Mr Simon Jennings
FRCS (Tr & Orth)
020 7486 9323
simonjennings107@btinternet.com

Surgery

Total Hip Replacement

Total Hip Replacement

What is Total Hip Replacement?

A total hip replacement is used to replace a damaged or worn hip joint to restore functional range of movement and reduce pain. The ball and socket hip joint is removed and replaced with an artificial ball and socket (prosthesis).

The majority of patients find that after their hip replacement they rapidly experience significant pain relief and improvement in movement. This means that they find everyday functions such as sitting, walking and driving much more comfortable than before.

What can I expect?

If you have arthritis of the hip you will have a rapid clinical assessment eliciting details of your difficulties and level of discomfort. You will require imaging of your hips to assess and plan surgery. All patient will undergo X-ray assessment but other scans may be required to confirm the diagnosis. You will be taken through all the available treatment options and your treatment will be tailored to your individual case and needs.

Do I need a hip replacement?

The decision to carry out surgery is only made after a thorough consideration of the symptoms you are suffering, the likely risks and benefits of surgery and an evaluation of whether other treatment modalities would be appropriate.

Other treatments include: exercise, taking pain killers including non-steroidal anti-inflammatories (NSAIDs), physiotherapy with muscle strengthening and corticosteroid injections. Self-help measures such as losing weight can also be beneficial.

What does surgery involve?

Hip replacement is carried out under a general or spinal anaesthetic.

The operation lasts from 70 to 90 minutes. An incision is made at the side of the hip in order to gain access and replace the damaged joint.

The latests techniques are used to reduced pain and discomfort and enhance your rapid recovery from surgery.

Your treatment will be aimed at early mobilisation. This will serve to dramatically reduce your risk of blood clots and will help you promote good muscle function and recovery.

How long until the hip is pain free?

After surgery you will probably feel a little tightness but should not feel significant pain. You will see a steady and rapid return of mobility once the surgical discomfort subsides. Depending on the pre-surgery condition you may feel a slight difference in posture that will rapidly improve with physiotherapy.

As your muscles become stronger you will be able to go up and down stairs in a normal fashion (usually 4-6 weeks).

Are there any Specific hip replacement precautions?

To reduce the risk of hip dislocation your physiotherapist will teach you how to safely get in and out of bed, give you advice on dressing and toileting.

They will also show you which movements to avoid during the early recovery period.

Before discharge you will be shown how to get in and out of a car and you will safely negotiate the stairs.

It is advisable to sleep on your back, though you may sleep on your operated side with a pillow between your knees to prevent your leg from turning in.

For the first 6 weeks you can only have a walk-in shower or strip wash sitting on a high stool. You should not attempt to have a bath until you are 6 weeks from surgery.

Do not be frightened to resume normal sexual relations, being careful not to force your hip into an uncomfortable position.

How long do I need off work?

This is variable and depends on the nature of your work. Most patients return to work 6 weeks after their operation. Some more physically demanding jobs may require longer off work.

When can I drive?

Usually you can drive for six weeks after hip replacement surgery.

If you are confident walking without crutches and able to enter a car unaided then a return to driving may be reasonable from 4 weeks after surgery.

Always check with your car insurance company before getting back on the road. It is important that in an emergency you are able to stop the car safely.

When can I return to activity?

Most patients are able to return to a high level of activity following hip replacement surgery. Repetitive loading and impact such as running may be possible but is more likely to wear your joint more rapidly. Activities that involve deep bending of your hip, such as certain yoga movements are best avoided. After 3 months (riding, golf, doubles tennis) should be fine.

When can I fly?

There is an extra risk of blood clots in the legs (DVT or deep vein thrombosis) after major hip surgery up to 6 weeks following operation. During this time long haul flights should be avoided.

Shorter flights may be contemplated with much less risk.

You should always consider using appropriate precautions including good hydration, regular movement /exercise, use of compression stockings when flying.