A guide to total hip replacement surgery

Typically, pain due to a damaged hip is brought on by walking or bending and is felt in the groin and thigh. A careful assessment by an orthopaedic specialist is important to confirm the diagnosis and rule out alternative causes such as problems with the back, abdomen or surrounding muscles.

What happens during hip replacement surgery?

Total hip replacement surgery involves replacement of the femoral head and pelvic socket. Once the worn out head is removed, a replacement ceramic ball that is attached to the femur using a metal stem. The socket is then cleared of worn cartilage and bone and an artificial cup is inserted. Total hip replacements may be fixed in position either by using bone cement or a surface treatment onto which bone grows. The decision as to which form of replacement is most appropriate depends on the patients age, activity levels, bone strength and bone shape.

The operation takes about 60 minutes. Usually, a full general anesthetic is not required and a spinal anesthetic is used to numb the legs and provide good pain relief after the operation.

Recovery time after total hip replacement surgery

Although the process of recovery is quite variable, most people are able to take a few steps on the same day as surgery. Usually a walking frame is needed for the first day and then crutches for about two weeks. Most patients stay in hospital for 3 nights, although less fit patients or those who live alone may need a little longer. Patients tend to report moderate pain and to require regular pain-killers for the first two weeks or so.

How can the risks of surgery be minimised?

The vast majorities of patients experience no problems and tend to be extremely pleased with the outcome of hip surgery. Although every effort is made to make surgery safe and easy to recover from, complications can happen. It is important for patients to discuss possible complications carefully with their surgeon as their age, fitness and the condition of the joint can affect the risk.

A smooth and uncomplicated recovery is more likely if the patient is in the very best possible physical condition before surgery. Starting a light exercise program the month or so beforehand can help to build muscle strength and make getting back “on-track” much easier in the days following surgery.

Long-term health conditions such as diabetes or high blood pressure must be checked carefully and brought under optimal control. Smoking should be stopped and alcohol intake should be minimal in the weeks preceding surgery. Patients should also not shy away from directly asking their surgeon about their level of experience (ideally preforming at least 50 replacements per year), how they monitor their own results and what the scientific evidence is to support the the replacement implant they propose to use.

What are the alternatives to surgery?

For many people, surgery is not required and a combination of weight-loss, activity modification and pain-killers may be all that is needed. It is of course the case that many people with arthritis find it difficult to lose weight. Similarly, although sometimes helpful, long-term use of pain-killers may cause side-effects and there are some risks. Physiotherapy and a moderate non-impact exercise program can help to strengthen the muscles around the hip that often become weak. A steroid injection into the hip joint can sometimes be helpful though the benefit only tends to last for a few months.