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Hip Replacement

Hip Pain

Hip Pain

As we get older, we can start experiencing severe hip pain. Cartilage acts as a cushion and it’s found in between the ball and socket of the hip joint. In most cases of hip pain, this cartilage starts to break down, leading to osteoarthritis (where the hip bones rub together, causing pain). There are non-surgical ways of treating hip pain including medications and injections. If these ways don’t reduce hip pain and improve mobility, a total hip replacement may need to be considered. Recovery from a total hip replacement can take anywhere between 6 and 12 months.

Hip Replacement

What is a Hip Replacement?

A hip arthroplasty is more commonly known as a hip replacement. This type of hip surgery involves replacing the damaged hip joint with an artificial implant, which is made from metal and plastic. The hip contains the hip socket (acetabulum) and the head of the thigh bone (femur). During surgery, these parts are removed and replaced with metal and plastic artificial parts. Similar to a total knee replacement, the parts are then fixed to the bone with cement or coatings that encourage bone in-growth. Cementless hip replacements can also be offered, which allow the bone to grow into it. This is something that should be considered for younger patients. Most hip replacement surgeries are carried out on individuals between the ages of 55 and 80. With that being said, there are many reasons why an individual of any age may require a hip replacement. You can find out more about hip replacements with patient resource videos.

Common Reasons for a Hip Replacement

Apart from osteoarthritis, your GP or doctor may recommend a hip arthroplasty if you are experiencing severe pain, inflammation, stiffness or damage to your hip joint, caused by the following conditions:

  • Rheumatoid arthritis – an autoimmune disease
  • Septic arthritis – joint infection
  • Osteonecrosis – disrupted blood flow
  • Hip fracture
  • Bone dysplasias – abnormal bone development
  • Avascular necrosis (blood flow failure)
What to Expect

What to Expect?

If the pain you are experiencing is regular throughout the day and night or it restricts the way you work or engage in social activities, we will need to examine the problem. We may consider other procedures before resorting to surgery, but if you are showing arthritis advancing rapidly during initial scans, hip replacement may be the best option.

Whilst the goal of a hip replacement is to relieve pain and to aid mobility, the replacement is not a normal hip and it won’t be as good as the original. For 90-95% of patients, it allows you to live nearly or completely pain-free for up to 10 years. The only restriction is that you won’t be able to return to strenuous active sports or heavy labour. After 10 years, you may need to consider hip revision surgery to replace the artificial hip and maintain a mobile life. This is due to the replacement loosening over time – 5-10% of patients require revision surgery after this amount of time. It should be noted that the risk complications of a second surgery are higher and won’t be as good as the first replacement.

Before

  • Ensure your doctor is aware of any medications you are taking
  • Try to stop smoking 8 weeks or more before your operation
  • Keep a healthy weight
  • Try to exercise regularly
  • Have a bath or shower the day of or the day before your operation

During

  • After you’ve been given the anaesthetic, an incision will be made on your hip where the damaged part of your hip will be removed
  • The replacement will then be placed where the original joint was – it will be held in place with cement or coating that seals to the bone
  • Using stitches, tape or staples, the wound will be closed

After

  • After your procedure, you’ll be transferred to the recovery room to come around
  • There will be a dressing covering the wound and there may be a small tube where excess fluid is drained. A nurse will be on hand during this time.
  • Some patients may be connected to an IV (drip) which keeps them hydrated and pain-free.
  • The nurse will check your vital signs and transfer you to your room when you are ready
Recovery

Recovery

You will need to ensure that your home is equipped for your recovery:

  • Someone will need to drive you home from the hospital
  • If you are looking after or caring for someone else, you may need to look into alternative carers
  • You may need assistance in your home whilst you recover – this may be for cooking and cleaning
  • Prepare and freeze meals in advance or ask friends and relatives for assistance when cooking and shopping
  • Remove tripping hazards such as rugs and mats
  • Organise your home to avoid excessive lifting and bending
  • Avoid flying and long journeys for at least 12 weeks after your surgery.
Hip Replacement Surgery

Are There Any Complications to Hip Replacement Surgery?

