Hip Replacement Surgery: Long-Term Care

Hip replacement surgery (hip arthroplasty) has many benefits including relieving hip pain and restoring hip function. Optimizing these benefits and minimizing the risk for complications (e.g., hip dislocation and infection) requires that you adhere to various lifestyle adjustments, such as avoiding high-impact activities after surgery and taking preventive antibiotics before invasive medical or dental procedures.

Benefits of Surgery

Hip replacement involves removing and replacing the worn-out cartilage and bone of the hip joint with artificial parts. In doing so, the surgery delivers its main benefit: alleviation of hip pain, which usually originates from hip osteoarthritis.

A second benefit is that the surgery restores hip function. This means that patients will be able to engage normally in activities of daily life after their operation. Around six weeks after surgery, patients will be also able to participate in low-impact sports/leisure activities, such as golf, hiking, dancing, cycling, doubles tennis, and rowing.

The reality of these benefits, of course, depends significantly on the patient's commitment to their post-operative rehabilitation program.

Patients must also follow-up with their surgeon as instructed. While the precise schedule for this varies among orthopedic surgeons, patients can expect to see their surgeon two to three times in the first couple of months after surgery, one year after surgery, then every five years or so thereafter.

During these follow-up appointments, the surgeon will evaluate for complications and ensure that the new hip joint is maintaining good strength and stability.

Possible Future Surgeries

While hip replacements are considered safe overall and are typically successful, a second surgery may be required. Called a revision hip replacement, this involves removing some or all parts of the original prosthetic parts and replacing them with new ones.

Due to their age and the fact that they tend to be more active, people who have a hip replacement in their 50s or younger can usually expect to require a revision hip replacement in their lifetime.

Unfortunately, revision surgery is a major undertaking that often has less successful results than an initial hip replacement.

Revision hip surgery may be indicated in the following situations:

• Implant loosening: Prosthetic parts are either cemented or "press-fit" into the bone during surgery. They can become worn out or loose over time, or the bone may fail to grow into a "press-fit" part.
• Osteolysis: When the bone surrounding the implant weakens and thins out
• Infection of the hip joint: This is rare, but may occur days, weeks, or even years after your surgery. Symptoms may include fever and new, significant hip pain and stiffness. If an infection is deep within the tissue that surrounds the hip implant, surgery to remove and replace the prosthetic parts—in addition to intravenous antibiotics—is usually required.
• Recurrent dislocation: Dislocation of the hip is when the metal or ceramic ball that is inside the hip socket is forced out (e.g., due to trauma or certain hip positions). While uncommon, this serious complication is most likely to occur in the first few months after surgery.
• Periprosthetic fracture: A broken bone around the implant, typically the result of a simple fall

Lifestyle Adjustments

To both maximize function and minimize complications, life after hip replacement surgery requires some adjustments including:

• Maintaining a normal weight: The more you weigh, the more stress that is placed on the joint replacement implant, which makes it more likely to wear out sooner.
• Optimizing bone health: In addition to taking vitamin D and ensuring sufficient calcium intake, you should be treated with prescription medication (e.g., a bisphosphonate) if you have osteoporosis.
• Preventing falls: Falls can dislocate the hip joint or break the bones surrounding the implant. Avoid them by ridding your home of tripping hazards (e.g., loose rugs or electrical cords), installing assistive devices like grab bars in the bathroom, and using a walking assistive device until given the OK to discontinue.
• Avoiding high-impact activities: High-impact activities, such as jogging, jumping, and contact sports, such as football, may not be painful or difficult, but they can place excessive stress on the hip replacement, causing the parts to wear out more quickly. 
• Avoiding certain positions: To prevent hip dislocation, surgeons typically advise patients to avoid certain positions or maneuvers for at least the first few months after surgery (e.g., crossing their legs, sleeping on their side, and sitting on low chairs or couches).
• Taking preventive antibiotics: People having invasive medical procedures (including dental work) may require antibiotic treatment to prevent bacteria from getting into the hip joint replacement.

A Word From Verywell

Undergoing this surgery requires vigorous effort, care, and devotion to ensure a healthy long-term recovery and to maximize the duration of the implant. Even if you do everything right, you may still need revision surgery at some point. This holds especially true for younger patients.

Still, there's no doubt that hip replacement surgery can dramatically improve your quality of life. Go into your procedure with realistic expectations and a clear sense of what you need to do to preserve your implant and reap the rewards of your procedure for years to come.