Total Hip Replacements, also known as Total Hip Arthroplasty, are extremely successful procedures which improve function and thus quality of life.
What is a Total Hip Replacement?
A Total Hip Replacement involves the removal of damaged sections of cartilage and bone from the hip joint and replacing them with prosthetic components. The prosthesis is implanted either using cement to bond the prosthesis to the bone or by allowing bone to grow into the prosthesis (press-fit)
The decision to undergo a Total Hip Replacement is a joint one between you, your family, GP and the Orthopaedic Surgeon. Those who benefit from Hip Replacement will have one or more of the symptoms:
- Hip Pain that limits everyday activities like walking with significantly reduced walking distance
- Pain at rest that affects sleep
- Severe stiffness affecting mobility
- Inadequate pain relief with NSAIDs or painkillers, Physiotherapy or walking aids
The indication for surgery are pain due to wear and tear Arthritis (Osteoarthritis),Inflammatory arthritis ( Rheumatoid arthritis), Loss of blood supply to the ball part of the hip (Osteonecrosis), Arthritis following significant trauma to the hip ( Posttraumatic Arthritis) or childhood hip conditions.
A Total Hip Replacement is usually done under a regional anaesthetic (which numbs you from the waist down) or sometimes under a general anaesthetic (which puts you to sleep).
The procedure begins with the surgeon making an incision over the side or front of the hip, followed by the removal of damaged and diseased cartilage and bone. The damaged ‘ball’(femoral head) is removed and replaced with a metal stem placed into the hollow centre of the thigh bone, the worn socket is replaced with a Metal Cup and a Metal or Ceramic Head is placed on top of the Metal Stem. A Plastic or Ceramic lining placed inside the metal cup will form a smooth gliding surface. The procedure takes approximately 60-90 minutes to complete.
After the procedure, you will be taken to a recovery room for a few hours, before being moved to a hospital room where you will stay for one to two days. You will be given painkillers such as opioids or non-steroidal anti-inflammatory drugs (NSAIDs). You will be encouraged to start moving as quickly as possible following surgery, to reduce the risks of blood clots.
Following the surgery, your Surgeon and Physiotherapist will visit you regularly. You will require a pair of crutches or some walking aid for a few weeks following surgery and you will be given a physical exercise programme to gradually build strength in your joint and muscles, while increasing the walking distance gradually.
Recovery is a fine balance between rest, following the recommended instructions/precautions reduce the risk of hip dislocation and staying active with increasing walks and exercise. Your surgeon and a trained physiotherapist will guide you through your recovery. It is common to require simple painkillers and NSAIDs during the early part of recovery.
Hip Replacements are very successful operations with most patients experiencing dramatic pan relief and significant improvement in their ability to perform routine daily activities including walking. Since hip replacement is a technical procedure, it is important to choose an experienced surgeon with high surgical volume to ensure an excellent outcome.
The activities one may be able to do after a successful Hip Replacement would include unlimited walking, swimming, hiking, biking, dancing, Golf, and light Badminton or Tennis. Most surgeons will advise against high impact activities. It is therefore important to have realistic expectations about the outcome following a hip replacement.
Hip replacement is a very successful operation. However, like any other procedures, there are risks associated with a Hip Replacement that you must be aware of and accept prior to undergoing the procedure. The risks include Infection, Clots (Deep Vein Thrombosis), Embolus, Dislocation, Limb Length inequality, Persistent pain, incomplete relief of symptoms following surgery, Vessel or Nerve damage, Fracture, Re-operation/revision, medical, anaesthetic and mortality risks. As a surgical team, we make every effort to minimise these risks. This will include giving antibiotics before and after surgery, Injection/Tablet and use of surgical stockings to reduce the risk of clots and thorough pre and post-operative assessment and care.