Howard J Kapp, Orthopedic Surgeon

Our Services

Total Hip Replacement

Total hip replacement is an operation which provides a new joint surface and substitutes for the lost cartilage. In the hip it is called total hip replacement, because it totally replaces the surface of the hip. Most commonly, this operation is performed by removing the bony ball and replacing it with a metal ball. The metal ball is held in the correct position by a stem (or rod) that goes into the middle of the femur (thigh bone). Most often this stem is permanently fixed to the body by bone ingrowth of the patient's bone into the metal. The metal has a rough surface which fools the bone into attaching to the metal.

Originally all were fixed with bone cement. That fixation is still preferred by some surgeons, again, for patients that are 75 years or older. Into the metal shell is placed a liner which locks into place. This liner is most commonly plastic. Currently the plastic being used is called a highly cross-linked polyethylene. The one we use is named Durasul. The other choices for liners into the metal shell include one which has a metal face so that when it articulates with the metal ball there is a metal-on-metal bearing, which is named Metasul. Another choice is a ceramic liner which would mate with a ceramic head to give a ceramic-on-ceramic bearing surface.

The rehabilitation protocol for the total hip replacement will be discussed in a separate section.