As with most surgeries, complications can arise – rest assured that they are very limited to a small case of patients. Please see below for a list of complications that can arise at various stages of surgery:

Anaesthetic complications for hip replacement

The choices of anaesthetics you will be given include general, spinal or a combination of the two. There is a very small risk of having a heart attack, stroke, or chest infection after your hip replacement. You will always be given the opportunity to speak with your anaesthetist, who will run through the risk and your options.

General complications for hip replacement

  • Deep vein thrombosis – this occurs when a blood clot forms in the veins in your legs. This can happen to 10-20% of patients. The clot may become dislodged and travel to the lungs in the bloodstream. The chances of the clot travelling to the lungs are very low (1-2% of patients)
  • Problems passing urine – 20% of patients experience this. In this instance, you may be given a catheter that’ll help drain your bladder
  • Pain – this happens for every operation. It can be managed through certain techniques
  • Nausea and vomiting – this can happen to 10% of patients
  • Wound infection – this can be treated quickly with antibiotics.

Hip Replacement Surgery Complications

  • Leg length difference – this can happen with 10% of patients. Although every measure will be taken to maintain the length, in some cases there is no guarantee
  • Stiffness in the hip – 10% of patients experience this
    Consistent pain in the hip – this happens to 5% of patients
  • Dislocation – this is where the ball pops out of the socket and can happen to 2% of patients
  • Weakened muscles can cause this in the early stages after surgery
  • Hip infection – this happens in 1% of patients. This can lead to the replacement loosening and ultimately the failure of the joint. Further surgery would be required to control it
  • Swelling from bleeding in the thigh (Haematoma) – this occurs in only 1% of patients
  • Injury to the nerves – this can lead to numbness and weakness in the leg. This is incredibly rare
  • Bone and blood vessel damage – this is an incredibly rare occurrence.
Recovery from Hip Replacement Surgery

Recovery from Hip Replacement Surgery

In the short term, a nurse will periodically check on you to ensure that you’re okay and recovering. After the anaesthetic has worn off, you will be able to eat and drink something and you can start moving your legs.

Whilst you are lying in bed, it’s important to prevent blood clots by encouraging circulation in your legs. This can be done in a number of ways:

  • Boots that are inflated with air for the first 2 days post-op
  • Support stockings, which we recommend keep wearing for 4-6 weeks
  • Injections or tablets on a daily basis, which will be administered for up to 6 weeks.

Walking

On the day of your surgery, your physiotherapist will recommend some exercises for you to do whilst you’re in bed. This will help to strengthen the muscles around the new hip. The day after your surgery, an X-ray will be taken of the new hip to ensure that it is in the correct position. On this day, you can start taking your first steps. Using a frame, your nurse will help you walk around until you are able to do this alone. You also need to regularly repeat your exercises. In the days after your surgery, you’ll be given some advice on how to get on and off your bed, a chair and the toilet to aid mobility and healing. You’ll be given crutches or a walking stick to aid walking and some more exercises to do.

Once you can walk up and down the stairs safely and you’re recovery is assessed by the healthcare team, you will be able to go home. You must ensure there is someone available to take you home, as you won’t be able to drive.

Driving

You can start driving again after 2 weeks, but some people need recovery for up to 8 weeks before attempting to drive. You must ensure you are covered by your insurance and have the go-ahead from your doctor.

Working

  • If you work in a job similar to an office-based role (sedentary) you can return in 4-6 weeks
  • If you work in a job similar teaching job (mixed-labour), you can return after around 3 months
  • If you work in a job similar to construction (manual labour), you can return in around 6 months.

You must come back to the hospital for a check-up within 6-12 weeks. This will be arranged before you go home.

Why Consider a Hip Arthroplasty with Us?

To discuss your options, you can arrange a consultation at Stoke Orthopaedic Solutions with our dedicated orthopaedic specialist and surgeon. We can make a diagnosis and treatment plan based on your medical history and further examination. During the consultation, you will also have the chance to ask any questions you may have. Book a consultation with us today.

Epidural & Spinal Anesthesia

This 3d medical animation shows epidural and epidural anaesthesia procedures.

Recovery from Hip Replacement Surgery
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