SMALL INCISION TOTAL HIP REPLACEMENT
WHAT IS IT?
A total hip replacement replaces both the ball and the socket of the hip join. The artificial hip is made of a metal shaft with a metal or ceramic head attached to the top and a socket component. This can be made purely of special polyethylene or a metal shell and a polyethylene or ceramic insert.
DO I NEED A HIP REPLACEMENT?
Total hip replacement is a brilliant operation to take away the pain caused by arthritis in the joint. In the first instance though you should try to manage your pain with lifestyle changes, exercise and medication. You can find further advice here. If you still cannot walk as much as you would like because of pain or cannot sleep the time has come to consider surgery.
WHAT IS INVOLVED?
Preparing for your operation
We need to make sure you are as fit and prepared as possible to minimise the risk of complications and to ensure a speedy and smooth recovery. You will have a pre-assessment to identify any correctable abnormalities such as high blood pressure, anaemia and diabetes. It is advised that you stop smoking and try to loose weight if applicable. If you have a BMI of 40 or more we may have to postpone your surgery until you can loose some weight.
We will ask you to take part in a joint replacement class which is run by our physiotherapists. This is an invaluable resource to prepare you for your joint replacement journey from pre-surgery exercises to rehabilitation afterwards.
Hip replacement requires a general or spinal anaesthetic and the consultant carrying this out will discuss with you which one is best considering your circumstances and preferences.
During surgery a 10-12 cm cut is made on the side of the hip and the joint is exposed. The damaged ball of the hip is removed and the bone around the socket is prepared for the artificial socket which is inserted and fixed using bone cement or uncemented. The thighbone is then prepared for the stem component. This too can be cemented or cementless. The metal or ceramic head is attached to the top of the stem component and the hip is reduced. To conclude the operation the soft tissues and the skin are carefully closed. We use dissolvable sutures so there is noting to be removed once the wound has healed.
We aim to get you out of bed on the day of your operation. We will keep you comfortable using the least possible amount of pain medication. Our physiotherapists will guide you through the process of how to get in and out of bed and use any walking aid you may require. All being well you can go home after one or two nights in hospital.
We will give you an exercise program for home and our physiotherapists will assess your progress regularly. You can walk and use your hip as you are comfortable. There are no special precautions apart from avoiding extreme positions. Learn more.
WHAT ARE THE BENEFITS?
Pain relief is instant and most patients feel less pain even on the day of surgery than before.
Range of movement improves quickly, although this may take longer if you had a very stiff hip to start with.
Your mobility should improve gradually and if there are no other limiting conditions you should be able to walk several miles after a few weeks and return to your favourite activities including sports after a few months.
If you had pain or stiffness in the lower back this often improves after hip replacement.
WHAT ARE THE RISKS?
Fracture of the thigh bone or the pelvis.
Leg length difference.
Dislocation can happen if the hip is put in an extreme position.
Infection may necessitate further surgery.
Significant bleeding requiring blood transfusion.
Nerve injury with subsequent numbness or loss of power.
Blood clots in the veins or lungs
Anaesthetic complications are rare but you may feel sick or drop your blood pressure after surgery.
The overall benefit of surgery should far outweigh the risks, but it is important that you understand these in detail so you can make an informed decision. Find out more.