Total Hip Replacement

Before scheduling a total hip replacement, you will meet with an orthopaedic surgeon to discuss your symptoms and medical history in detail. The surgeon will conduct a physical examination to assess the hip joint and range of motion and may order imaging tests such as X-rays, MRI, or CT scans to determine the severity of joint damage. Pre-operative tests, including blood work and an electrocardiogram (ECG), will be performed to ensure you are fit for surgery. Your surgeon will guide you through the process, answer any questions, and help you feel prepared for the procedure.

This comprehensive evaluation helps the medical team at OSD Healthcare to tailor the surgical plan to your specific needs, ensuring the best possible outcome for your hip replacement surgery.

Choosing a hip replacement surgeon

Choosing the right hip replacement surgeon is crucial to ensure a successful outcome. Here are some factors to consider:

Qualifications and experience

• Experience: Check if the surgeon has extensive experience in performing hip replacement surgeries, as this can significantly impact the success of the procedure.
• Success and Complication Rates: Ask about the surgeon’s success rate and complication rate to gauge their proficiency and reliability.
• Patient Reviews: Read online reviews and ask for referrals from friends or family members to get a sense of the surgeon’s reputation and patient satisfaction.

It’s also important to consider the surgeon’s bedside manner and communication style. You want to choose a surgeon who is willing to answer your questions, address your concerns, and provide you with personalised care, ensuring you feel confident and comfortable throughout the process.

Preparing for surgery

Preparing for hip replacement surgery involves several important steps. You may need to stop taking certain medications, such as blood thinners, a few days before surgery to reduce the risk of complications. A pre-operative assessment will be conducted to confirm your readiness, and you’ll meet with the surgical and anaesthesia teams to discuss the operation and address any concerns. It’s essential to arrange for someone to drive you home after the surgery and provide help with daily tasks during the initial recovery period. Finally, packing a bag with essentials, such as comfortable clothing and toiletries, will help make your hospital stay more comfortable.

Medical evaluation

A medical evaluation is a crucial step before undergoing hip replacement surgery. Your orthopaedic surgeon will review your medical history, perform a physical examination, and order diagnostic tests to assess your overall health and determine if you’re a good candidate for surgery. This evaluation will help identify any potential risks or complications and ensure that you’re prepared for the surgery.

During the medical evaluation, your surgeon will:

• Review your medical history, including any previous surgeries, allergies, and medications.
• Perform a physical examination to assess your hip joint and surrounding muscles.
• Order diagnostic tests, such as X-rays, MRI, or CT scans, to evaluate the condition of your hip joint.
• Discuss your expectations and goals for the surgery.
• Explain the risks and benefits of the surgery.
• Answer any questions you may have.

This thorough evaluation process ensures that your surgeon has a complete understanding of your health and can tailor the surgical plan to your specific needs, maximising the chances of a successful outcome.

Preparing your home and lifestyle

Preparing your home and lifestyle before hip replacement surgery can help ensure a smooth and safe recovery. Here are some tips to consider:

• Home Modifications: Remove tripping hazards, install handrails, and set up a comfortable recovery area to make your home safer and more accessible.
• Stock Up on Essentials: Prepare by stocking up on food, water, and other necessities to minimise trips to the store during your recovery.
• Hire Help if Needed: Consider hiring a home health aide or physical therapist to assist with your recovery and ensure you follow your rehabilitation plan.
• Plan for Transportation: Arrange transportation for follow-up appointments and physical therapy sessions to ensure you can attend all necessary post-surgery visits.

By taking these steps, you can create a supportive environment that promotes healing and helps you regain your mobility more quickly.

The surgical process for hip replacement is a meticulously planned procedure designed to alleviate pain, restore joint function, and improve quality of life. Before the surgery begins, you will be placed under general anaesthesia, where you are fully asleep.

Once you are prepared and positioned on the operating table, the surgical team will clean the hip area with an antiseptic solution to reduce the risk of infection. The surgeon will then make an incision near the hip joint to access the damaged area. The location and size of this incision depend on the surgical approach used. For example, the posterior approach involves an incision at the back of the hip, the anterior approach uses an incision at the front, and the lateral approach makes the incision along the side of the hip. The chosen method depends on factors like your anatomy and the condition of your hip joint.

