Hip replacement: what are my options?

Hip replacement is one of the most common surgeries performed in the UK each year, but why are they so common? We speak to leading consultant trauma and orthopaedic surgeon, Mr Peter Craig, who discusses why the surgery is performed and the various types of hip replacements available.

Why is hip replacement surgery performed?

Total hip replacement surgery is done first and foremost to relieve pain. It involves the replacement of the hip joint by an implant i.e. by a prosthesis. It consists of a femoral component or stem and an acetabular component or cup. Both components are articulated with a head applied to the femoral stem and an insert in the cup.

Types of hip replacements

The stem inserted into the femur can either be used with or without cement. The latter is coated with a material that stimulates the bone to grow onto the prosthesis, achieving a “biological fixation”. The decision when choosing between the two is multifactorial.

In my practice, I use a cemented stem called the “Exeter hip”, which has the most established track record of any stem on the market. It affords complete control of positioning and sizing, which permits accurate recreation of normal hip anatomy. The acetabular component I use most frequently is an uncemented version that achieves the biological fixation described above. Occasionally, if the bone quality is very soft, a cemented socket is placed.

The “bearing couple” (the materials that will be in contact during the motion of the hip) is the femoral head and the acetabular liner. In modern practice, this is most commonly a metal femoral head articulating against a very hard-wearing plastic liner sat within the metal acetabular shell. In very young patients, a ceramic ball is occasionally used.

Fortunately, because of the enormous advances made in these materials, hip replacements should remain well-functioning for upwards of 20-25 years after surgery.

What complications are associated with the surgery?

Despite the surgeon’s best efforts, complications can occur. The majority of these complications occur very rarely, but some can be serious. The most significant possible complication is an infection on and around the implant.

Antibiotics alone cannot eradicate this sort of infection and therefore, more surgery is needed to remove the implant.

There are some other infrequent but serious complications that can arise. These include the developnent of a vein clot (deep vein thrombosis) that may travel to the lung (pulmonary embolus) and the dislocation of the ball from the socket.

If you are considering hip replacement surgery and would like to book a consultation with Mr Peter Craig, simply visit his Top Doctors profile today.