Orthopaedics

Total Hip Replacement

Alternative names: Total Hip Arthroplasty (THA)

Ted's Story (Flash 05:48)

Ted, 55, is an active sportsman who enjoys mountaineering. Read about how he made his decision to have a total hip replacement and what the recovery period was like.

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What is a total hip replacement?

Total hip replacement (THR) is a procedure that has brought increased mobility and less pain to hundreds of thousands of people. Orthopaedic surgeons replace a painful, dysfunctional joint with a highly functional, long-lasting artificial joint. In the past few decades, there have been many advances in the use of artificial hip joints, resulting in a high percentage of successful long-term outcomes.

The hip is a ball-and-socket joint. The round head of the thighbone (femur) moves inside the hollow socket (acetabulum) of the pelvis. This is what allows your leg to swing easily from your hip. To duplicate this action, a total hip replacement implant has three parts: the stem, which fits into the femur and provides stability; the ball, which replaces the spherical head of the femur; and the cup, which replaces the worn-out hip socket. Each part comes in various sizes in order to accommodate various body sizes and types.

What is a partial hip replacement?

If only one part of the joint is damaged or diseased, a partial hip replacement may be recommended. In most cases, the pelvic socket is left intact and the head of the femur is replaced, using a component similar to those of a total hip replacement. Another option uses a device resembling a half circle which fits over the head of the femur so that it need not be replaced. This is fixed to the femur with cement around the femoral head and has a short stem that passes into the femoral neck.

Why would a doctor recommend a total hip replacement?

Total hip replacements are usually performed for serious arthritic conditions. The operation is sometimes performed for other problems such as hip fractures or aseptic necrosis (a condition in which the bone of the hip ball dies). Circumstances vary, but generally patients are considered for total hip replacements if:

  • The pain is severe enough to restrict not only work and recreation, but also the ordinary activities of daily living
  • The pain is not relieved by arthritis (anti-inflammatory) medicine, the use of a cane, and restricting activities
  • There is significant stiffness of the hip
  • X-rays show advanced arthritis, or other problems

What does hip replacement surgery involve?

Several visits to the hospital will probably be necessary before the day of your surgery. In most cases you will be asked to donate some of your own blood for transfusion purposes, and you will also be asked to stop taking certain medications before the operation.

Depending on the type of hip replacement you have (total or partial), the surgery itself can take from two to four hours. Most patients remain in hospital for three or four days after the procedure.

For more information view the DHMC Total Hip Replacement Guide.

How long is the recovery after hip replacement surgery?

After the initial time in hospital, you will need to have some help at home since you will not have regained mobility or full strength for several weeks or sometimes months. Patients without help at home may need to arrange to spend some time in a care facility. Your doctor will discuss the recovery period with you and will arrange for you to have a follow-up appointment after about six to eight weeks.

Hip replacement operations are very successful in relieving pain and restoring movement. However, there can be ongoing problems with wear which may eventually necessitate further surgery, including replacing the prosthesis (revision surgery). Men and patients who weigh more than 165 pounds have higher rates of failure. The chance of a hip replacement lasting 20 years is about 80 percent.