Hip Replacement (Total)

A Total Hip Replacement (also known as a Hip Arthroplasty) replaces all parts of the natural hip joint with an artificial device known as a hip prosthesis. A hip prosthesis is typically made of metal, plastic or ceramic, or a combination of all three materials. The prosthesis is designed in two parts to replace both the head of the thighbone, commonly referred to as " the ball" and the Acetabulum in the pelvis, commonly referred to as "the socket".

Why is a Total Hip Replacement procedure performed?

A Total Hip Replacement is mostly performed on individuals over the age of 55 who have experienced chronic and debilitating hip pain that will not respond to non-surgical treatments. Joint 'wear and tear', caused by degenerative conditions such as Osteoarthritis or Rheumatoid Arthritis is the most common reason for a Hip Replacement to be performed. Trauma that results in a hip fracture is also usually treated with Total Hip Replacement surgery. Less commonly, degenerative diseases caused by a reduced blood flow to the hip joint, such as Avascular Necrosis, will also be treated with a Total Hip Replacement.

How is a Total Hip Replacement operation carried out?

A Total Hip Replacement can be performed under General Anaesthetic (you will be asleep) or Spinal/Epidural Anaesthetic (you will be awake, but sedated). The procedure usually takes around one and a half hours to complete and is performed with a patient positioned on their unaffected side on the operating table. An incision is made along the hip joint of the affected side and the hip muscles are carefully divided to fully expose hip joint. The head of the damaged or diseased thighbone (Femur) is then surgically removed. Following this, the diseased or damaged socket in the pelvis is cleared of any arthritic debris and re-shaped in preparation for the insertion of an artificial socket.
There are two types of artificial socket:

1. a cemented socket.
2. an un-cemented socket.

Your surgeon will advise which would be the best type for your individual condition and age range.

Following on, the remaining thighbone is then prepared with various instruments to accept the insertion of a new artificial thighbone head, which again can be cemented in place or deliberately left un-cemented depending on individual recommendation. The two prosthesis components now fit together as a new 'ball and socket' joint and the wound is usually closed with absorbable stitches and a surgical drain to minimise the risk of any developing blood clots.

How long do I have to be hospitalized?

Once a patient is fully recovered from the effects of anaesthetic they are normally quickly encouraged to be as active and mobile as possible to avoid serious complications such as Deep Vein Thrombosis (DVT) from developing. It is therefore normal for patients to be encouraged to take a few steps with the support of a walking frame and guidance from a physiotherapist the day after surgery.
Following a progressive improvement of mobility and pain control, patients are normally discharged home 5-7 days following their surgery.

Recuperation

Over the next 6 weeks patients will be expected to work on improving their own mobility and range of joint movement through dedicated and progressive physiotherapy and by increasing their daily activity and walking distances. Your Consultant Surgeon will then assess your joints range of movement after 6 weeks and then again after three months. Patients who are in employment should not resume work until after their first consultation and dependant on the physical nature of their job may be advised to take longer off work.

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