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Arthritis and Hip Replacement Surgery
Hip replacement surgery is a procedure in which a doctor surgically removes a painful hip joint with arthritis and replaces it with an artificial joint. It usually is done when all other treatment options have failed to provide adequate relief. The procedure should relieve a painful hip joint, making walking easier.
What Happens During Hip Replacement Surgery?
Hip replacement surgery can be performed traditionally or by using what is considered a minimally-invasive technique. The main difference between the two procedures is the size of the incision.
During standard hip replacement surgery, you are given general anesthesia to relax your muscles and put you into a temporary deep sleep. This will prevent you from feeling any pain during the surgery. A spinal anesthetic also may be given to help prevent pain.
The doctor will then make a cut along the side of the hip and move the muscles connected to the top of the thighbone to expose the hip joint. Next, the ball portion of the joint is removed by cutting the thighbone with a saw. Then an artificial joint is attached to the thighbone using either cement or a special material that allows the remaining bone to attach to the new joint.
The doctor then prepares the surface of the hipbone -- removing any damaged cartilage -- and attaches the replacement socket part to the hipbone. The new ball part of the thighbone is then inserted into the socket part of the hip. A drain may be put in to help drain any fluid. The doctor then reattaches the muscles and closes the incision.
While most hip replacement surgeries today are performed using the standard technique (one 8 to 10 inch cut along the side of the hip), in recent years, some doctors have been using a minimally-invasive technique. In the minimally-invasive approach, doctors make one to two cuts from 2 to 5 inches long. The same procedure is performed through these small cuts as with standard hip replacement surgery.
The small cuts are thought to lessen blood loss, ease pain following surgery, shorten hospital stays, reduce scar appearance, and speed healing.
However, it's important that the surgeon be highly skilled in this technique. Research has shown the outcomes may be worse than with standard hip replacement surgery if done by a doctor that is not very experienced with this minimally-invasive approach.
Since there can be some blood loss during hip replacement surgery, you may need a blood transfusion, so you may want to consider donating your own blood before the procedure.
What Happens After Hip Replacement Surgery?
You will likely stay in the hospital for 4 to 6 days and may have to stay in bed with a wedge-shaped cushion between your legs to keep the new hip joint in place. A drainage tube will likely be placed in your bladder to help you go to the bathroom. Physical therapy usually begins the day after surgery and within days you can walk with a walker, crutches, or a cane. You will continue physical therapy for weeks to months following the surgery.
WebMD Medical Reference provided in collaboration with the Cleveland Clinic
ORENCIA® (abatacept) Important Safety Information
Indication and Usage
ORENCIA® (abatacept) is a prescription medicine that reduces signs and symptoms in adults with moderate to severe rheumatoid arthritis (RA), including those who have not been helped enough by other medicines for RA. ORENCIA may prevent further damage to your bones and joints and may help your ability to perform daily activities.
Important Safety Information About ORENCIA® (abatacept)
Before you receive treatment with ORENCIA, a lyophilized powder for intravenous infusion, you should tell your doctor about all your medical conditions, including if you:
- have any kind of infection even if it is small (such as an open cut or sore) or an infection that is in your whole body (such as the flu).
- have an infection that will not go away or a history of infections that keep coming back.
- have had tuberculosis (TB), a positive skin test for TB, or if you recently have been in close contact with someone who has had TB. If you get any of the symptoms of TB (a dry cough that doesn’t go away, weight loss, fever, night sweats), call your doctor right away. Before you start ORENCIA, your doctor may examine you for TB or perform a skin test.
- have or have had viral hepatitis. Before you use ORENCIA, your doctor may examine you for hepatitis.
- have a history of chronic obstructive pulmonary (lung) disease (COPD).
- are scheduled to have surgery.
- are allergic to any of the following ingredients in ORENCIA: abatacept, maltose, monobasic sodium phosphate, or sodium chloride for administration.
- recently received a vaccination or are scheduled for any vaccination.
- have diabetes and use a blood glucose monitor to check your sugar levels. The infusion of ORENCIA contains maltose, a sugar that can give falsely high blood glucose readings with some monitors on the day you receive your infusion. Your doctor may tell you to use a different way to monitor your blood sugar levels.
- are pregnant, planning to become pregnant, or are thinking about becoming pregnant. It is not known if ORENCIA can harm your unborn baby.
- are breast-feeding. You will need to decide to either breast-feed or receive treatment with ORENCIA, but not both.
- take any other kinds of medicine, including prescription and nonprescription medicines, vitamins, and herbal supplements.
- are taking other biologic medicines to treat RA such as: Enbrel® (etanercept), Humira® (adalimumab), Remicade® (infliximab), Kineret® (anakinra) or Rituxan® (rituximab). You may have a higher chance of getting a serious infection if you take ORENCIA with other biologic medicines.
Possible Side Effects of ORENCIA® (abatacept)
ORENCIA can cause serious side effects including:
- Serious infections. Patients receiving ORENCIA have a higher chance of getting infections including pneumonia, and other infections caused by viruses, bacteria, or fungi. Call your doctor immediately if you feel sick or get any of the following signs of infection: fever, feel very tired, cough, feel flu-like, or warm, red or painful skin.
- Allergic reactions. Allergic reactions can happen on the day of treatment or the day after receiving ORENCIA. Tell your doctor or get emergency medical help right away if you have hives, swollen face, eyelids, lips, tongue, throat, or trouble breathing.
- Cancer (malignancies). Certain kinds of cancer have been reported in patients receiving ORENCIA. It is not known if ORENCIA increases your chance of getting certain kinds of cancer.
- Vaccinations. You should not receive ORENCIA with certain types of vaccines. ORENCIA may cause some vaccinations to be less effective.
- Respiratory problems in patients with COPD. You may get certain respiratory problems more often if you receive ORENCIA and have COPD, including: worsened COPD, pneumonia, cough, or trouble breathing.
The more common side effects with ORENCIA are headache, upper respiratory tract infection, sore throat, and nausea.
Please read the Patient Information in the Full Prescribing Information below.
ORENCIA is a registered trademark of Bristol-Myers Squibb Company.
All other trademarks are property of their respective companies.
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