1. I am stiff and notice that my gait has shortened when I walk. Do I need a hip replaced?  
  2. What materials does a hip replacement consist of?  
  3. What does hip replacement surgery entail?  
  4. How long is surgery for a hip replacement? I'm worried about anesthesia. What do I need to know?  
  5. How long is recuperation and rehabilitation after hip replacement surgery?  
  6. Why do I have to have a dental clearance before hip replacement surgery?  
  7. Are there activities I will not be able to do after hip replacement surgery?  
  8. How soon after surgery can I drive a car?  
  9. Will I be able to play golf again?  
  10. What causes arthritis in the hip?  
  11. Aren't hip replacements for older people?  
  12. If I have arthritis in one hip, will I develop arthritis in the other hip?  
  13. How long will the implant last?  
  14. Will I be aware of the implant in my hip? Will cold weather affect it?  
  15. Will I be able to go through the metal detector at airports?  
  16. What happens if I get an infection in my new hip?  
  17. I have heard that the hip replacement can loosen and that I will need another operation. Is this true?  
  18. Can I have an MRI after a hip replacement?

1. I am stiff and notice that my gait has shortened when I walk. Do I need a hip replaced?
A shortened gait, especially if you are without pain, is probably not related to your hip but instead to tightness in the muscles, tendons and ligaments that surround the hip joint. Light stretching exercises and a regular walking program may help restore your range of motion.

2. What materials does a hip replacement consist of?
A hip replacement is comprised of chrome-cobalt, titanium alloy, and polyethylene plastic. Ceramics may be used as well. 

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3. What does hip replacement surgery entail?
Having a hip replaced is a major surgical procedure performed in an operating room. During this procedure, your surgeon will remove damaged cartilage and bone, resurface the "socket" in your pelvis, and replace the "ball" or head of the thigh bone (femur) that moves within the socket.  

4. How long is surgery for a hip replacement? I'm worried about anesthesia. What do I need to know?
The length of your operation may range from one to two hours. Virginia Mason has one of the best anesthesia programs in the country and we specialize in regional anesthesia. You will be well cared for during your operation by your anesthesiologist.

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5. How long is recuperation and rehabilitation after hip replacement surgery?
Your recuperation and rehabilitation begins while you are still in the hospital and often on the same day as your surgery. A physical therapist will help you sit up and will also show you light exercises to do while in bed. Eventually, you will stand and walk a short distance with a walker. Each day you are in the hospital, and several times a day, your physical therapist will work with you. Your road to recovery begins with these simple exercises that will eventually help you regain strength and functional use of your hip.

Your surgeon or physical therapist will talk to you about exercises to do at home after surgery, either on your own or with the help of home health services. Rehabilitation services also are available through Virginia Mason's Department of Physical Medicine and Rehabilitation and the Sports Medicine clinic.

Most patients reach a point of independence within three days. You will continue to slowly improve for about a year because you will not just be recovering from the operation. You also will be recovering from the weakening of muscle and tendons that may have been occurring for years before the surgery.

6. Why do I have to have a dental clearance before hip replacement surgery?
All patients having joint replacement surgery, as well as patients having heart valve replacement surgery, must have clearance from their dentists showing that there is no infection (such as an abscessed tooth) in the mouth. The reason is that infection in one part of the body can travel to the new joint or valve and cause infection in these newly replaced parts.

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7. Are there activities I will not be able to do after hip replacement surgery?
It is not advisable to take part in repetitive high impact activities such as running or jogging. On the other hand, if you were already an expert downhill snow skier, you might return to skiing but will be advised to avoid the more high-impact aspects of the sport.

8. How soon after surgery can I drive a car?
It is best not to drive until six weeks have passed because of the fatigue factor that occurs after most major surgeries. Reflexes are impaired and you may be taking pain medications.

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9. Will I be able to play golf again?
Yes, you will be able to play golf approximately eight to 12 weeks after surgery.

10. What causes arthritis in the hip?
As a weight-bearing joint, our hips absorb shock over the course of our lifetime and can begin to show wear and tear on the surface of bone and in the cartilage that sits between bones. This damage can be accelerated with even mild congenital structural abnormalities of the hip that you may not even know about. Some medical conditions — inflammation or rheumatoid arthritis — also can cause degeneration. Direct injury to the hip from contact sports or accidents can destabilize the joint and cause uneven wear, eventually leading to arthritis later in life.

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11. Aren't hip replacements for older people?
No. The hip can degenerate from a number of factors that have nothing to do with age. Athletes in their 30s who participate in contact sports, for example, have had hips replaced. A traumatic injury from an accident also may require that the hip be replaced. Rheumatoid arthritis and avascular necrosis (dead tissue) of the hip can occur at any age and affect the hip causing degeneration.

12. If I have arthritis in one hip, will I develop arthritis in the other hip? 
No, not always. However, some conditions leading to degeneration of the hip can occur in both hips. Your surgeon can explain this process in more detail.

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13. How long will the implant last?
The answer must take into account several factors, including your age, physical condition and activity level. Because these devices are made with strong materials that provide a secure fit, 20-year implant survival is not an unreasonable expectation. The exact survival rates are not yet known.

14. Will I be aware of the implant in my hip? Will cold weather affect it? 
No, most hip replacements result in a natural feeling joint. Weak or damaged soft tissues existing before surgery, however, can sometimes persist after the hip has been repaired and symptoms may continue to occur in those tissues.

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15. Will I be able to go through the metal detector at airports?
Yes, you will be able to go through a metal detector. Some are more sensitive than others and you may "set off" the alarm in some instances. 

16. What happens if I get an infection in my new hip?
A deep infection in an artificial hip replacement is a very serious complication. It usually requires the complete removal of the implant before the infection can be cured. During the time the implant is gone and the patient is being treated with powerful antibiotics, a temporary antibiotic-soaked implant is used to maintain joint spacing and motion. After the infection is gone a new hip replacement can be placed.

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17. I have heard that the hip replacement can loosen and that I will need another operation. Is this true?
It is very unlikely that your implant will loosen. But if it does, it can usually be redone. Oftentimes, only a part of the implant needs to be revised.

18. Can I have an MRI after a hip replacement?
Yes, but if the MRI imaging is being done to look at structures near the hip implant, the metal of the implant can distort the image.

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To speak with an orthopedic surgeon about hip replacement surgery, call (206) 341-3000.