What is a total hip replacement?
A total hip replacement involves replacing a worn out hip joint with a metal and plastic replacement. The femoral head (ball part of the joint) is replaced but a metal equivalent and the acetabulum (cup part of the joint) is resurfaced in plastic. The metal components are made of cobalt chrome and the plastic of polyethylene.
Are there any alternative treatments to a hip replacement?
Yes there are and include adequate pain relief, physiotherapy and injections. Your consultant will explore all these avenues with you before embarking on a hip replacement.
What happens during the operation?
A 25cm cut is made just along the outside of your hip region and the bone is prepared to allow the hip replacement. The metal and plastic components are attached using bone cement which is comparable to grout. Once the new hip is stabilised, it is then washed out and the wound stitched up and bandaged. The operation usually takes about an hour and a half.
What happens after the operation?
Once you have woken up you will be returned to the ward. The next day you will be encouraged to get out of bed and start physiotherapy to get your hip moving. Most people require about seven days in hospital before they are safe to go home, but it depends on the individual. The important aspect is that you are safe to go home. Your physiotherapist will arrange further physiotherapy as an out-patient.
How long does it take to recover from the operation?
Everyone varies but in general you should feel comfortable in about three months, but will continue to improve for over a year. You may feel tired for a number of months.
Are there any complictions with this surgery?
The overall success rate from this surgery is about 90% although you will need to be aware of the following complications;
- Thrombosis refers to blood clots in the leg. These are quite common, but most patients are unaware of them and they cause no problems and resolve with no specific treatment. However, sometimes they can be large and cause considerable problems. If they break off and travel to the lungs they are called embolisms, and can be fatal to 3 in 1000 patients. We will give you specific treatment to try and prevent this.
- Infection is a serious potential problem that occurs in about 1% of patients despite the use of antibiotics. If the metalwork gets infected, it is exceedingly difficult to eradicate the infection, and may require numerous operations, with no guarantee of success. We will give you antibiotics to try and prevent infection.
- Aseptic loosening is a term used to describe the wearing out of a joint in time. Roughly 95% of total hip replacements last 10 years, but in certain people the lifetime of the joint may be a lot less. Many joints can last far longer, if the patients looks after his or her joint well.
- Persistent pain can occur even after anotherwise apparently successful hip replacement. The cause is often not evident and it may be impossible to eradicate it.
- Dislocation can occur any time after the operation, but most commonly within the first few months. We will teach you various exercises to improve the muscles around your hip to try and prevent this, but most importantly there are certain movements around your hip that you must avoid.
If the joint wears out in the future can it be replaced again?
Yes it can but the success rate is not quite as good. Surgery is more difficult, the complications are twice as likely and it takes more outof the patient who is older and perhaps not quite as fit and he or she was the first time around.