Two locations to choose from: 1000 Galloping Hill Rd #202, Union, NJ 07083 | 654 Broadway, Bayonne, NJ 07002
TOTAL HIP REPLACEMENT
The hip joint is a ball and socket joint and is formed by the upper part of the thigh bone (femur) and the hip bone. the upper end of the femur is ball shaped and is called the head of the femur.
The Hip Joint
The hip joint is a ball and socket joint and is formed by the upper part of the thigh bone (femur) and the hip bone. the upper end of the femur is ball shaped and is called the head of the femur. The socket of the hip bone is cup shaped and is called the acetabulum. The surfaces of the head of the femur and the acetabulum are coated with a smooth lining of cartilage that allows movement with very little friction. However, diseases of the hip may make these smooth surfaces so rough and irregular and that movement becomes very difficult and painful. The hip may then have to be replaced with an artificial (prosthetic) hip.
Arthritis of the Hip
Diseases that primarily damage joints are known as arthritis. One of the most common types of arthritis that requires hip replacement is osteoarthitis. This results from years of ordinary use that wear away the coating of smooth cartilage that covers the ends of the bones inside the knee joint. First the cartilage becomes rough and then it is gradually but completely worn away in areas where there is the most friction. Pain occurs when bones come directly in contact with each other where there is no more cartilage. Nodules of cartilage pile up at the edges of the joint where there is little friction. Traumatic arthritis is similar to osteoarthitis but the wear and tear is accelerated because of previous injury to the knee joint which did not heal properly. Rheumatoid arthritis and osteonecrosis are other conditions that can damage the hip. In rheumatoid arthritis, the body's immune system attacks the tissues of the joint. In osteonecrosis, the blood supply to the head of the femur is cut off so that a part of the bone dies and becomes deformed.
Diagnosis of Your Hip Problem
During your office visit, we will ask you where you feel pain and for how long you have had it. We also need to know if you have ever injured your hip recently or in the past, and whether you have any other problems that may impact your treatment such as diabetes, high blood pressure, previously diagnosed arthritis, bleeding disorders, or sensitivity to anesthesia. You should also tell us of any medications you are currently taking since some of these, like aspirin, ibuprofen, and blood thinners may cause bleeding if you have surgery. We will examine your knee for its range of motion, and how you move, bend, walk, and sit. X-rays will help us determine the size, shape and condition of the bones of your hip. They also help us with fitting your new hip. You may require other types of tests such as an EKG (electrocardiogram) and blood tests. We may remove some joint fluid (joint aspiration) to check for infection.
Before the day of surgery arrives you should take care of a number of things. Considering that you will have some difficulty moving immediately after surgery, you should arrange to have someone drive you home after surgery and help you with household errands for several weeks after surgery. Arrange items at home - set up your sleeping area where you can limit the number of times you have to use the stairs, store a generous amount of non-perishable food (canned, frozen, and dried) and keep it at an easily reachable level, remove small rugs and tape down electrical cords to prevent falls. Since you should not bend the artificial hip too far it is a good idea to purchase items like a raised toilet seat, a bath bench, and long-handled grippers to reach things on the floor.
Have dental work completed before surgery so that germs from your mouth do not infect your prosthesis. Donate blood for yourself (autologous donation) to be used to replace blood lost during surgery. If necessary, tested blood from other donors can usually be obtained from the hospital's blood bank. You may need to stop taking medications (like aspirin) which might cause bleeding problems during surgery. Losing excess weight helps to reduce the amount of stress you put on your new hip. You should also stop smoking to reduce the risk of lung complications after surgery.
You will be told not to eat or drink anything after midnight the night before surgery. You will generally come to the hospital either the day before or on the day of surgery. When you come to the operating room your vital signs (pulse, blood pressure, temperature, and breathing) will be checked and you will be given an IV (intravenous) line and perhaps an injection to help you relax. General anesthesia will allow you to sleep through the operation.
We will make an incision down the side of your hip, remove the head of the femur and replace it with a shiny metal ball. After we scrape out the bone from the acetabulum of your hip bone we will replace it with a sturdy, plastic cup shaped device will become your new hip socket. The X-rays that were taken of your knee help us to place the different parts of the prosthesis in the right locations. Once we are satisfied that the prosthesis fits properly we will secure it in place. When we are finished with the hip replacement and are ready to close the incision, a tube is inserted to drain excess fluid. The diseased bone and tissues that we remove are sent to the pathology department for examination.
Although hip replacement is generally a safe procedure, sometimes complications occur. These complications may include infection, blood clots in your legs, and damage to the muscles, blood vessels, and nerves around the hip.
After surgery you will be moved to the recovery room where your condition will be closely watched until your anesthesia wears off. At this time you will be given medication to control pain and you may also be given a catheter to drain urine from your bladder. A pillow may be put between your legs to keep your new hip in the proper position. To prevent pneumonia, you should cough frequently and take deep breaths. This clears your lungs of fluid that has accumulated during surgery.
Afterwards you will be moved from the recovery room to your hospital room where condition will continue to be watched. You will probably need one to two days of bed rest. Your pain medications will also continue. Special stockings may be applied to prevent blood clots from forming in your legs. A special pillow is used to keep your legs at shoulder-width and to prevent your legs from rotating inwards. A physical therapist will teach you how to exercise and walk. You will learn how to gradually increase the amount of weight you put on your artificial hip by progressing from a walker to crutches to a cane. Exercise is necessary to strengthen your muscles and increase your range of motion. You may have difficulty balancing since your artificial hip does not contain any nerves and therefore your brain cannot automatically know how much the hip is bent. Gait training helps you learn to balance when walking.
When you are ready to be discharged, your sutures and bandages should already have been removed and you may receive additional pain medications to take with you. An occupational therapist may speak to you about how to manage your physical activities at home and you may get other instructions as well. You are encouraged to ask questions.
Once you are home you should take care not to overuse your new hip so that your own natural tissues get a chance to grow around your prosthesis and hold it in place. Do not bend more than 90 º at the hip. Avoid bending down to pick things up from the floor. To keep your hip in the proper position when sitting you may need to put a pillow on your chair so that you keep your hips above knee-level. Keep your knees 3 to 6 inches apart while sitting. Don't cross your legs while sitting or lying down.
Since it usually takes several months for complete healing, it is advisable to get help from your family and friends for your daily activities. Using a cane helps to reduce the weight that your new hip bears while walking. Avoid sports like tennis and skiing that put a lot of stress on your hip - eventually you should, however, be able to engage in activities like swimming, upper body exercises, and golf using a golfcart. Use hand-rails and low shoes to help you balance. If you ever need dental work or minor surgery, tell the dentist or doctor about your prosthesis since these procedures may allow bacteria to get into your bloodstream and cause an infection in your artificial hip. You will probably be given antibiotics to prevent this. Take care of your prosthesis and it should last you for many years. If your prosthesis does wear out, it can be replaced with a new prosthesis.
Call Us If ...
If you have any of the following, CALL US (Union office: 908-964-6600, Bayonne office: 201-858-1500):
• sudden shortness of breath or chest pain
• increase in hip pain
• excessive warmth, redness, or discharge from the incision site
• swelling or pain of the calf or leg
1000 Galloping Hill Rd
#202, Union, NJ 07083
Tel: 908 964-6600
Fax: 908 364-1025
Bayonne, NJ 07002
Tel: 201 858-1500