hip replacement [AS, hype] , substitution of an artificial ball and socket joint for the hip joint. Hip replacement is performed to relieve a chronically painful and stiff hip in advanced osteoarthritis, an improperly healed fracture, degenerative joint disease, or rheumatoid arthritis. Antibiotic therapy is begun before surgery, and the patient is taught to walk with crutches or a walker. During surgery the femoral head, neck, and part of the shaft are removed, and the contours of the socket are smoothed. A prosthesis of a durable, hard metal alloy or stainless steel is attached to the femur. A metal or a plastic acetabulum is implanted. The affected leg is kept abducted and in straight alignment with pillows; external rotation of the leg must be prevented. The nurse observes nerve function and circulation in the leg frequently during the first postoperative day. The most frequent complications are infection requiring removal of the new joint and dislocation. Ambulation begins gradually, with frequent short walks. Sitting for more than 1 hour is to be prevented, and hip flexion beyond 60 degrees may cause dislocation of the prosthesis. The patient continues an exercise program after discharge to maintain functional motion of the hip joint and to strengthen the abductor muscles. Weight-bearing may be modified according to the type of prosthesis implanted.
