What is it?
The hip is a ball and socket joint at the juncture of the leg and pelvis and is one of the largest weight-bearing joints in the body, second to the knee. Hip replacement surgery—also known as total hip arthroplasty—may become necessary when the cartilage covering the hip joint becomes damaged. Although most common in elderly patients aged 60-80, hip replacement surgery is also recommended for problems with hip development in children or those with fractures in the hipbone. The surgery is generally recommended to patients who suffer from rheumatoid arthritis, osteoarthritis or the inflammatory condition ankylosing spondylitis. This major surgery replaces the damaged hip with a metal or hard plastic prosthesis that is designed to last 15 years. Alternatively, partial surgery, known as hip resurfacing, replaces damaged parts of the bone with metal alloy. Hip resurfacing is less popular, however, as the procedure has been known to damage the soft tissues surrounding the hip. Hip replacement tends to be offered as a last resort, with doctors implementing alternative measures to treat it first. These may include painkillers, physiotherapy or aids such as crutches and walking sticks.
Risks
As with all major surgeries, there are potential risks and complications that you can expect from hip replacement surgery. The most common problem is loosening of the joint, which occurs in around 10 percent of patients. According to Arthritis Research UK, serious risks include blood clots, infection of the joint, nerve damage and wound haematoma (bleeding). Some patients also experience on-going pain or a difference in leg length.
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What to expect
When considering what to expect from hip replacement surgery you should keep in mind that it typically takes around 60-90 minutes to perform and you should be able to go home within three to five days. The procedure can be carried out under a local anaesthetic or with epidural anaesthesia (numbing the lower half of the body). While there will be initial pain from the operation, a result you would commonly expect from hip replacement surgery is for the original pain felt before the surgery to be significantly reduced.
If the surgery is minimally invasive, you may be encouraged to walk on the same day. A physiotherapist may be assigned to teach strengthening exercises for the hip, demonstrating how best to sit and bend so as not to damage yourself or the prosthesis in the future.
Aftercare
What you should expect from hip replacement surgery recovery time is for it to take around around three months, especially if it is a total hip arthroplasty. For the first six weeks you will be given a hip abduction wedge—a support mechanism placed between the legs designed to keep them straight during sleep. You will also need a walking stick or crutches to aid walking during this time. While healthcare professionals advise regular gentle exercise after the operation, like walking or swimming, it is important to avoid any extraneous activity. Continuing the exercises practiced with your physiotherapist is crucial to a happy recovery. It is critical to learn as much as possible about what is involved in the surgery before making a decision. Your hospital should provide literature and video information that covers all bases when it comes to the surgery. If in doubt, arrange an appointment with a surgeon to discuss any questions you may have.
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Do I need hip replacement surgery?
Look for:
• Severe pain, swelling or stiffness in the hip that persists despite pain medication
• Sleep interference
• Difficulty in rising from a seated position
• Reduced mobility
• Feelings of depression due to pain and lack of mobility
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