What is a hip replacement

A hip replacement is a surgical procedure which replaces the severely damaged hip bone with an artificial ball and socket that does the function of the natural joint. Appropriate cuts are made in thigh bone (femur) and pelvic bone (metallic/plastic components inserted in their place depending on surgeons choice.

Why is it done ?

The purpose of a new hip joint is to: relieve pain, improve the function of your hip, improve your ability to move around and improve your quality of life. Some common reasons why a hip joint can become damaged include:

  • osteoarthritis – so-called "wear and tear arthritis", where the cartilage inside a hip joint becomes worn away, leading to the bones rubbing against each other
  • hip fracture – if a hip joint becomes severely damaged during a fall or similar accident it may be necessary to replace it Many of the conditions treated with a hip replacement are age-related so hip replacements are usually carried out in older adults. However, a hip replacement may occasionally be performed in younger people.

What are other options?

The options you have depend on the degree of arthritis you have. If you have

Degree of arthritisoptions

The operation itself usually takes one to two hours. From the time you leave your bed and return to the ward will take few hours as following operation, you will be kept in recovery ward till you recover fully from the operation.

How long would I stay in the Hospital?

Most people stay for 3-5 days. The factors which decide length of your stay at hospital are Your age, pre-op health, how you used to walk before the procedure, associated medical problems, any problems after operation itself, your mental attitude and the help you have at home etc., Stitches / clips are removed between 10-14 days from operation.

When can I walk after the operation?

Usually the next day once the nursing staff are happy that you have made a good recovery from the operation and all your observations are satisfactory. Take things one at a time and do so at your own pace. In the first few days you will be able to walk with a zimmer frame with the help of physiotherapist. Once you have made reasonable progress, you might use crutches. With time you might want to walk with one crutch and finally without any!!!!!!. Remember every one is different and it is quiet normal if you are using a crutch at 6 weeks.

What will happen after discharge?

You will be followed in the clinics periodically to see how you are getting on and to address any of your doubts. You may need home or outpatient physiotherapy sessions for supervised exercises. Speak to your doctor or physiotherapist regarding the frequency or duration of physio required. You can drive a car usually after 6 weeks. In general, once you are able to walk without crutches or sticks without a limp, you are able to drive. If your work is sedentary or supervisory, you may return as a part timer doing light duties at 6 weeks provided you have some control on your working environment.

How long does this new hip last?

A total hip replacement lasts approximately 15-20 years with an annual failure rate between 0.5-1.0%. This means that if you have your total joint replaced today, you have a 90-95% chance that your joint will last 10 years, and a 80-85% that it will last 20 years. It is estimated that around 1 in 10 people with an artificial hip will require revision surgery at a later date. For simplicity, it can be said that if we operate on 100 patients and see them after 10 years about 95 to 98 of them are doing well.

What problems can happen ?

As every thing else in life, there are pros and cons for anything we do. The good thing about the hip replacement is if the operation is successful, you will have a near painless hip to enable you to carryout most of your daily activities.

What problems can happen ?

As every thing else in life, there are pros and cons for anything we do. The good thing about the hip replacement is if the operation is successful, you will have a near painless hip to enable you to carryout most of your daily activities.

COMMON :

  • DVT:(deep vein thrombosis) is a blood clot in a vein. The risks of developing a DVT are greater after any surgery (and especially bone surgery). You may be given medication and or stockings to try and limit the risk of DVTs from forming. Starting to walk and moving early is one of the best ways to prevent blood clots from forming
  • Bleeding: this is usually small and can be stopped in the operation. However, large amounts of bleeding may need a blood transfusion or iron tablets. Rarely, the bleeding may form a blood clot or large bruise within the wound which may become painful & require an operation to remove it.
  • Joint dislocation: if this occurs, the joint can usually be put back into place without the need for surgery. Sometimes this is not possible, and an operation is required, followed by application of a hip brace or rarely if the hip keeps dislocating, a revision operation may be necessary.
  • Pain: the hip will be sore after the operation. If you are in pain, it’s important to tell staff so that medicines can be given. Pain will improve with time. Rarely, pain will be a long term problem. This may be due to altered leg length or any of the other complications listed below, or sometimes, for no obvious reason.
  • Prosthesis wear/loosening: Modern operating techniques and new implants, mean that most hip replacements last over 15 years. In some cases, this is significantly less. The reason is often unknown. Implants can wear from overuse. There is still debate as to which material is the strongest. The reason for loosening is also unknown. Sometimes it is secondary to infection. This may require removal of the implant and revision surgery.
  • Altered leg length: the leg which has been operated upon, may appear shorter or longer than the other. This rarely requires a further operation to correct the difference or shoe implants.

