Hip Joint Replacement
Hip replacement surgery is undertaken when the joint surfaces in the hip are worn and the pain from the hip is not manageable by medication.
Types of Implants
Ceramic Hip Replacements
I recommend that a young patient (with an expected lifespan of more than 20 years) have an implant with ceramic on ceramic bearings. These have very low wear rates and have the potential to last a lifetime without the need for revision surgery.
The implant is press-fit into the bone, which grows onto the mineral (Hydroxyapatite) coating on the titanium alloy support structures.
Plastic/Metal Hip Replacements
These are used in older patients with lower physical demands and less life expectancy. The component parts are fixed to the bone with acrylic cement. The cost of this implant ($1500) is substantially less than that of a ceramic implant ($8500).
Following hip joint replacement
A hip joint replacement is a major operation, and it takes several months for the tissues about the hip to heal and remodel, and the body takes time to make a general recovery from surgery.
You can expect a feeling of tiredness in the weeks following surgery. This is due to the effect of the anaesthetic, a disturbance of metabolic functions, and the loss of blood which takes time to reform. A good healthy and balanced diet is important. You should lead a quiet, orderly life style and follow a progressive daily exercise and walking programme. Try and avoid stress and becoming over tired. Riding an exercycle is excellent for regaining your fitness. Swimming, water walking and exercising in the pool are recommended – as soon as you feel confident enough getting in and out of the pool.
Crutches should be used for as long as you feel the need to have them support you. It may only be necessary to use a single crutch or stick. Continue to use one for a month when going out.
The implanted hip parts are all quite solid immediately after operation, and will quite safely take all of your weight. Should there be any concern about how solid the hip implant is, I will advise you, and may recommend limited weight bearing. It is very important to avoid a fall following operation, as this may result in hip dislocation.
You should avoid low chairs, and a raised toilet seat may be helpful. Again , it is a matter of what you are comfortable with. On getting up from a sitting position (particularly if the hips are flexed up) it is very important to avoid any sideways or turning movements. This may also result in hip dislocation.
Remember: Keep your knees locked together and you will always be safe. Remember to put your operated leg straight backwards to allow you to reach down.
You should wait until you feel physically confident to drive again – this usually takes 3-4 weeks or more.
Your hip replacement is there for you to enjoy your life and recreational activity – within limits. Out of limits are parachuting, jumping and impact loading sports, contact sports and high mileage running. Skiing is somewhat of a risk, but do it with caution.
You are quite safe to resume normal sexual activity straight away but this activity is safest on your back for the first month.
You can expect a pain free hip, though the range of movement in it may not be much different (although freer) then before operation.
Any infection elsewhere in your body (chest, skin, teeth, urine) should be treated very promptly. There is a risk of it spreading via the bloodstream into the hip.Let your doctor know that you need antibiotic cover before any surgical or dental operations.
Should you develop any unusual feelings in your hip replacement (clicking, clunking, squeaking or pain) you should alert me to these symptoms promptly.
You should have an orthopaedic surgeon have a look at your hip every 3-5 years with an x-ray. It is important to detect possible loosening of the implanted parts as early as possible.