Howard J Kapp, Orthopedic Surgeon

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Articulation of the Total Hip Replacement

Once the implants are in place, a trial ball is put onto the femoral stem, and this ball is located into the acetabulum. The surgeon then makes a series of moves to be sure that the hip is stable. Many patients ask how the hip is held together after the operation. It is held together by the correct length of ball being placed onto the stem, creating enough tension across the hip joint that the ball will not 'fall out'. Secondly, the muscles across the joint have a certain tension that hold the ball in place. Thirdly, the hip will heal the capsular incision and the capsule will once again become tight around the hip.

The moves by the surgeon to determine the stability are to pull on the leg and be sure that it is tight; secondly, the leg is placed through a range of motion which is the same motion the patient will use. It is determined with this maneuver that the hip is stable and that the ball fits correctly into the cup. Lastly, the leg length can be determined by three or four methods, the choice of which is that of the surgeon. However, the leg lengths will be confirmed before the surgeon leaves the operating room to be sure they are as close to the same as possible.