What is Partial Hip Replacement

Partial hip replacement is a surgery to remove damaged bone in the hip joint and replace it with an artificial (prosthetic) hip joint. The hip is a ball-and-socket type of joint. It has two main parts.

The ball part of the joint (femoral head) is the top of the thigh bone (femur). The socket part of the joint is a large, hollow area on the outer side of the pelvis (acetabulum) where the femur and pelvis meet.

In a partial hip replacement, only the ball part of the joint is replaced with a prosthesis. The healthy parts of the hip, including the socket, are left intact. The purpose of this surgery is to reduce pain and improve your hip function.

Tell a health care provider about:

• Any allergies you have.
• All medicines you are taking, including vitamins, herbs, eye drops, creams, and over-the-counter medicines.
• Any problems you or family members have had with anesthetic medicines.
• Any blood disorders you have.
• Any surgeries you have had.
• Any medical conditions you have.
• Whether you are pregnant or may be pregnant.

What are the risks?

Generally, this is a safe procedure. However, problems may occur, including:

• Infection.
• Bleeding.
• Allergic reactions to medicines.
• Damage to nerves or other structures.
• Dislocation of the prosthetic joint.
• Loosening of the prosthesis.
• Fracture of the bone.
• Blood clot.
• Continued stiffness or loss of mobility.
• Continued pain.

What happens before the procedure?

Staying hydrated

Follow instructions from your health care provider about hydration, which may include:

• Up to 2 hours before the procedure – you may continue to drink clear liquids, such as water, clear fruit juice, black coffee, and plain tea.

Eating and drinking restrictions

• Follow instructions from your health care provider about eating and drinking, which may include:
  • 8 hours before the procedure – stop eating heavy meals or foods such as meat, fried foods, or fatty foods.
  • 6 hours before the procedure – stop eating light meals or foods, such as toast or cereal.
  • 6 hours before the procedure – stop drinking milk or drinks that contain milk.
  • 2 hours before the procedure – stop drinking clear liquids.
• Do not drink any alcohol for at least 48 hours before the procedure.

Medicines

Ask your health care provider about:

• Changing or stopping your regular medicines. This is especially important if you are taking diabetes medicines or blood thinners.
• Taking medicines such as aspirin and ibuprofen. These medicines can thin your blood. Do not take these medicines unless your health care provider tells you to take them.
• Taking over-the-counter medicines, vitamins, herbs, and supplements.

General instructions

• You may have a physical exam or testing, including X-rays.
• Plan to have someone take you home from the hospital or clinic.
• Plan to have a responsible adult care for you for at least 24 hours after you leave the hospital or clinic. This is important.
• Ask your health care provider how your surgical site will be marked or identified.
• To avoid the risk of infection, have routine teeth cleanings or any dental work done well in advance of your surgery, or wait until several weeks after your surgery.
• Do not use any products that contain nicotine or tobacco, such as cigarettes and e-cigarettes. These can delay bone healing after surgery. If you need help quitting, ask your health care provider.
• Ask your health care provider what steps will be taken to help prevent infection. These may include:
  • Removing hair at the surgery site.
  • Washing skin with a germ-killing soap.

What happens during the procedure?

• An IV will be inserted into one of your veins.
• You will be given one or more of the following:
  • A medicine to help you relax (sedative).
  • A medicine to make you fall asleep (general anesthetic).
  • A medicine that is injected into an area of your body to numb everything below the injection site (regional anesthetic).
  • A medicine that is injected into your spine to numb the area below and slightly above the injection site (spinal anesthetic).
• The surgeon will make an incision. The location of the incision will depend on the approach:
  • Anterior approach. The incision will be at the front of the hip. Muscles and tendons will be moved aside.
  • Posterior approach. The incision will be over the buttock. Muscles and tendons will be detached from the hip and repaired after the prosthesis is placed.
• Then, the surgeon will:
  • Remove the ball part of the joint.
  • Attach a new prosthetic ball to the top of the thigh bone with a prosthetic stem, and then secure the ball into the healthy socket. In some cases, a type of cement may be used to hold the prosthesis in place.
  • Place a drain to remove excess fluid, if needed.
  • Close the incision with stitches (sutures) and apply a bandage (dressing) over the surgical site.

The procedure may vary among health care providers and hospitals.

What happens after the procedure?

• Your blood pressure, heart rate, breathing rate, and blood oxygen level will be monitored until you leave the hospital or clinic.
• You will be given pain medicine.
• You will be asked to do breathing exercises. These will help prevent congestion in the lungs.
• You may have to wear compression stockings. These stockings help to prevent blood clots and reduce swelling in your legs. You may also be given a blood-thinning (anticoagulant) medicine.
• You will receive physical therapy until your health care provider thinks it is safe for you to go home. You may need to use a walker, crutches, or a cane.

