Total hip replacement

Overview

In this procedure diseased parts of the hip are removed and replaced with an artificial joint (prosthesis). The aim is to replace the hip that is painful and stiff with one that is pain-free, mobile and correctly aligned.

The artificial hip joint is made up of two parts:

• One to replace the head of the femur (the ball shape part of the thigh bone)
• Another replaces the acetabulum (hip socket) and is fitted into the pelvic bone.

The operation

1. This is usually done under a general anaesthetic
2. This operation takes approximately 75-90 mins
3. An incision is made on your side, over the hip joint
4. The worn ball and socket part of the hip joint are removed and the new artificial implants are fitted.
5. Your hip replacement may be held in place with bone cement. Alternatively an ‘uncemented’ procedure is used where the implants have a material that allow bone to grow onto and hold the new implants in place.

Occasionally may need a blood transfusion due to blood loss during this operation

After the operation

• Pain relief – good pain relief is important and you will be given this during and after your procedure. Some people need more than others so please inform the nursing staff if you are in any discomfort following your procedure.
• Hospital stay is usually 1-3 days.
• Physical activities – you will start to put weight on the hip with support from a frame or crutches from the day of your surgery. Usually by 6 weeks you would be able to walk independently or down to using one crutch.
• Swelling and bruising may take up to 8-12 weeks to improve.
• Showering and bathing – you need to keep your wound well covered using the waterproof dressing provided whilst showering. When bathing do not submerse wound in water as dressing are not designed to withstand this. This is important until the wound is healed and stitches have been removed
• Do not remain in one position for too long whilst in bed to prevent sores on your back, heels,ankles and to also reduce the risk of developing deep vein thrombosis.
• Increase activity with each day. You will notice most improvement in the first 3 months but can expect further improvement up to 12 months as your muscle become stronger.

Your surgeon and physiotherapist will discuss with you issues surrounding:

• Returning to work
• Using your knee following your operation
• Driving
• Anticipated length of rehabilitation
• Positions to avoid to reduce the risk of dislocation

Possible complications

All surgery has associated risks. These risks are higher in some patients than others. Risks include:

• Anaesthetic – your anaesthetist will discuss risks associated with the anaesthetic with you.
• Infection – there is a very small risk of wound infection following your operation that is minimised by giving you antibiotics. If at any time you notice a fever or increased pain, swelling or redness around you wound, please contact us urgently. Rarely patients may require to return to theatre for further surgery and/or be placed on prolonged course of antibiotics.
• Bleeding – this can sometimes occur after surgery and if severe may require a return to theatre.
• Deep vein thrombosis – this is a blood clot in the leg. You will be given blood thinning medication and support stocking to help prevent this. If you notice a pain in your calf then please seek immediate medical attention.
• Pulmonary embolism – this is a blood clot in your lungs. You will be given blood thinning medication to help prevent this. If you notice a sharp pain in your chest or shortness of breath then please seek immediate medical attention.
• Loosening – your new hip may eventually become loose or wear out over time. This will need to be replaced depending on your level of symptoms.
• Dislocation – the risk is highest when the muscles around the new hip are still relatively weak in the first 3 months.
• Less common complications – these include fractures and nerve injuries both of which are relatively rare. Please ask your surgeon for more information if required.

Precautions

There are some general precautions that must be considered especially in the first 6 – 8 weeks following hip surgery.

• Please contact us if you notice any redness, leaking of fluid or increased pain in the operated area
• Do not bend your hip to more than a right angle to avoid dislocation. This includes avoiding low chairs and toilet seats.
• Do not twist your hip or cross your legs
• It is better to lie on the operated side if you need to sleep on your side usually for the first 3 months

Please notify your surgeon if undergoing any other operations, hospital examinations, dental work or if you have an infection before your scheduled operation. Your operation may have to be deferred to reduce the risk of developing a deep infection of your artificial joint. If you are unsure please discuss this with your surgeon.