Total Hip Replacement Surgery
About Total Hip Replacement Surgery
Total hip replacement is undertaken to treat various conditions of the hip joint, such as different types of arthritis, trauma to the hip, or congenital conditions that can lead to abnormal wear of the joint’s cartilage. Hip replacement aims to reduce pain and restore movement of the affected hip and, for some people, simply improve their overall quality of life.
During total hip replacement, the hip joint is removed and replaced with an artificial joint, called a “prosthesis”. Hip prostheses are made up of metal and either plastic and/or ceramic parts. These different materials each have pros and cons, and the decision to use a specific prosthesis is made by Mr Patten and the patient in consultation. This decision is based on factors such as the patient’s age, lifestyle, and functional expectations and goals.
Total hip replacement can be performed via several approaches:
A posterior approach, which involves making an incision at the back of hip, close to the buttocks;
A lateral approach, also referred to as a Hardinge approach, where the incision is made on the side of the hip; and
An anterior approach, called the anterior minimally invasive approach, in which the incision is made at the front of the hip in the groin.
Each approach has benefits and limitations, and some approaches may be better suited to an individual than others. This is discussed between Mr Patten and the patient during their consultation.
Patients feel almost fully recovered from hip replacement by three months. Patients tend to gain the last subtleties of their recovery in the three months or so after that.
What to expect after hip replacement surgery
After surgery, you will be transferred to the recovery room, where hospital staff will monitor you as you wake up after the anaesthetic. You will then be taken back to your hospital room.
Walking and weight bearing is encouraged immediately after surgery. The day after surgery or sometimes on the day of surgery, physiotherapists will give you exercises to improve your recovery. It is very important to follow these exercises in hospital and continue these at home to ensure the maximum result from your surgery.
Patients are usually hospitalised for approximately three to five days before returning home. It is rare for patients to require inpatient or outpatient rehabilitation after hip replacement, however rehabilitation requirements will be discussed with you by the hospital’s rehabilitation coordinator during your admission.
You will initially be using two crutches or a walking frame. You will use these for two to four weeks, followed by a single crutch held in your opposite hand for a further three to six weeks, or until you are able to walk normally without a limp. You will be taught the proper techniques for simple activities of daily living, such as bending, sitting, and using stairs, to prevent injury to your new hip such as dislocation. You should sleep with a pillow between your legs for up to six weeks to prevent your legs from crossing. Avoid sitting in low or deep chairs and bending over.
Some pain and swelling around the hip and thigh is expected, and you may even notice some swelling in your lower leg and foot.
Caring for your wounds after hip replacement surgery
The dressing over your wound will need to remain intact, clean and dry for two weeks after surgery. You may shower, but do not have a bath or swim until you see Mr Patten in his rooms at your post-operative appointment and has cleared you for such activities. You should avoid getting the dressing wet in the shower. If the dressing begins to lift, use tape to stick the dressing back down. A small amount of bleeding into the dressing is normal. Resting, elevating the leg, and applying ice can significantly help reduce swelling.
Mr Patten almost always uses dissolving stitches to close your wound, which will not need to be removed. For further information regarding wound management, please read the ‘post-operative wound management’ leaflet provided to you by our rooms before surgery.
Managing pain after your hip replacement surgery
Pain is a normal part of the healing process after surgery and will slowly improve over time. In the early days following surgery you should rest and elevate the leg, as well as regularly ice your hip and thigh, as this will all significantly help to reduce pain and swelling.
On discharge from hospital you will be provided with some pain relief for pain control. For ongoing pain relief requirements, we suggest you arrange an appointment with your GP to obtain a prescription. After surgery you should take pain relief as long as you have pain, particularly when walking or at night.
If you are concerned about your level of pain, please do not hesitate to contact our rooms for reassurance and to rule out a rare complication.
Recovery from hip replacement surgery
You will generally feel quite comfortable after four weeks, and almost fully recovered after three months from surgery. Patients tend to regain the last subtleties of their recovery in the three to six months after that.
The average time before you can drive following a right hip replacement is four to six weeks, and two to four weeks for a left hip replacement, depending on whether your car is manual or automatic. Generally, however, you can resume driving when you feel comfortable doing so. It is recommended to start driving for short periods of time as the muscles around your hip may become tired.
The time you may require off work varies depending on the nature of your job. For sedentary, desk-based work you will likely require three to four weeks off work, whereas for more labor-intensive duties you will need to remain off work for approximately six to eight weeks.
Prior to any dental work, advise your dentist that you have had a hip replacement, as antibiotic cover is recommended. Mr Patten does not suggest antibiotic cover for a scale and clean only.
Hip replacement surgery risks and complications
Although uncommon, complications can occur. These include superficial wound infection, blood clot, or persistent hip area pain. Rare complications include injury to surrounding structures such as nerves or blood vessels, or infection within the hip joint (peri-prosthetic infection).
Over time a hip replacement can wear out, come loose, or the bone around the prosthesis may fracture (peri-prosthetic fracture), all of which may require further surgery.