Total Hip Replacement (THR)

1. What is Total Hip Replacement (THR)?

Total Hip Replacement (THR) is an excellent treatment option for people with late-stage degenerative hip disease. Hip replacement is currently the most successful and reliable orthopaedic operation with 97% of patients reporting improved outcome. Hip replacement is a surgical procedure in which the hip joint is replaced by a prosthetic implant. Hip replacement surgery can be performed as a total replacement or a semi (half) replacement.

2. How is it done?

Doctors replace both balls (femoral head) and socket (acetabulum) during THR surgery. During surgery, once the hip joint is exposed, the head and neck of the femur are removed. The shaft of the femur is then reamed to accept the metal component consisting of the head, neck, and stem. The acetabulum is then reamed to accept a plastic cup. The ball and socket are then replaced into normal position. Both of these implants can be fastened into the bone with or without special cement.

3. Why is it done?

Such joint replacement orthopaedic surgery generally is conducted to relieve arthritis pain or fix severe physical joint damage as part of hip fracture treatment.

4. What are the possible risk and complication?

Risks and complications in hip replacement are similar to those associated with all joint replacements. They can include aseptic loosening, dislocation, impingement, infection, osteolysis, metal sensitivity, infection, bleeding and pain.

  • In the long term, many problems relating to osteolysis from acrylic bone cement debris, and/or wear debris. An inflammatory process causes bone resorption and subsequent loosening or fracture, often requires revision surgery. Very hard ceramic bearing surfaces are being used in hopes that they will have less wear and less osteolysis with better long term results.
  • Metal hypersensitivity is a well-established phenomenon and is common, affecting about 10-15% of the population. Contact with metals can cause immune reactions such as skin hives, eczema, redness and itching.
  • A small number of people can develop an infection with a THR. Patient may require further surgery to remove the prosthetic components and clean out the joint along with a course of antibiotics lasting six to eight weeks.
  • As with any surgery, patient will experience bleeding both during and after the procedure. Patient will often need a blood transfusion.
  • Fracture: Other bones may be broken during surgery. These breaks may affect patients’ rehabilitation and require a longer hospital stay.
  • A few patients who have had a hip replacement suffer chronic pain after the surgery despite normal imaging. Also some patients can suffer severe pain when it comes to facing cold weather (most commonly when it is a metal implant).
5. Is THR for you?

THR can benefit individuals suffering from a variety of hip problems resulting from either wear and tear from a lifetime of activities or from diseases and injuries. The doctor might suggest this surgery to the patient if they have some of the common hip problems as below:

  • Osteoarthritis
  • Rheumatoid arthritis
  • Traumatic arthritis
  • Avascular necrosis
  • Bone tumors that break down the hip joint
  • Other reasons
6. What are the alternatives?

There are few alternatives other than hip replacement which are conservative management, hemiarthroplasty and hip resurfacing. Conservative management involves a multimodal approach of medication, activity modification and physical therapy. Heniarthroplasty is a surgical procedure which replaces one half of the joint with an artificial surface and leaves the other part in its natural (pre-operative) state. Hip Resurfacing is an alternative to hip replacement surgery. It is a bone conserving procedure that places a metal cap on the femoral head instead of amputating it.

7. What is the estimated cost?

To find out the estimated cost for procedure, please visit our Real Cost Estimation page.