Surgery Benefits

Total hip replacement is one of the most successful of all surgical procedures. The expected initial success rate (which is an estimate of how many implants are doing well) is now 95-98%, except in certain circumstances. A success is defined as freedom from pain and restoration of motion as well as function. A successful hip replacement will allow a person to return to the routine activities of daily living. With the newer bearing materials (Cross-linked polyethylene, metal-on-metal and ceramics) most patients can also resume most recreational and work activities. Although some physicians today will allow unrestricted activity, we feel it is prudent to warn patients to try to avoid repetitive heavy lifting (over 50 pounds) and to limit impact loading such as running, jumping and jogging. Vigorous tennis and racketball are not advised but golf, swimming and bicycling are good exercises.

The use of larger femoral heads on the current implants, as well as improved surgical techniques, have allowed increased range of motion with less chance of dislocation. Some surgeons are allowing unrestricted motions. We however, still advise that for patients in whom the “posterior approach” is used in surgery (most patients in this practice), they should avoid positions of the leg in which the hip is flexed over 90 degrees combined with turning their knee inwards toward or across the midline of the body. Although the leg with a hip replacement can flex up to 120 degrees, it is not advised that you attempt to bend it more than 90 degrees unless the knees are kept apart. Therefore, squatting or sitting in very low chairs can be dangerous because of the possibility of dislocation of the hip. This can be avoided easily by keeping the knees apart when in these positions.

In the past, younger, more active patients have been considered “high risk” for total hip replacement. With the use of modern bearing materials and newer techniques, however, nearly all patients with severe arthritis of their hip are considered acceptable candidates for surgery.