What is arthritis and how can it affect my hip?
Osteoarthritis is the commonest sort of arthritis, and can be thought of as the result of wear and tear. Your hips are ball-and-socket joints that carry all the weight of your body. Years of use wear away the smooth, shock-absorbing layers of cartilage that cover the ball and line the socket of the joint. Your body reacts by trying to repair the damage, often making spiky new bone (or osteophytes) around the hip. This new bone makes things worse by restricting movement and making the hips stiff. Osteoarthritis is most common in older people, but it can occur in young people after injury, if they do a lot of sport, or if they happen to have a hip shape which is more prone to wear and tear. In these younger people, painful labral tears (part of the lining of the socket), hip impingement caused by a naturally egg-shaped ball, or looseness caused by a naturally shallow socket (hip dysplasia) may cause pain before arthritis really sets in.
Other types of arthritis, like inflammatory rheumatoid arthritis, and avascular necrosis where the blood supply to the ball is damaged, can occur at any age. They are much less frequent than osteoarthritis due to hip impingement, shallow hips and labral tears.
See also: Soothing Aches and Joints
What is hip replacement surgery?
When the cartilage surfaces are completely worn away, pain and stiffness can become intolerable, stopping you doing the things you most enjoy. If painkillers and physiotherapy don’t work, then an operation to give you a new hip may be the best solution. In a total hip replacement, a surgeon will remove the ball of the hip and the lining of the socket, and replace them with metal, plastic, or ceramic components. In very young people, a resurfacing type of hip replacement may be appropriate where the surface of the ball and the socket are replaced with a thin layer of metal. Hip replacement surgery is a fantastically successful operation that can return you to a normal life. Even in young, active people, modern implants and specialised techniques of minimally invasive surgery can enable you to quickly recover and get back to everything you want to do including the most challenging sport.
How can I tell if I need a hip replacement?
The only way to tell whether you should have your hip replaced is to talk to an orthopaedic surgeon. There may be several things contributing to your pain and disability, so it’s important that the right X-rays and scans are done, and that you have the time to discuss them and your best treatment options with your consultant.
How long does a hip replacement surgery last for?
This depends on lots of things, so you should ask your consultant about the outcome in people like you. In general, most people could reasonably expect their hip replacement surgery to last more than 20 years, but some surgeons specialise in treating younger people where the objective is for it to last much longer.
Are there are alternatives to hip replacement surgery?
Yes, and this has been one of the most exciting new areas of orthopaedic surgery in the last few years. A few surgeons specialise in hip preservation, repairing damage to young and middle-aged people’s hips before they develop real arthritis. This can involve surgery to reshape the hip, making the ball properly round or deepening the socket. It can also involve healing the cartilage and labrum, and repairing damage to the ligaments and tendons around the hip. The great advantage of hip preservation surgery is the opportunity to relieve pain and return you to full activity without having to remove your own hip and replace it with an artificial one.
See also: Maintaining Mobility
Can I have keyhole surgery for my hip?
Hip arthroscopy is a very sophisticated technique performed by some surgeons in specialist centres. It enables hip preservation surgery through two or three tiny cuts. These operations are done under general anaesthetic, and may take several hours, but you recover quickly, and are almost always up and about on the same day. As surgeons have developed these techniques, they have been able to reshape bone, fix injuries, stitch the labrum and repair, graft or even regrow cartilage. Arthroscopy is often the preferred approach in young sports people because it lets you get back to unrestricted activity as quickly as possible.
Are there any risks involved in hip replacement surgery and general hip surgery?
Thousands of hip operations are carried out in the UK every year with no complications. But, like all surgery, there are some risks. These vary according to your particular operation, the problems in your hip, and the skills and experience of your surgeon. You should discuss risks in detail with your consultant, and always ask him or her for information about their training and experience in the operation they propose, and the complication rates in their own practice.
Is there an age limit for having hip surgery?
No, but you need to be fit enough for an operation. In older people, hip replacement surgery may be the only way to correct a badly worn hip. Younger people can often avoid or put off a total hip replacement if joint preserving surgery is done before there is too much damage to the joint.
What happens before my hip surgery and how should I prepare for it?
The most important thing is to have time with your consultant. Bring a family member or friend with you if you like. Your surgeon should discuss with you what will happen before, during and after the operation, and how they and the nurses will manage any pain you might have. Ask any questions you may have about your procedure, your time in hospital, and what will happen when you go home. Take this time with your consultant to ensure your mind is put at rest.
What tips or advice could you give for recovery after hip replacement surgery?
After most hip operations you can get up and about very quickly, even if you have had a total replacement. You may need to use crutches for a week or two, but regular exercise will help you return to normal activities as soon as possible. Your surgeon and physiotherapist will give you detailed advice on this. Discuss it before your operation so you can get together any equipment or help you might need before you go into hospital.
Just remember, most people make very good recovery after surgery: They get rid of their pain, move more freely, and get back to the life they want to lead.
BMI Healthcare is an independent provider of private healthcare, offering treatment to private patients, medically insured patients and NHS patients. To find out more about their services visit their website: bmihealthcare.co.uk
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