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Hip Replacement Surgery: A Nurse-Patient View

x-ray of hips showing a prosthesis on one side

More than one million patients undergo successful total hip replacement (THR) procedures yearly, which is expected to double in the next 20 years.

Having lived through 10 hip surgeries (1985-2016), I feel qualified to discuss the process and progress of hip replacement surgery over the years.

In 1985, I had my first total hip replacement after learning that my hips had severely deteriorated from congenital hip dysplasia (shallow hip sockets like German shepherds get). Although hip replacement surgery dates back as far as 1891, modern-day hip surgery essentially dates back to the 1960s when hip prostheses began being made of metal with a polyethylene liner for the metal to set it in the acetabulum (pelvic hip joint) and acrylic bone cement.

When I had my first total hip replacement, chrome and cobalt cement-less prostheses were in vogue. Having learned that acrylic cement tended to loosen, especially in younger, more active patients, surgeons found other ways to fix hip components by using rough surface coatings on the metal to attract bone to grow onto the components.

Over the years, I have had prosthesis failures due to wear and tear on the polyethylene (plastic) liners and metallosis (build-up of metal debris in the joint and soft tissues) from a metal-on-metal prosthesis.

My hip dislocated once on each side despite my best efforts to adhere to hip precautions.

Today, I have a distinct limp due to deterioration of the bone, which attaches the lateral muscle (abductor) from my pelvis to my left hip. Still, I'm grateful for the advances that have allowed me to remain ambulatory all these years. I also feel that I have had the honor of being part of the learning curve of today's modern advances in hip surgery.

In 2023, my 80-year-old husband underwent hip replacement surgery due to osteoarthritis in his left hip. In stark contrast to the general anesthesia and 7-day hospitalization I had for my first hip replacement, he was seen in an ambulatory surgery clinic, had spinal anesthesia, was up walking with a walker within 2 hours, and was home the same day. The anterior approach left him with a 6-inch scar as compared to my 11.5-inch bilateral scars. His recovery has been remarkable; he was back on his tractor less than four weeks after his surgery. The years have brought advances I never dreamed of, and I look forward to seeing (hopefully not participating in) future advances.

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