Hip Surgery at OSI
OSI surgeons perform hip surgery ranging from arthroscopic procedures to total and revision hip replacement. When an operation is the right step, the decision is made with you from your imaging and exam, and your surgeon stays with you through recovery.
Hip operations are performed at our partner hospitals across the region, with follow-up at any of our six clinic locations. For information on hip conditions, evaluation, and non-operative treatment, see Hip Care at OSI, or browse the full list of hip conditions.
Total Hip Replacement
Total hip replacement is one of the most successful and reliable operations in orthopedics. The worn-out ball is removed and replaced with a metal or ceramic ball on a stem that fits inside the femur. The damaged socket is relined with a metal cup and a plastic or ceramic liner. The result is a smooth, pain-free joint that for most patients lasts 15 to 20 years or longer.
The operation takes about an hour. Most patients are up walking the same day, and for a primary replacement many go home the same day, though it depends on your health, your procedure, and how the day goes. By six weeks, most patients are walking without a limp and driving again. By three months, most have returned to their normal activities. The single most important factor in recovery is pre-operative function: the better shape your muscles and motion are in going into surgery, the faster and more complete the recovery on the other side.
Anterior vs. posterior approach
The two most common approaches to total hip replacement differ in how the surgeon reaches the joint.
The anterior approach goes through the front of the hip, working between muscles rather than cutting through them. Advantages include a potentially faster early recovery, fewer post-operative hip precautions (restrictions on bending and crossing the legs), and a lower dislocation risk in the early weeks. The trade-off is that the approach is more technically demanding, requires specialized table positioning, and has a learning curve.
The posterior approach goes through the back of the hip, moving and then repairing some of the muscles. It gives the surgeon a clear view, works well across different body types, and has the longest track record of any hip replacement approach. Afterward, most patients follow some precautions (no deep bending, no crossing the legs) for about six to eight weeks while the muscles heal.
Both approaches produce the same long-term result: a durable, well-functioning hip replacement. Your surgeon will recommend the approach that fits your anatomy, your body type, and the complexity of your case.
Revision Hip Replacement
Revision total hip replacement is a bigger, more complex operation reserved for patients whose previous hip replacement has worn out, loosened, become infected, or is painful for a definable mechanical reason. The original implants are removed and replaced with larger, more specialized components, often with augments, longer stems, or structural grafts to compensate for bone loss. The operation takes longer than a primary replacement, recovery is slower, and the rehabilitation is more involved.
The most common reason for revision is wear of the plastic liner between the metal parts. Over many years of use, the liner slowly wears down, and the worn material can loosen the implant from the bone. Other reasons include a hip that keeps dislocating, infection, a break in the bone around the implant, and parts that are not sitting in the right position.
Hip Fracture Surgery
Hip fractures are among the most common orthopedic emergencies, particularly in older adults. A fall from standing height is the usual mechanism. The fracture pattern determines the operation.
Femoral neck fractures break through the narrow part of the femur just below the ball. In younger patients, the break is usually fixed with screws or a plate to save the patient's own ball. In older patients when the ball has lost its blood supply, the usual treatment is to replace the ball, either with a partial hip replacement (replacing the ball and leaving the socket) or a full hip replacement. Which one is right depends on how active you are and the condition of the socket.
Intertrochanteric fractures break through the wider part of the femur just below the ball. The ball usually keeps its blood supply, so these breaks are fixed rather than replaced. The standard fix is a metal rod and screw placed inside the bone, which lets most patients start putting weight on the leg early.
Subtrochanteric fractures break a little lower, in the upper part of the femur. They are fixed with a long metal rod inside the bone and take longer to heal than the breaks higher up.
Acetabular fractures and pelvic ring fractures involve the socket side of the hip or the surrounding pelvic bones, usually from a higher-force injury. These are managed through our fracture-care service. For the full picture, see Fracture & Trauma Care here.
All Hip Procedures We Perform
Joint replacement
Fracture fixation
What Surgery Day Looks Like
Your surgeon will tell you ahead of time whether to plan on going home the same day or staying a night. Either way, you will be up and walking with support before you leave: early movement is part of the operation working. You leave with written instructions, walker or crutch guidance, blood-clot prevention, and a plan for the first follow-up visit. Someone needs to drive you home and ideally stay with you the first night.
Recovery and What to Expect
Recovery timelines vary by procedure and by patient. A typical total hip replacement patient is often walking without a cane by four to six weeks and back to most activities by three months. A hip fracture patient in their 80s has a longer road: the surgery is urgent and necessary, but regaining pre-injury function depends on pre-injury fitness, the severity of the fracture, and the quality and consistency of rehabilitation. A revision hip replacement falls somewhere between: the operation is more involved, but the goal is the same as the original replacement.
Recovery is active from the start: you will be moving the day of surgery. For some patients, home health is arranged so the first stretch of rehabilitation happens at home before transitioning to outpatient care. Your surgeon sets specific milestones and restrictions for each phase and adjusts them based on how your hip is actually responding.
Who You Will See Here
All three of our board-certified orthopedic surgeons perform hip surgery, including hip replacement. Dr. Vrana also performs hip revisions. Meet our providers.
