Ortho Hips and Knees- Part 4

When total hip replacement is the only option

As we’ve pointed out in previous blogs, the first line of treatment for hip pain is nearly always non-surgical, even if the pain is significant.  But if alternative methods such as medications, injections, bracing, weight loss or exercise don’t give you relief, you may consider a total hip replacement – a THR.

If you are considering such a move, you’re bound to have questions.  Here are some of the most common ones, and the answers as provided by the American Association of Hip and Knee Surgeons.

How long does a THR last?

A common reply is that total joint replacement lasts 15-20 years. A more accurate way to think about it is through the annual failure rates: most current data suggests that both hip and knee replacements have an annual failure rate between 0.5-1.0%. This means that if you have your total joint replaced today, you have a 90-95% chance that your joint will last 10 years, and a 80-85% that it will last 20 years. These numbers may improve with improvements to technology.

Are all hip replacement implants the same?

As surgeons and manufacturers determine which designs work best, most implants today have become more similar than different. One variable that still remains is the bearing surface – the  ball and liner that attach to the stem and cup that fix to the bone. The ball can be composed of either metal or ceramic, and the liner can be made of plastic, metal, or ceramic.

My surgeon talks about “approach;” what is he talking about?

The way a surgeon gains access to the hip during hip replacement surgery is referred to as an “approach.” There are several types of approaches: the “posterior approach,” which is done from the back of the hip and is the most common; the “anterior approach,” which is performed from the front of the hip, and the lateral approach, which is less popular.

Will I need general anesthesia?

Not necessarily: both hip and knee replacements can be performed under regional anesthesia such as spinal anesthesia, epidural anesthesia, or one of a variety of peripheral nerve blocks. Regional anesthesia has a high preference rate because data shows it can reduce complications and improve your recovery with less pain, less nausea, and less narcotic medicine required.

What is minimally invasive surgery?

Minimally invasive surgery is a combination of reduced incision length and lessened tissue disruption beneath the incision. This includes cutting less muscle and detaching less tendon from bone.

How big will my scar be, and when will it disappear?

This depends on several factors: the size of the patient, the complexity of the surgery, and surgeon preference, to name a few. The scar will heal within a few weeks, but then will remodel and change appearance over the next one to two years.

How long will I stay in the hospital?

You will likely stay in the hospital for one to three days,  depending on your rehabilitation program and how fast you progress with physical therapy. This is highly dependent upon your condition before surgery, your age, and medical problems that can hinder your rehabilitation.

When will I be able to walk after surgery, and when can I shower?

Most people are walking with the aid of a walker on the day after surgery, and using a cane or nothing at all by 2-3 weeks. Most surgeons do not like the wound to be exposed to water for 5-7 days; however, more surgeons are using waterproof dressings that allow patients to shower the day after surgery. You can remove the dressing at 7-10 days after surgery.

How long does it take to recover?

The majority of people who undergo THA are able to participate in a majority of their daily activities by 6 weeks. By 3 months, most people have regained much the endurance and strength lost around the time of surgery, and can participate in daily activities without restriction.

Will I need physical therapy, and if so, for how long?

Initially, you will receive some physical therapy while in the hospital. Depending on your preoperative conditioning and support, you may or may not need additional therapy as an outpatient. Much of the therapy after hip replacement is walking with general stretching and thigh muscle strengthening, which you can do on your own without the assistance of a physical therapist.

We at Blue Sky Therapy are ready to assist you after hip replacement therapy!

Blue Sky Therapy has a continued commitment to patient-driven quality, excellence, integrity and innovation in everything that we do. That’s why we are scrupulous about planning the treatment of each and every client, and carefully documenting the outcome!

In our next blog, we’ll talk about surgical options for knee arthritis. 


American Association of Hip and Knee Surgeons. Developed by the AAHKS Patient Education Committee. Authors: Craig J. Della Valle, MD, Frank R. DiMaio, MD, Marc W. Hungerford, MD.