Guide to hip replacement surgery

Caroline Cassidy

There is little doubt that advancements in medicine have changed lives, and hip replacements are a case in point. If you think you may need such an operation, here's what you need to know about the procedure.

Hip replacement surgery
Hip replacement surgery

Pic: Getty

About hip replacements
The hip joint is one of the largest joints in the body. The bones of this 'ball and socket' joint are connected to each other with ligaments, and surrounded by cartilage that prevents them from rubbing against each other.

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When the joint itself, or the cartilage that surrounds it, becomes damaged, it can cause pain that leads to problems with certain movements, such as walking or driving. A hip replacement does exactly what it says on the tin - the damaged joint is replaced with an artificial one, and most patients report a significant reduction in pain, or improved movement, following the procedure.

Often age-related, hip replacements are most commonly carried out on adults between the ages of 60 and 80. Wear and tear to the cartilage caused by osteoarthritis is often a cause of pain and impaired movement, while rheumatoid arthritis sometimes causes the immune system to attack the lining of the joint, leading to pain and stiffness. A fall or similar trauma to the joint itself that causes significant damage may also mean the hip needs replacing.

Though uncommon in children and younger adults, those suffering from hip dysplasia (where the hips have formed incorrectly) may sometimes need an operation to improve function and relieve pain.

The procedure
Hip replacements are common in the UK, with the NHS performing more than 70,000 such operations from April 2010 to April 2011. Patients are given a general anaesthetic or epidural while the operation is performed, and the surgery, during which the damaged joint is replaced with a metal alloy or ceramic prosthesis, usually takes between 60 and 90 minutes.

With the surgery over, most patients are encouraged to walk as quickly as possible, with the help of staff, and some are even able to get up the same day. Discomfort is to be expected, and sometimes the legs and feet can become swollen. Patients usually remain in hospital for three to five days.

Recovery and rehabilitation can be a painful process, and patients will need a walking aid for four to six weeks after the op, followed by a gentle exercise programme designed to regain and then improve use of the replacement joint. At this stage, patients will be advised to take care with certain movements or activities.

Often, patients are back to normal day-to-day activities with two or three months, but it can take up to a year to fully benefit from the new hip.

In the longer term, the surgeon who performed the operation will generally want to see the patient again after twelve months, just to check that all is working as it should, and an X-ray every five years will ensure that the hip joint is not loosening.

Risks and complications
In the immediate aftermath of the operation, any redness, fluid or increase in pain in the joint may be cause for concern, and patients should contact their GP to get things checked out.

According to the NHS, hip dislocation occurs in around one in 20 cases, and this requires further surgery, but the most common problem associated with hip replacements is loosening of the joint, which usually occurs 10 to 15 years after the initial surgery. Wear and tear can also occur, with metal-on-metal implants particularly prone to accelerated wear, so an annual check for these types of replacements is advised.
More serious complications include blood clots or infection of the tissue around the new hip joint, but these are uncommon, affecting fewer than one in 100 patients.

Though there are alternatives, a hip replacement could significantly improve quality of life for those suffering from arthritis-related problems or a hip fracture. If you think it could help you, visit your GP to further discuss the options.

Have you had a hip replacement? Did it improve your life? Leave your comments below...