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Total Hip Arthroplasty Print E-mail

In order to schematically see how total hip arthroplasty (THA) is performed press here


What is to be expected by a hip arthroplasty?

When all other treatments (medication, physiotherapy, weight loss) are unable to fight hip pain, hip arthroplasty may offer relief from pain and improvement of hip’s mobility.


Which patient are candidates for hip arthroplasty?

Hip arthroplasty is, in most cases, the outcome of hip osteoarthritis. You should consider arthroplasty if you feel intense pain, movement restriction or hip joint malformation.

Hip arthroplasty also addresses patients with hip injury (dislocation, hip fracture), patients with rheumatoid arthritis as well as in other conditions as tumors, femoral head’s aseptic necrosis.

The symptoms that may lead you to consider hip arthroplasty conclude:

  • Pain that wakes you up in the night
  • Little or no response to painkillers
  • Difficulty in going up and down the stairs
  • Difficulty in rising from sited position
  • Pain that forces you to stop your favorite activities (walking, riding the bicycle)


Which patients’ age addresses hip arthroplasty?

Initially, hip arthroplasty addressed patients over 60. As technology advances, more powerful and of greater life expectancy artificial hip joints are being created, which are suitable for younger and more active patients. However, younger patients confront the possibility of artificial prothesis wear and its possible replacement after the passing of 15-20 years.


How to prepare for a Hip arthroplasty?

Before surgical operation, you need to contact your orthopaedic surgeon for a clinical examination. Your orthopaedic will ask you about your medical history and the medication you probably receive, in order to certify that your health state allows the conduction of the arthroplasty. Also, he will examine your hip (range of motion, muscle condition around hip) and will order all the necessary blood examinations as well as x-rays. In this appointment you may ask the doctor whatever you need to know about the operation.

End stage hip osteoarthritis  

During the operation and after that there will be blood loss, usually not health threatening for the patient. In order to minimize the blood loss’s complications auto-transfusion is being used (the patient receives part of his own blood being lost after the operation through the drain wound tube).


How does hip arthroplasty is performed?

Hip arthroplasty includes the replacement of the suffering joint with a metal prothesis.

Initially, the damaged femoral head is removed. The creation of a pelvic recess follows, where a specific cup will be placed in which the artificial femoral head will fit and function. In the end, the proper femoral bone’s lumen preparation is performed in which the artificial head will be supported.

The prothesis parts assemble the normal anatomy of the hip and function as a normal joint. The parts of the artificial joint created consist of either specific durable plastic and really durable alloys of steel and titanium or cobalt – chrome metal surfaces (“metal on metal”).


Metal on metal total hip arthroplasty  

In order to schematically see how total hip arthroplasty (THA) is performed press here

The procedure of total hip arthroplasty usually lasts 1-2h. In this time the patient remains under anesthesia (general or regional) and does not feel any pain. After the operation the patient remains in resuscitation area for about an hour where he is closely observed by the anesthesiologist and his nurse assistant, until he recovers from the anesthesia.

After the operation

The first night after the operation, the patient remains bedridden and has urinary catheter, a drain wound tube which drains the joint blood as well as an intravenous catheter from which he receives all the necessary medication (antibiotics, painkillers, etc).

On the second day after surgery, the drainages are removed and the patient rises from the bed and walks with the help of a pair of canes or walker.
On the following days of his hospitalization, a physiotherapy program is designed according to every patients needs, which is daily implemented from our associate physiotherapists. On the sixth day the patient exits the clinic fully mobilized, without feeling any pain and with written instructions about the recovery period.

The results of hip arthroplasty

After the operation, the patient is mobilized without pain and with the help of two cratches (for the first month), one (for the second month) and none from the third month and on.


Fully and painless weight bearing, 3 months after the operation


Slowly, the patient may walk great distances, swim, and drive, ride a bicycle and do other everyday activities.


Hip arthroplasty complications

  • Pulmonary embolism: blood clots created during the operation may enter blood circulation and provoke embolism to the lungs resulting serious respiratory distress. Embolism is rarely clinically serious. In this case, the patient receives prophylactic anticoagulant medication up to 6 weeks after the operation.

  • Inflammation: wound microbe growth may occur in a very low percentage (<1%) and is dealt with the administration of proper antibiotics. All patients receive prophylactic antibiotic treatment on the day of the operation.

  • Limp discrepancy: because of the preoperative joint wear the muscles that surround the hip loosen and inadequate. Thus, in some cases, in order to deal with this muscular insufficiency it is necessary to elongate the hip in order to provide more stability to the operated limp. Usually, though, an effort is made to keep the difference between the two limps under 0.5cm.

  • Dislocation: particular extreme positions of the operated limp may lead to a dislocation of the prosthetic head on the first postoperative period. The patient is teached to avoid these extreme positions postoperative for several months.