Hip replacement surgery
Hip replacement surgery is a common type of surgery where a painful hip joint (usually as a result of osteoarthritis) is replaced by an artificial hip joint (known as a prosthesis).
Most hip replacements are carried out on people between the ages of 60 and 80 but adults of any age can be considered for a hip replacement.
Surgery is usually carried out when all other treatment options have failed. After surgery, most people can expect a significant reduction in pain and some improvement in their range of movement.
A modern artificial hip joint is designed to last for at least 15 years.
Why do I need a hip replacement operation?
Hip replacement surgery is usually necessary when the hip joint is worn or damaged to the extent that your mobility is reduced and you experience pain even while resting.
Most patients needing hip replacement surgery will have osteoarthritis. However other conditions that can cause hip joint damage include:
- rheumatoid arthritis
- septic arthritis
- a hip fracture
- ankylosing spondylitis
- disorders that cause unusual bone growth (bone dysplasias).
A hip replacement is major surgery, so is normally only recommended if other treatments, such as physiotherapy or steroid injections, haven't helped reduce pain or improve mobility.
You may be eligible for hip replacement surgery if:
- you have severe pain, swelling and stiffness in your hip joint and your mobility is reduced
- your hip pain is so severe that it interferes with your quality of life and sleep
- everyday tasks, such as shopping or getting out of the bath, are difficult or impossible
- you're feeling depressed because of the pain and lack of mobility
- you can't work or have a normal social life.
However a consultant orthopaedic surgeon will need to assess you first.
What happens during hip replacement surgery?
A hip replacement can be carried out under a general anaesthetic (where you're asleep during the procedure) or an epidural (where the lower body is numbed). With a selection of anaesthetic techniques available, your surgeon will decide on the best one for you.
For the operation an incision will be made to the hip so that access can be gained and the damaged ball and socket removed. The artificial hip implant may either be a metal stem and metal acetabular cup with ceramic on ceramic bearing, or a metal stem and metal acetabular cup with a polyethylene (hard plastic) lining. The new artificial hip may or may not be secured with acrylic cement depending on your age, bone quality and consultant preference.
The new ball and socket will be bonded to the bone either via a special coating on the new ball and socket or using acrylic cement. This surgery is likely to take between one and one and a half hours. You'll need to be well enough to cope with both a major operation and the rehabilitation afterwards.
Recovering from hip replacement surgery
Recovery time in hospital is between three and seven days.
Your doctor / physiotherapist will give you a rehabilitation exercise programme to follow after surgery designed to help you regain strength and improve the use of your new hip. It’s very important that you commit time and effort to completing these exercises, designed to help you recover.
You will need to use walking aids such as crutches or for the first few weeks four to six weeks.
Total hip replacement surgery has a good success rate with patients making positive recovery, feeling less pain and becoming more mobile. However, good care should be taken of the new artificial hip so that any deterioration is kept to a minimum. This is because, like a normal hip joint, an artificial one has a finite life.
Most people are able to resume normal activities within two to three months but it can take up to a year before you experience the full benefits of your new hip.
Preparing for hip replacement surgery
Risks of hip replacement surgery
Complications of a hip replacement can include:
- hip dislocation
- infection at the site of the surgery
- injuries to the blood vessels or nerves
- a fracture
- differences in leg length
However, the risk of serious complications is low – estimated to be less than 1 in a 100. There's also the risk that an artificial hip joint can wear out earlier than expected or go wrong in some way. Some people may require revision surgery to repair or replace the joint.
To sum up
Although injury or rheumatoid arthritis can be the reason for arthritis of the hip joint, often there is no recognisable cause. However, total hip replacement could relieve you of harsh pain, restricted mobility and disability so that you can walk normally again.