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Total Hip Replacement Surgery

Clip Number: 10 of 37
Presentation: Bone and Joint Conditions, Tests, and Procedures
The following reviewers and/or references were utilized in the creation of this video:
Reviewed By: Arthur Schoenstadt, MD
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After anesthesia is given, a catheter or thin tube is inserted into the bladder.
Then you will be placed on your side. This is the best position to access the hip joint. for safety on the operating table, straps will be placed.
To help reduce the chance of infection, the surgical area will be scrubbed with a special soap, and will be covered with sterile sheets.
The doctor will begin by making an eight to fifteen inch incision over the hip. Tissue and muscle are carefully moved aside to expose the hip joint. The end of the thighbone is then cut using special guides and saws. The natural "ball" of the hip joint is then removed. The thighbone is then prepared, which involves removing a portion of the middle part of the bone.
Special instruments are then used to prepare the socket area for the implant. This involves removing some of the tissue and bone to make a smooth round surface for the implant. Screws are sometimes used to fix the metal replacement socket into place.
Once the thighbone and pelvis have both been prepared, the ball and socket of the new implant are connected. The thighbone and hip parts of the implant will look something like this. The implants are made of metal, normally an alloy, which is a combination of several metals.
Most implant designs use a small, specialized plastic insert between the two metal parts to act as a weight bearing surface for the joint, like natural cartilage. It will look something like this.
Depending on the type of implant used, bone cement may be used to fix the implant components securely into place.
The surgeon will then check the hip's range of motion. If it is unstable, or comes apart too easily, a larger or longer implant may be used to make it more stable. This might make the leg slightly longer than it was before surgery
Often plastic drains will be placed inside the joint to drain excess blood into a plastic container outside the skin. These are usually removed in 1 to 2 days. The soft tissue and muscles are stitched back into place with stitches that will absorb over time.
The skin is then closed with stitches or staples. A sterile bandage is taped over the wound to keep it clean.
 

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