A hip replacement is a very successful operation for someone having a difficiult time with a worn-out hip. It is usually an option for a patient with bone-on-bone arthritis, who has failed to get satisfactory relief from other treatments.
The idea of the operation is to decrease pain and improve function.
The surgery itself involves removing the head of the femur (thigh bone), which is the ball of the joint, and fashioning a new socket. A stem inside your thigh bone provides support to the ball. Some people have an idea that an artificial joint will be a “super joint”, which isn’t the case, but an artificial hip is usually much better than a worn-out, painful one.
Dr Martin routinely uses the anterior approach for hip replacement surgery.
People typically stay 1-2 days in hospital for the surgery. As techniques and recovery from the surgery improve, this has been getting shorter. You can stay longer if you need to though! For appropriate patients who would find a very short stay in hospital convenient, Dr Martin can offer a 24 hour stay for the surgery. Dr Martin uses dissolvable stitches, but you still need to keep the wound covered with a dressing for about 2 weeks.
Most people feel that they are on the mend and are back to doing what they were before the surgery by 4-6 weeks, or even sooner. From this point on most people would just get better and better, but people do recover at different rates.
If you are thinking about having major hip surgery it is important to have a good discussion with Dr Martin about whether the operation is right for you or not. All surgical procedures have risks associated with them. The decision to proceed with the surgery basically comes down to a discussion around whether the risks are worth taking, or not. Please see the frequently asked questions section for more information.
What is arthritis?
Osteoarthritis (OA) is wear to, or failure of, a joint lining down to bare bone-on-bone. Many people use the term osteoarthritis to dismiss vague aches and pains that they resign themselves to put up with, but osteoarthritis is something specific and usually treatable. Osteoarthritis can cause pain, stiffness, bony lumps, bow or knock kneed legs and swelling.
Hip and knee replacements are examples of major operations for osteoarthritis, but for other areas in the body smaller operations may be appropriate too. Surgery for osteoarthritis is generally the last resort and there are many non-operative treatments that can also be discussed with the doctor.
Other types of arthritis, like rheumatoid or psoriatic arthritis, are often treated by a rheumatologist. An orthopaedic surgical opinion may be useful in these cases too if a lot of damage has been done to the joints.
What is osteoporosis?
Osteoporosis is a condition often associated with ageing, in which bones become weaker and break more easily. It is something to ask your general practitioner about as it is known to be associated with other medical conditions or medications.
If you are middle aged or older and have broken a bone it is also something to have checked out. There are tests to rule out important causes and there are effective treatments. If someone has osteoporosis it doesn’t mean they can’t have a hip replacement.
Osteoporosis is sometimes confused with osteoarthritis as both can be shortened to osteo.
Can my worn-out hip get too bad for an operation?
Normally it isn’t possible to let your worn-out hip get too bad for surgery. Actually it is usually in the best interests of your health to put joint replacement surgery off for as long as possible.
Your worn hip is normally tough and won’t disintegrate or grind away to nothing. People also worry about the worn hip joint throwing other joints out and causing damage to something else, but that wouldn’t typically be a reason to proceed with surgery. If a joint near or opposite the first one wears out then realistically it was probably going to do so eventually anyway.
The decision to proceed with hip replacement surgery is generally made when the problem in terms of pain and disability with the hip or hips is bad enough in its own right. The surgery is to alleviate current trouble rather than protect against problems in the future.
Am I too old for a hip replacement? If I put it off will I be too old?
No one is too old for a joint replacement. It is important to make a careful and considered decision about proceeding with major surgery at any age, and this is especially the case in the very elderly.
A joint replacement is never out of the question, so long as your medical fitness allows it. Dr Martin takes time with elderly patients to really get to the bottom of their issues and to help the person decide whether an operation is right for them or not.
Am I too young?
Joint replacements don’t last forever and younger people wear them out more quickly. This is more of an issue in knee replacement surgery than hip replacement surgery.
The results of surgery in young people are improving so there probably is no longer a need for a hard and fast cut off as there previously was.
Some young people can end up with a very bad hip. For those people a hip replacement can be a great solution if they have tried other sensible alternatives.
If you are young and are having a lot of trouble from arthritis, it isn’t a straightforward situation. This is a good reason to see an orthopaedic surgeon, who can talk through the different options and associated decision making.