Total Hip Replacement
Hip pain that keeps you awake at night or limits daily activities like walking or bending.
Stiffness in the hip that limits the ability to move or lift the leg.
Inadequate pain relief from anti-inflammatory drugs, physical therapy, or walking supports.
Advanced joint damage or "bone-on-bone" contact visible on X-ray imaging.
Difficulty performing simple tasks such as putting on shoes and socks.
Methods of Total Hip Replacement
Posterior Approach (Back): The traditional method providing excellent visibility; involves a slightly higher risk of post-operative dislocation.
Anterior Approach (Front): A technique that parts the muscles rather than cutting them, often leading to less initial pain and a faster recovery.
Lateral Approach (Side): A balanced approach providing stable access to the joint, though it may cause temporary muscle irritation.
Cemented Fixation: Using specialized bone glue to secure the prosthesis, often used for older patients with thinner bone.
Press-fit (Cementless) Fixation: Featuring a porous metal surface that allows natural bone to grow into the implant over time.
How Total Hip Replacement Is Performed
Femoral Head Removal: The surgeon removes the damaged "ball" of the thigh bone to prepare for the new prosthesis.
Acetabular Preparation: The "socket" in the pelvic bone is hollowed out to fit the new artificial cup.
Cup and Liner Placement: A metal cup is pressed or screwed into the socket, and a plastic, ceramic, or metal liner is snapped inside.
Stem Insertion: A metal stem is inserted into the hollow center of the femur to provide a stable foundation.
Ball Attachment: A metal or ceramic ball is attached to the top of the stem to complete the new "ball-and-socket" joint.
Pre-Procedure Preparation
Comprehensive evaluation including X-rays to measure the exact "cup" and "ball" sizes for the implants.
"Pre-hab" exercises to strengthen the gluteal muscles, which are critical for supporting the new joint.
Medical clearance from specialists for patients with existing heart or lung conditions.
Fasting (NPO) and stopping specific medications, such as blood thinners, as directed by the surgical team.
Tests Before Total Hip Replacement
Hip X-rays: The primary tool used for surgical templating and assessing the severity of joint degradation.
Blood Panels: To ensure the patient is fit for surgery and to check for markers of systemic health.
Electrocardiogram (ECG): To evaluate heart function before the administration of spinal or general anesthesia.
Physical Assessment: To check current leg length and range of motion for post-operative comparison.
Life After Total Hip Replacement
Patients are typically required to stand and walk with a walker within 4 to 6 hours of surgery to prevent blood clots.
Hospital stays are generally 1 to 2 days, with some healthy patients eligible for same-day discharge.
Strict "hip precautions" are followed for 6–12 weeks, such as avoiding bending the hip past 90 degrees or crossing legs.
Mandatory use of blood thinners (Aspirin or Xarelto) for 3–6 weeks to prevent Deep Vein Thrombosis (DVT).
Most patients return to low-impact activities like walking, swimming, and cycling after the initial healing phase.
Benefits of Total Hip Replacement
Over 95% of patients report a total loss of hip pain and a significant increase in mobility.
Provides a highly durable solution, with modern implants expected to last 20 to 25 years.
Restores the ability to perform daily tasks that were previously impossible due to joint stiffness.
Corrects physical deformities and helps normalize gait and leg alignment.