Arthroplasty is, replacement of the joint surfaces with artificial materials in cases where extensive cartilage loss is present in the joint. The motion will occur through the artificial replacement thus the pain that occurs due to cartilage loss will disappear and the limited joint motion will return almost to its natural range.

Some joints in the body may degenerate with time. Hip and knee joints are the most commonly effected joints. In most of the cases, there is no detected underlying etiology. However in some cases, over-weight, misuse, trauma and skeletal abnormalities might be the causative factors. "Hip dysplasia", present at birth, is one of the most common skeletal abnormality that causes early hip joint degeneration. Minimal angle changes in the hip joint causes uneven loads on the hip joint which eventually leads to massive cartilage load at age 30-40s. Another underlying pathology that causes hip joint arthritis is the "femora-acetabular impingement syndrome". Unlike to hip dysplasia, femora-acetabular impingement mostly occurs later in life and is a progressive pathology. The impingement of the femoral head to acetabulum causes eccentric loading and rotation of the hip joint that with progression of the disease it causes hip joint cartilage loss. In both dysplasia and femora-acetabular impingement, early intervention may save the hip joint at least prolong the survival of the joint before artificial replacement.

In advanced cases, hip arthroplasty may be the only solution in hip arthritis. The main indication for hip arthroplasty is pain. Although shortening and limited range of the joint may be disturbing, those are the secondary causes for hip arthroplasty. The intensity of pain varies according to patient's weight, daily activities and social life. If the patient has intensive pain despite conservative treatment and walking distance is limited to 200-300 meters with apparent night pain means that time to hip replacement is very close.

How is hip replacement surgery?

Total hip replacement surgery usually takes 2-2,5 hours. In the surgery, both the acetabular surface and the femoral head is replaced with artificial materials. Hospitalization takes 3-4 days. The patient begin to sit the day after the operation. At the post-operative day 2, the drains are removed and patient begin to mobilize with partial weight bearing. Crutches are used 4-6 weeks after the operation till the patient get enough strength and the biological healing is progressed.

The prosthesis has cemented and uncemented types. The cemented type allows early weight bearing however not advised in younger patients. The uncemented type is mainly made of titanium and has the capacity for biological healing. Although weight bearing is limited for a while after the surgery, it is the most commonly preferred type due to its longer survival. There is also variation in the materials of the prosthesis. Ceramic to ceramic surface interference has the lowest friction coefficient , thus lowest erosion rate.

What is the risk and success rate of hip replacement surgery

Hip arthroplasty surgery has risks such as infection, deep vein thrombosis and pulmonary emboli. Although those are severe complications, the total incidence is less than 3 % and all precautions are taken at the pre-operative and post-operative period. The over-all patient satisfaction of hip arthroplasty is more than 95%.