After the incision is made, the surgeon will gently move aside the soft tissues, such as muscles and tendons, to expose the hip joint. In the posterior approach, the gluteal muscles are separated but left intact, while the anterior approach typically avoids cutting any muscles altogether, which can promote quicker recovery. Once the hip joint is exposed, the surgeon dislocates it to remove the damaged femoral head, or the “ball” part of the ball-and-socket joint. The acetabulum, or “socket,” is then cleaned and reshaped using a special reaming tool to remove any damaged cartilage and bone, ensuring a smooth surface to secure the prosthetic cup.

The acetabular component, a prosthetic cup made of metal, ceramic, or a combination of materials, is then inserted into the prepared socket. Hip implants are designed to replicate the natural function of the hip joint and are made from durable materials to ensure longevity. Depending on the type of implant, the cup may be press-fitted into place or secured using surgical cement. A liner made of plastic or ceramic is often placed inside the cup to provide a smooth surface for the new femoral head to move against.

Next, the surgeon prepares the femur for the prosthetic stem. The upper portion of the femur is carefully reshaped to accommodate the metal stem of the prosthesis. The stem is then inserted into the hollowed-out femur, either fixed with surgical cement or designed to bond naturally with the bone over time. A prosthetic ball, made of metal or ceramic, is attached to the top of the stem, replacing the natural femoral head.

Once both components are in place, the surgeon tests the new joint to ensure proper alignment and stability. The hip is moved through a range of motion to confirm that it functions correctly. Adjustments are made as necessary to optimize the fit and ensure smooth, stable movement.

Finally, the surgeon closes the incision. Stitches or staples are used to seal the layers of tissue and skin, ensuring proper alignment to minimise scarring and promote healing. A sterile dressing is applied to protect the wound, and the surgical site is wrapped securely.

The entire procedure typically takes one to two hours, although this can vary depending on the complexity of the case.

After the procedure, you will be moved to a recovery room where your vital signs will be monitored as the anaesthesia wears off. Pain and swelling are common initially but are managed with medications, ice packs, and elevation of the leg. Within hours of surgery, a physical therapist will assist you with gentle movements to begin restoring mobility and prevent stiffness.

Recovery continues at home, where physical therapy plays a critical role. Exercises will help strengthen the muscles around the hip and improve joint mobility. Depending on your progress, you may begin putting weight on the hip using a walker, cane, or crutches. Pain management, wound care, and reducing swelling are essential during this phase. Medications will be prescribed for pain, and you will receive instructions on caring for the incision to prevent infection.

After hip replacement surgery, following your surgeon’s instructions is crucial for a smooth and successful recovery. Using a raised toilet seat and other assistive devices can help reduce strain on your new hip. It’s important to avoid heavy lifting, bending, and twisting to prevent dislocation or damage to the new hip.

Follow-up appointments with your surgeon will monitor healing and ensure the prosthesis is functioning correctly. You’ll gradually return to light activities such as walking and driving within four to six weeks, but full recovery can take six to twelve months.

Long-term recovery and care

Full recovery from a total hip replacement surgery typically takes six months to a year. During this time, physical therapy and strengthening exercises will help improve muscle support and joint stability. Most patients experience significant pain relief and improved mobility, though some mild discomfort or stiffness may persist initially. High-impact activities like running or jumping are discouraged to avoid premature wear on the prosthesis, but low-impact exercises such as walking, swimming, or cycling are encouraged. Maintaining a healthy weight and staying active are crucial for long-term success and prolonging the lifespan of the hip replacement, which typically lasts 15 to 20 years or more with proper care.

Pain management and complications

Hip replacement surgery is generally a safe and effective procedure, but as with any surgery, there are potential risks and complications. These may include:

• Pain and discomfort during the recovery period, which can be managed with prescribed pain medication.
• Blood clots or deep vein thrombosis (DVT), which can be prevented with blood thinners and regular movement.
• Risk of infection around the artificial hip joint, which can be minimised with antibiotics and proper wound care.
• Dislocation of the artificial hip joint, which can be avoided by following movement restrictions and using assistive devices.
• Wear and tear of the artificial joint surfaces, which may require future revision surgery.
• Nerve damage or numbness in the leg, which is rare but can occur.

To manage pain and minimise the risk of complications, patients may be prescribed pain medication, blood thinners, and antibiotics. Regular follow-up appointments with the surgeon and physical therapist are also essential to monitor the patient’s progress and address any concerns or complications that may arise. By adhering to the post-surgery care plan and attending all follow-up appointments, you can ensure a successful recovery and enjoy the benefits of your new hip joint.