During hip replacement, a surgeon removes the damaged sections of the hip joint and replaces them with parts usually constructed of metal, ceramic and very hard plastic. This artificial joint (prosthesis) helps reduce pain and improve function.

Also called total hip arthroplasty, hip replacement surgery might be an option if hip pain interferes with daily activities and nonsurgical treatments haven't helped or are no longer effective. Arthritis damage is the most common reason to need hip replacement.

Why it's done

Conditions that can damage the hip joint, sometimes making hip replacement surgery necessary, include:

• Osteoarthritis. Commonly known as wear-and-tear arthritis, osteoarthritis damages the slick cartilage that covers the ends of bones and helps joints move smoothly.
• Rheumatoid arthritis. Caused by an overactive immune system, rheumatoid arthritis produces a type of inflammation that can erode cartilage and occasionally underlying bone, resulting in damaged and deformed joints.
• Osteonecrosis. If there isn't enough blood supplied to the ball portion of the hip joint, such as might result from a dislocation or fracture, the bone might collapse and deform.

Hip replacement may be an option if hip pain:

• Persists, despite pain medication
• Worsens with walking, even with a cane or walker
• Interferes with sleep
• Affects the ability to walk up or down stairs
• Makes it difficult to rise from a seated position

Need for second hip replacement

The artificial hip parts might wear out eventually, especially for people who have hip replacement surgery when they're relatively young and active. If this happens, you might need a second hip replacement. However, new materials are making implants last longer.

How you prepare

Before the operation, you'll have an exam with the orthopedic surgeon. The surgeon may:

• Ask about your medical history and current medications
• Examine your hip, paying attention to the range of motion in your joint and the strength of the surrounding muscles
• Order blood tests and an X-ray. An MRI is rarely needed

During this appointment, ask any questions you have about the procedure. Be sure to find out which medications you should avoid or continue to take in the week before surgery.

Because tobacco use can interfere with healing, it's best to stop using tobacco products. If you need help to quit, talk to your doctor.

What you can expect

When you check in for your surgery, you'll be asked to remove your clothes and put on a hospital gown. You'll be given either a spinal block, which numbs the lower half of your body, or a general anesthetic, which puts you into a sleep-like state.

Your surgeon might also inject a numbing medicine around nerves or in and around the joint to help block pain after your surgery.

During the procedure

The surgical procedure can be completed within two hours. To perform a hip replacement, the surgeon:

• Makes an incision over the hip, through the layers of tissue
• Removes diseased and damaged bone and cartilage, leaving healthy bone intact
• Implants the replacement socket into the pelvic bone
• Inserts a metal stem into the top of the thighbone, which is then topped with a replacement ball

After the procedure

After surgery, you'll be moved to a recovery area for a few hours while your anesthesia wears off. Medical staff will monitor your blood pressure, pulse, alertness, pain or comfort level, and your need for medications.

You'll be asked to breathe deeply, cough or blow into a device to help keep fluid out of your lungs. How long you stay after surgery depends on your individual needs. Many people can go home that same day.