A hip replacement is a common type of surgery where a damaged hip joint is replaced with an artificial one. Over 100,000 are performed in England and Wales each year with adults of any age being considered for a hip replacement, although most are done on people between the ages of 60 and 80.
Why is it done?
Hip replacements are usually carried out when the hip joint is worn or damaged so that your mobility is reduced and you have pain – even at rest. Many patients find their sleep is disturbed which can be exhausting and affect your general health.
If you are thinking about having this operation you will often present with severe pain and stiffness. Your quality of life will suffer, everyday tasks such as shopping and self-care can become almost impossible. You may struggle to work or even have a social life. All these things can leave you feeling depressed.
The most common diagnosis for hip replacement is osteoarthritis (wear and tear). Other conditions include rheumatoid arthritis, hip fracture, hip infections and unusual bone growth (dysplasias).
Preparing for hip replacement surgery
Before you go into hospital, find out as much as you can about what’s involved in your operation. You will likely be provided with written information to take home after it has been explained to you in your consultation. There is also a wealth of information in websites such as https://www.versusarthritis.org.
Stay as active as you can. Strengthening the muscles around your hip will help your recovery. If you can, continue to do gentle exercise, such as walking and swimming, in the weeks and months before your operation.
How is it done?
Your hip replacement is highly likely to be carried out under a spinal anaesthetic which is when you are given an injection in your back to numb you from the waist down. You can be sedated on top of this but many of my patients listen to music, chat to the staff or even watch a movie on a phone! General anaesthetic is a more old fashioned technique with higher risks for most patients so tends to be avoided.
I will make a cut on the side of the hip to remove your damaged hip joint and replace it with the artificial implant. The surgery tends to take 1-2 hours and you are likely to need to stay in hospital for about 2 nights afterwards.
A physiotherapist will see you after your operation to give you advice on rehabilitation and fast recovery. There are certain positions it is best to avoid for the first 6 weeks and these are clearly show to all patients. An occupational therapist will check if you need any equipment to help you manage at home. It’s usually possible to return to light activities, office-based work or driving a car within around 6 weeks.
What are the risks?
The chance of having a complications during or after surgery is low. Risks can include hip dislocation, infection at the site of the surgery, injuries to the blood vessels or nerves, a fracture in the bone around the hip replacement during or after the operation, differences in leg length and also DVT (blood clots).
There’s also the risk that an artificial hip joint can wear out earlier than expected. Some people may require revision surgery to repair or replace the joint. However a modern artificial hip joint is designed to last for at least 15 year, with most implants lasting far longer than that.
Take home message
Hip replacement surgery has one of the highest patient satisfaction scores of all operations. In the right patient it can transform your life and get you back to how you used to feel before hip pain started to creep in. It is often the family members who tell me that they have got “their old” partner back when the pain burden is lifted.