Hip Replacement Surgery

Damage to the hip joint is most commonly caused by osteoarthritis, age related general wear and tear, rheumatoid arthritis or a fracture/injury.  The majority of hip replacements are carried out for those suffering with severe osteoarthritis and do not get adequate pain relief from more conservative treatments such as physiotherapy or steroid injections.

Hip replacement surgery is a major procedure, so it is important to understand the benefits and risks involved before coming to a decision on whether you want to go ahead with the operation.  

There are no upper or lower age restrictions for hip replacement surgery, but the majority of patients who undergo the procedure are between 60 – 80 years of age.  It is important to bear in mind that the younger you are, the more likely it is that you will need to have the procedure redone at a later date.

The process of making the decision will begin with your GP referring you to an Orthopaedic surgeon for an initial consultation.  There are several reasons why your consultant may recommend hip replacement surgery, and individuals who are likely to most benefit include those who:

• Experience pain with daily activities such as walking and bending
• Pain that continues whilst resting, day or night
• Have limited movement of the hip due to stiffness
• No longer get any benefit from conventional pain relief such as anti-inflammatory drugs, walking aids or physiotherapy.

Private hip replacement surgery is usually carried out under a general anaesthetic, so you will be asleep throughout the procedure.  The anaesthetic will relax your muscles and prevent you from feeling any pain during surgery.  You will not have any awareness of the procedure.  On occasion, a spinal anaesthetic may be used (epidural) whereby you will be awake during surgery.  However, you will be numb from the waist down and will not feel any pain.

During the procedure, the surgeon will remove the worn and eroded cartilage (arthritis), along with the top of the femur (the ball of the ‘ball and socket’ joint) and replace it with the prosthesis in order to restore the alignment and function of your hip.  Once the procedure is finished, your surgeon will close the incision in your skin with either stitches or clips and cover it with a dressing.  You will then be moved to the recovery room where you will remain for several hours whilst your recovery from the anaesthetic is monitored.  Once you wake up, you will be taken to your private room to rest.

The success of your surgery will largely depend on how well you follow your surgeon’s post-operative instructions.  Rehabilitation plays a crucial role in helping you get back on your feet and returning to an active lifestyle, but in order to do so, you must play an active role in your rehabilitation programme.

Physiotherapy will begin the day after your surgery and within a few days, you will most likely be able to walk assisted with a walking frame or crutches.  The emphasis in the early stage of rehab is to maintain motion of the hip joint and to ensure that you can walk safely.  A member of our physiotherapy team will teach you important skills that help you move around more freely during your everyday activities.  By participating in an active therapeutic recovery, there is no reason why you cannot resume your pre-surgical level of activity.

It is important that you have a good support network upon discharge from the hospital, as you will not be able to carry out day-to-day activities unaided for the first couple of weeks.

There are a few simple measures you can take to make life easier when you return home following your hip replacement. These include:

• Use an elevated toilet seat as this will help keep you from bending too far at the hips.
• Keep stair climbing to a minimum and make the necessary arrangements so that you will only have to go up and down them once or twice a day.
• Sit in a firm, straight-back chair. Do not use a recliner.
• To help avoid falls, remove all rugs, and keep the floors and room clutter free.
• Keep excitable pets away until you have healed completely.

You can return to work approximately 6 weeks after your operation, but if your job involves a lot of walking, standing or lifting, you may need to stay off longer, sometimes up to 3 months if it is not possible to provide assistance for you.

You should be able to drive again after approximately 6 weeks, but check with your doctor first.  It is important that you do not drive if you are in any sort of pain and taking medication that causes drowsiness.  It is advisable not to get in and out of a car for the first 3 weeks after your operation as the action itself puts a lot of strain on your hip, so only do so if it is essential.

Bear in mind that even after you have recovered from your private hip replacement surgery, for anywhere from 6 – 12 months you should avoid pivoting or twisting on the affected leg.  You should not cross the leg past the midline of the body or turn it inward.  You should also not bend at the hip past 90 degrees; this includes both bending forward at the waist and squatting.