Here you’ll find some of the most commonly asked questions about hip replacement surgery. If you have a question that’s not covered here, please get in touch.
A In a total hip replacement, the ball at the top of the upper thigh bone is removed, together with damaged cartilage from the hip socket. An artificial ball is fixed into the thigh bone, and an artificial lining in the socket.
A It depends on how much your quality of life is being affected by pain and reduced mobility. This, together with your medical history, an examination, and X-rays will be the basis on which a recommendation for surgery is given.
A There are no upper or lower age limits, but the majority of hip replacements are carried out in older people because arthritis increases with age. Artificial hips should last many years, but the younger you are, the more likely it is that you will need subsequent replacements.
A The different materials used for the ball and socket are:
The fixation of the hip replacement into the body can be cemented or uncemented. The Exeter hip that I use has a cemented femoral stem for the ball and the socket can be either cemented or uncemented. If you choose to have a hip replacement I will discuss all these options with you before the operation.
A Usually between 60 and 90 minutes.
A We tend to use a spinal anaesthetic to numb the legs, with sedation to give a gentle sleep during the operation. This allows us to avoid the deep general anaesthetics that used to be given and the side effects that went with them. The anaesthetist will talk you through the options before your surgery and you can decide what is best for you.
A It varies from person to person depending on things like your age, lifestyle and how active you are, but today’s artificial hips can last more than 20 years.
A The Orthopaedic Data Evaluation Panel (ODEP) was set up in 2002 to monitor guidance on hip replacements issued by the National Institute of Health and Care Excellence (NICE). NICE have stated that a successful hip replacement should have a failure rate of less than 10% at 10 years and prostheses with good evidence of meeting this standard are given a 10A rating. The NICE guidance was updated in February 2014 and a stricter benchmark was introduced, proposing that a successful hip replacement should work well in 95% cases over a 10-year period. Components that possess good evidence that they meet this benchmark, such as the Exeter stem that I use, are awarded a 10A* rating.
A Thousands of hip replacement operations are carried out every year with no complications whatsoever. But any surgery carries the risk of complications and, although with hip surgery these are rare, it’s important to understand them so that you can decide whether or not to have the operation, and so that any necessary corrective action can be undertaken quickly.
A Yes, it’s a good idea to exercise before your operation and to avoid weight gain as much as possible – the fitter you are, the faster you will recover. You may find it helpful to get professional medical advice on which forms of exercise to do, as some may exacerbate the problems you already have.
A As soon as the day of your surgery itself, and certainly the next morning, when you’ll be encouraged to walk with a walking aid and help from hospital staff.
A Yes, there is likely to be some pain from the operation site, but you will be given medication to relieve it. Typically, the pain you’ve been experiencing as a result of damage to your hip will disappear, and any post-operative pain will be short-lived.
A Most people stay in hospital just two or three nights.
A Yes, it’s important that you have someone at home who can help you in the first couple of weeks after your operation. You will be more tired than normal and you’re likely to need help with everyday tasks such as cooking and cleaning.
A In general, the hip replacement will be able to take your full weight from the moment it’s done but most people feel more confident using some form of walking aid for a while. While you’re in hospital a physiotherapist will assess which aid is best for you. You can do without the walking aid as soon as you feel confident enough in your strength and balance.
A Yes, in the first few days and weeks after surgery a ‘grabber’ – to pick things up off the floor – is very useful and prevents you from having to bend down. For around six weeks after your operation you will need a special raised toilet seat. This will all be explained and arranged at your pre-operative assessment.
A While you’re in hospital a physiotherapist will take you through a series of exercises that will help build strength and flexibility in your new hip. When you return home it’s very important to keep up these daily exercises. We’ll assess whether or not you need any additional post-operative physiotherapy, but most people don’t need it.
A You should be able to return to driving six weeks after your operation.
A We advise you keep the wound dry for the first week or so after the operation. At about that time you’ll be visited at home by a district nurse, who will remove the dressing and inspect your wound. As long as it’s healing well, you should then be able to have a shower, but I advise against sitting in a bath until six weeks after the operation.
A Yes, there are some precautions we advise you take to minimise the risk of dislocation. For example, you must not cross your legs, bend down or twist from the hip after surgery and the physiotherapists will advise you on the movements to avoid.
A While you’re having a hip replacement to relieve pain and restore your function, there are some activities that are best avoided. High-impact activities like contact sports, running, off-piste skiing and singles tennis are not recommended, but once you’ve gained stability in your new joint, activities such as walking, swimming, cycling, golf, doubles tennis and gardening are actively encouraged. If you’re already a good skier, you can aim to get back to piste skiing and you’ll be able to use gym facilities, perhaps with some initial advice from the gym staff when you first go back. You will have a post-operative appointment with me around six weeks after your hip replacement and this is a useful opportunity for us to discuss how we get you back to your favourite pastimes.
A This varies from person to person, but as a guide you should be able to resume all normal activities within around 12 weeks. The hip replacement continues to heal and improve for more than a year after the operation.
A Lots of people ask me this and the answer is yes, it is very likely the alarm will go off. Most of the time you just need to tell the airport staff that you’ve had a hip replacement, but sometimes they will ask you to go through a body scanner to confirm that everything is OK.
A If you have decided you’d like some advice about your hip, you simply need to make an appointment with your GP and ask to be referred to me.