Hip Replacement

What is it?

During a hip replacement, the orthopaedic surgeon cuts away the diseased and damaged parts of the joint and replaces them with a prosthetic implant made from metal, ceramic and hard plastic. Depending on the extent of the damage to your hip joint, you may be offered a total hip replacement (also called total hip arthroplasty) or a partial hip replacement (hemiarthroplasty). With a total hip replacement, both the hip socket and the head of the femur (the “ball”) are replaced, using a durable plastic cup for the socket and a ball made from ceramic or metal alloy. In a partial hip replacement only one side of the hip joint – the femoral head – is replaced. For some patients – usually younger, more active ones – hip resurfacing is sometimes possible which retains your natural femoral head. This procedure offers greater stability than a total hip replacement, although it is not suitable for everyone.

Who might need it?

You will normally be offered hip replacement surgery if you are experiencing severe pain due to a condition like arthritis or if you have sustained a serious fracture to your hip. Although joint replacement surgery is a routine procedure, it is still a major operation and carries a risk of complications. For this reason, it is normally only offered once other less invasive procedures, such as painkillers, physiotherapy or therapeutic injections, are no longer effective.

What to expect

Hip replacements are normally carried out under general anaesthetic, which means you will be asleep throughout. In some cases, however, the operation can be performed with an epidural which means you will be awake but unable to feel any pain. An incision of around 20-30cm is made along the hip and thigh. Once the damaged bone has been cut away, an artificial implant is carefully positioned in its place and the incision closed with stitches or clips. In some cases, it is possible to perform the procedure arthroscopically (using keyhole surgery) although not everyone is suitable for this procedure. After surgery you will be encouraged to get up on your feet as quickly as possible. A physiotherapist will recommend exercises to build strength and flexibility in your new hip joint and prevent stiffness. You will stay in hospital for four to eight days.

Benefits of hip replacement surgery

A hip replacement is a highly successful procedure that can help to alleviate the pain and disability associated with severe joint damage. It restores function and mobility, enabling you to do many of the activities you used to enjoy and experience an improved quality of life. Your surgeon will discuss potential risks with you beforehand. These can include swelling and soreness which can last for several weeks, infection which will be treated with antibiotics or the development of a blood clot which can have serious implications. You will be carefully monitored after surgery and advised of any warning signs to look out for.