Total Hip Replacement Surgery in Bethesda, MD
Your hip joint plays an important role in the activities you perform every day. It bears your body’s weight, and it also offers you stability as you stand, walk or run. If your hip joint becomes injured from trauma, arthritis or another hip-related condition, everyday tasks like getting in and out of a chair, putting on your shoes and even resting can begin to feel uncomfortable or painful. You may need a total hip replacement.
At OrthoBethesda in Bethesda, Maryland, our highly trained orthopedic surgeons can assess your condition to determine if total hip replacement surgery is the best treatment option for you.
What Is Total Hip Replacement?
Your hip is a ball and socket joint. The ball, called the femoral head, is part of your femur. The socket, called the acetabulum, is part of your pelvic bone. When your hip joint is healthy, the surfaces where the ball and socket rub together are smooth. Synovial fluid serves as a natural lubricant, and cartilage also covers and protects the bones. Ligaments provide additional stability by connecting the ball to the socket.
Damage can occur to the various components of your hip joint, causing intense pain as the damaged surfaces of the bones eventually wear. The main causes of hip damage include:
- Diseases causing bone death in joints
- Fractures and other injuries
- Bone tumors
When you meet with the orthopedic surgeons at OrthoBethesda, we will discuss conservative treatment options, such as medication or walking supports. However, if these do not relieve your hip pain, we may suggest total hip replacement surgery.
Also called total hip arthroplasty, this surgery involves removing the damaged ball and socket as well as other damaged tissue. Then the ball and socket are replaced with artificial parts, also called implants or prosthetics.
Two Types of Implant Fixation Techniques
Your implant consists of two basic components — the ball, which is made of a strong metal or ceramic, and the socket, made from durable ceramic, plastic or metal. One implant we could use to replace the socket is made of a metal shell with a plastic liner inside. The metal stem fits securely into the femur. The metal ball is either preattached so the whole thing is one piece or mounted to the stem during surgery.
Before your surgery, your OrthoBethesda physician will discuss two different types of fixation techniques for these implants and help you choose the type that best meets your needs:
- Cemented hip implants: This technique involves using bone cement to hold the implant in its proper position within the bone.
- Porous hip implants: This type of hip implant can be inserted without the use of bone cement. The implant fits snugly in place, and its porous surface allows the bone to grow around it. Eventually, the bone growth provides added security to hold the implant in its desired position.
Your Total Hip Replacement Surgery
Before your surgery, your orthopedic surgeon will go over everything you should know ahead of time, including which medications you should discontinue before surgery and what to bring with you to the hospital.
Depending on your individual condition, you can expect your total hip arthroplasty to follow these general steps:
- Once in the operating room, you’re given anesthesia.
- The skin around your upper thigh is thoroughly cleaned with antiseptic.
- An incision is made over the hip joint to give the surgeon access to the joint.
- To replace the socket portion of the joint, the head must first be dislocated from the socket.
- Then the surface of the socket and damaged cartilage is removed using a special reamer. It’s shaped so that the socket will match the shape of the implant to be inserted.
- Depending on which fixation technique is employed, the outside shell portion of the socket implant is attached using bone cement or pressing it tightly into place, so it’s held secure by friction. Your surgeon may also need to use screws so the implant won’t move.
- Once this shell is in place, the plastic liner portion of the socket implant is locked inside.
- To remove the damaged femoral head, the surgeon uses a power saw.
- The upper part of the femur has relatively soft bone tissue around its center which is called cancellous bone. This portion surrounds the canal that contains mainly fatty tissue and blood vessels.
- Some of the cancellous bone needs to be cleared from the canal so the surgeon can mold its inside walls to fit the implant stem.
- Like the socket portion, the stem implant can either be held in place with bone cement or by tightly fitting it into the canal.
- Depending on the type of implant used, the stem and ball will either be one piece or separate pieces. If the ball is separate, it will be secured to the top of the stem once the stem is inserted.
- Once the surgeon has inserted the hip implant components, the new ball is placed into the new socket. The surgeon may need to adjust ligaments surrounding the hip for the best possible hip function.
- Once everything is adjusted properly, the surgeon sews the layers of tissue back in place, and the patient can go to the recovery room.
The decision to have a total hip replacement is one that should be made very carefully. When you schedule an appointment at OrthoBethesda, our highly trained surgical team can walk you through the ins and outs of this procedure as well as provide you with conservative treatment alternatives.