Summary

• Partial hip replacement is a surgery to replace the ball part of the hip joint and replace it with an artificial part (prosthesis).
• Before the procedure, follow instructions from your health care provider about eating and drinking.
• Plan to have someone take you home from the hospital or clinic.
• You will receive physical therapy after the surgery. You may need to use a walker, crutches, or a cane.

Care After Partial Hip Replacement

This sheet gives you information about how to care for yourself after your procedure. Your health care provider may also give you more specific instructions. If you have problems or questions, contact your health care provider.

What can I expect after the procedure?

After the procedure, it is common to have:

• Pain.
• Stiffness.
• Discomfort.

Follow these instructions at home:

Medicines

• Take over-the-counter and prescription medicines only as told by your health care provider.
• If you were prescribed a blood thinner (anticoagulant) to help prevent blood clots, take it as told by your health care provider.

Incision care

• Follow instructions from your health care provider about how to take care of your incision. Make sure you:
  • Wash your hands with soap and water before you change your bandage (dressing). If soap and water are not available, use hand sanitizer.
  • Change your dressing as told by your health care provider.
  • Leave stitches (sutures), skin glue, or adhesive strips in place. These skin closures may need to stay in place for 2 weeks or longer. If adhesive strip edges start to loosen and curl up, you may trim the loose edges. Do not remove adhesive strips completely unless your health care provider tells you to do that.
• Check your incision area every day for signs of infection. Check for:
  • Redness, swelling, or pain.
  • Fluid or blood.
  • Warmth.
  • Pus or a bad smell.

Bathing

• Do not take baths, swim, or use a hot tub until your health care provider approves. Ask your health care provider if you may take showers. You may only be allowed to take sponge baths.
• Keep the dressing dry until your health care provider says it can be removed.

Managing pain, stiffness, and swelling

• If directed, put ice on the affected area.
  • Put ice in a plastic bag.
  • Place a towel between your skin and the bag.
  • Leave the ice on for 20 minutes, 2–3 times a day.
• Move your toes often to avoid stiffness and to lessen swelling.
• Raise (elevate) your leg above the level of your heart while you are sitting or lying down.

Activity

• Rest as told by your health care provider.
• Avoid sitting for a long time without moving. Get up to take short walks every 1–2 hours. This is important to improve blood flow and breathing. Ask for help if you feel weak or unsteady.
• Do exercises as told by your health care provider or physical therapist.
• Follow instructions from your health care provider about using a walker, crutches, or a cane.
  • You may use your legs to support (bear) your body weight as told by your health care provider. Follow instructions about how much weight you may safely support on your affected leg (weight-bearing restrictions).
  • A physical therapist may show you how to get out of a bed and chair and how to go up and down stairs. You will first do this with a walker, crutches, or a cane and then without any of these devices.
  • Once you are able to walk without a limp, you may stop using a walker, crutches, or cane.
• Return to your normal activities as told by your health care provider. Ask your health care provider what activities are safe for you.

Safety

• To help prevent falls, keep floors clear of objects you may trip over, and place items that you may need within easy reach.
• Wear an apron or tool belt with pockets for carrying objects. This leaves your hands free to help with your balance.

Driving

• Do not drive or use heavy machinery while taking prescription pain medicine.
• Ask your health care provider when it is safe to drive.

General instructions

• Wear compression stockings as told by your health care provider. These stockings help to prevent blood clots and reduce swelling in your legs.
• Continue with breathing exercises as directed by your health care provider. These will help prevent congestion in the lungs.
• If you are taking prescription pain medicine, take actions to prevent or treat constipation. Your health care provider may recommend that you:
  • Drink enough fluid to keep your urine pale yellow.
  • Eat foods that are high in fiber, such as fresh fruits and vegetables, whole grains, and beans.
  • Limit foods that are high in fat and processed sugars, such as fried or sweet foods.
  • Take an over-the-counter or prescription medicine for constipation.
• Do not use any products that contain nicotine or tobacco, such as cigarettes and e-cigarettes. These can delay bone healing. If you need help quitting, ask your health care provider.
• Keep all follow-up visits as told by your health care provider. This is important.

Contact a health care provider if:

• You have a fever or chills.
• You have a cough or feel short of breath.
• Your medicine is not controlling your pain.
• You have redness, swelling, or pain around your incision.
• You have fluid or blood coming from your incision.
• Your incision feels warm to the touch.
• You have pus or a bad smell coming from your incision.

Get help right away if you have:

• Severe pain.
• Trouble breathing.
• Chest pain.
• Redness, swelling, pain, and warmth in your calf or leg.

Summary

• Follow instructions from your health care provider about how to take care of your incision.
• Do not take baths, swim, or use a hot tub until your health care provider approves.
• Use crutches, a walker, or a cane as told by your health care provider.
• Make sure you know which symptoms should prompt you to get medical help right away.