HIP REPLACEMENT

What is a Hip Replacement?

Hip replacement surgery is one of the most successful surgical procedures performed today. The operation itself involves cutting and removing the upper thigh bone which connects to the hip socket.

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In its place a metal substitute is inserted into the upper end of the thigh which has a separate ball bearing surface attached.  The hip socket is also resurfaced. In its place a thin metal shell is inserted. Inside the metal shell is a special plastic which helps to improve the longevity of the hips success.

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FAQ’s

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Why is my hip sore?

Hip pain is multi factorial in its origin. The source of which is determined by the clinical judgement of your surgeon. One of the most common reasons for hip pain is arthritis. Two of the most common types are osteoarthritis (sometimes called wear-and-tear arthritis) and rheumatoid arthritis (a systemic auto-immune disease).

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With osteoarthritis, the cushioning cartilage at the end of the femur may have worn down, making walking painful as bone rubs against bone.

With rheumatoid arthritis, sometimes called inflammatory arthritis, a person’s immune system attacks the joints with uncontrolled inflammation, potentially causing joint erosion.

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With post-traumatic arthritis, a less common form of arthritis, a broken or fractured bone extends into the joint space, causing the surface to become uneven. Over time, friction causes the joint to break down and become arthritic.

Will I need surgery?

You will not always need surgery to obtain pain relief. Mr Leonard may recommend a combination of treatments to alleviate your pain and help you get moving again.

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However those patients with significant joint disease like osteoarthritis that haven’t responded to non-invasive treatment options such as physiotherapy may need a hip replacement. Each patient is different and this is why a consultation is necessary to discuss the most appropriate options for you.

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What should I expect during a hip replacement?

There are two anaesthetic options for surgery. One is a spinal, which is most common and the second is a general anaesthetic. If a spinal injection is the preferred option recommended by the anaesthetist there is a possibility to combine this with sedation so that you are unaware of the procedure.

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What is a “hip” made of?

A hip is actual composed of a few different parts. The parts used will depend upon what the surgeon deems is the best choice for you. Essentially there are two categories of hips, cemented hip and un-cemented hips. Cemented as the name suggests involves the use of a specially designed and manufactured bone cement which helps position the hip stem in the bone. Cemented stems are generally made from stainless steel while the femoral “head” that sits on the stem can be made from stainless steel or ceramic. Un-cemented stems are manufactured from commercially pure titanium. The socket that the head rotates within is a highly cross linked polyethylene plastic which sits inside a titanium shell. There are also cemented shell options but these are less frequently used. 

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How long is the operation?

The operation will last approximately one hour.

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What should I expect after surgery?

Post-operative care is vital to successful surgery. The medical staff such as doctors and nurses will monitor your progress and care for you as needed. You will be required to partake in a rehabilitation programme as research shows that your participation here will have a large bearing on the successful outcome of your knee replacement. All of this will be overseen by your surgeon.

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How long will I be at the hospital?

Most patients stay in the hospital one to two nights and are then discharged. Each patient must meet medical criteria for discharge as well as meet certain physiotherapy criteria.

If you require more therapy or medical management we will delay discharge until those needs are addressed.

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When can I shower?

You will be advised by the nursing staff as to how soon you can shower when you are in the hospital. Waterproof dressing are used on all incisions to ensure that the surgical site remains clean and dry. You should avoid however getting too much water onto the dressing. After the dressing is removed at approximately one to two weeks you can shower normally with the incision exposed. Be sure to pat the skin over the incision and avoid rubbing it with a towel.

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When can I drive?

This is very much dependent upon each individual. A good indicator is when you are able to sit, rise and rest comfortably in a chair. Being able to lift your leg from side to side is also a good test. Remember though that driving will require a significant amount of bending at your knee and a prolonged period of time in a car may cause pain. This will lessen over time but we advise caution with regard to this.

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I am experiencing a lot of swelling, is this normal?

Due to the effect of gravity fluid can accumulate in the legs. It is common that this wasn’t present in the hospital but now is present when you return home. This is generally because you are being more active at home. In order to address this you should elevate your legs at night by lying on your back and placing pillows under the legs so that they are above your heart.

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Compression stockings can be worn during the day to help. Maybe someone at home can help you put these on in the morning, use them during the day and then take them off at night. These can be purchased from most pharmacies if needed.

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When can I return to work?

This is determined by your occupation. Your recovery period is important and a time off work will enable you to concentrate on your rehabilitation programme. It is good advice to take time off during the initial post-operative period.