LESS COMMON:

  • Infection: You will be given antibiotics at the time of the operation and the procedure will also be performed in sterile conditions (theatre) with sterile equipment. Despite this infections still occur (1 to 2%). The wound site may become red, hot and painful. There may also be a discharge of fluid or pus. This is usually treated with antibiotics and an operation to washout the joint may be necessary. In rare cases, the prostheses may be removed and replaced at a later date. The infection can sometimes lead to sepsis (blood infection) and strong antibiotics are required.
  • Bone Damage: the thigh bone may be broken when the implant (metal replacement) is put in. This may require fixation, either at time or at a later operation.
  • RARE:

  • Altered wound healing: the wound may become red, thickened and painful (keloid scar)
  • Nerve Damage: Nerve Damage: efforts are made to prevent this, however damage to the nerves around the hip is a risk. This may cause temporary or permanent altered sensation along the leg. In particular, there may be damage to the Sciatic Nerve, this may cause temporary or permanent weakness or altered sensation of the leg.
  • Blood vessel damage: the vessels around the hip may rarely be damaged. This may require further surgery by the vascular surgeons.
  • Pulmonary embolism (PE) is the spread of a blood clot to the lungs and can affect your breathing. This can be fatal.

What problems can happen ?

As every thing else in life, there are pros and cons for anything we do. The good thing about the knee replacement is if the operation is successful, you will have a near painless knee to enable you to carryout most of your daily activities.

The things that can go wrong are COMMON:

  • Pain: the knee will be sore after the operation. If you are in pain, it’s important to tell staff so that medicines can be given. Pain will improve with time. Rarely, pain will be a chronic problem & may be due to any of the other complications listed below, or, for no obvious reason. Rarely, some replaced knees can remain painful.
  • Bleeding: A blood transfusion or iron tablets may occasionally be required. Rarely, the bleeding may form a blood clot or large bruise within the knee which may become painful and require an operation to remove it.
  • DVT:(deep vein thrombosis) is a blood clot in a vein. The risks of developing a DVT are greater after any surgery (and especially bone surgery). You may give you medication to try and limit the risk of DVTs from forming. Starting to walk and moving early is one of the best ways to prevent blood clots from forming
  • Knee stiffness: may occur after the operation, especially if the knee is stiff before the surgery. Manipulation of the joint (under general anaesthetic) may be necessary
  • Prosthesis wear: With modern operating techniques and new implants, knee replacements last many years. In some cases, they fail earlier. The reason is often unknown. The plastic bearing is the most commonly worn away part

LESS COMMON:

  • Infection: You will be given antibiotics at the time of the operation and the procedure will also be performed in sterile operation theatre conditions with sterile equipment. Despite this infections still occur (1 to 2%). The wound site may become red, hot and painful. There may also be a discharge of fluid or pus. This is usually treated with antibiotics and an operation to washout the joint may be necessary. In rare cases, the prostheses may be removed and replaced at a later date. The infection can sometimes lead to sepsis (blood infection) and strong antibiotics are required.

RARE:

  • Pulmonary embolism (PE) is the spread of a blood clot to the lungs and can affect your breathing. This can be fatal.
  • Altered leg length: the leg which has been operated upon, may appear shorter or longer than the other.
  • Altered wound healing: the wound may become red, thickened and painful (keloid scar)
  • Nerve Damage: efforts are made to prevent this, however damage to the small nerves of the knee is a risk. This may cause temporary or permanent altered sensation around the knee. There may also be damage to the Peroneal Nerve, this may cause temporary or permanent weakness or altered sensation of the lower leg. Changed sensation to the outer half of the knee may be normal.
  • Bone Damage: bone may be broken when the implant / prosthesis is inserted. This may require fixation, either during or at a later operation.
  • Blood vessel damage: the vessels at the back of the knee may rarely be damaged. may require further surgery