Hip replacement surgery: Exploring your options for a pain-free life

If you experience worsening hip pain that is making it difficult to move and do the things you want, hip replacement surgery may be an option for relief. Learn more below about what to expect as you explore hip replacement surgery.

The hip joint is a ball and socket that connects the top of your thigh bone (femur) to your pelvis. There is a layer of cartilage between the ball and socket that works as a shock absorber. Hip replacement surgery may be necessary when this layer is worn down by osteoarthritis, injury or other conditions.

“Losing this layer of cartilage in your hip is like losing tread on your car tires. When the car tire is gone, you’re riding on the rim. In the hip joint, the ball starts rubbing against socket bone, which causes pain and stiffness,” says Rory Sandberg, MD, an orthopedic surgeon specializing in hip and knee replacement at IU Health Ball Memorial Hospital. “In a total hip replacement surgery, we replace the worn-out ball and socket with man-made materials, alleviating the pain.”

Most people who have total hip replacement surgery are experiencing pain from osteoarthritis or rheumatoid arthritis in the hip joint. Patients also undergo hip replacement surgery to treat hip fractures, hip birth defects, hip dysplasia, or osteonecrosis, where blood supply to the hip bone is interrupted and causes bone collapse.

Patients of all ages may need hip replacement surgery. These are people experiencing:

• Pain in the groin or at the front of the hip or thigh.
• Pain that gets worse from weight-bearing activities like walking, standing from a seated position or putting on socks.
• Stiffness in the hip that limits motion, such as bending over or lifting the leg.

Most hip replacement surgeries are total hip replacements, although some rare fractures to the upper thigh bone require a partial hip replacement surgery. Partial hip replacement surgery replaces only the top of the thigh bone, and the recovery is similar to total replacement.

What to expect

You will have a pre-operative evaluation before your hip replacement surgery. This helps ensure you are healthy enough to undergo surgery. You’ll learn what to expect from the surgery and how to prepare your home for recovery. This includes:

• Making sure your home is well lit.
• Removing fall or trip hazards like clutter, rugs or loose carpet.
• Finding a pet sitter for animals who may be underfoot.
• Ensuring the bathroom is accessible with safety bars or an elevated seat.
• Freezing prepared meals for easy cooking.

Also, it’s important to have a close friend or family member stay with you immediately after surgery.

“Although most patients are up, walking on the hip the day of surgery, it’s good to have someone around those first few days,” Dr. Sandberg says. “They won’t need to help change incision dressings or assist you in the bathroom; you just need someone there in case you fall.”

Hip replacement surgeries can be done as an outpatient procedure, although some people may need to stay one night in the hospital. You receive dissolvable stitches that won’t need to be removed. A physical therapist meets with you before you leave the hospital to ensure you can walk using a walker. From there, Dr. Sandberg says walking is the main source of physical therapy for hip replacement surgery recovery.

“After hip replacement surgery, patients don’t need intense physical therapy like they would if they were getting a knee replaced,” Dr. Sandberg says. “Generally, I don’t send people to physical therapy after hip replacement. I tell them to walk. Walking helps improve pain and limping. Patients usually go from a walker to a cane on their own and stop using the cane in four to six weeks after surgery.”

Managing pain

Patients receive a spinal anesthetic for the surgery, which wears off a couple of hours later. To manage pain at home, doctors prescribe narcotic pain relievers plus Tylenol, ice, anti-inflammatory medications and steroids. Most patients stop using narcotic pain medications a couple of weeks after surgery, which is necessary to drive a car. Patients may be able to drive a car if their left hip was replaced, however, the right hip may need six weeks to recover full braking reaction time.

Dr. Sandberg says patients typically feel that their pain improves within a few days after surgery, and the functional recovery of the replaced hip will continue for months thereafter.

“Soon after surgery, people say their hip feels different. They may have surgical pain, but that deep pain they’ve had for years is improved, if not gone,” Dr. Sandberg says. “The most rapid recovery happens in the first six weeks after hip replacement surgery, and data tells us people continue to recover for a full year afterward.”