Hip replacement can be total when the femoral and acetabular joint components are replaced or partial when the operation just involves the femur.
The purpose is to re-establish joint shape, bringing back stability and mobility, as well as reducing pain and improving the patient’s quality of life.
The technological development of artificial implants allows the hip to support more effort and weight with more durability.
The reasons for hip replacement range from osteoarthritis (the most common cause) to rheumatoid arthritis, osteonecrosis, lesions and bone tumours. The kind of damage will determine the surgical team’s choice of prosthesis.
People with hip joint damage which causes pain and interferes with daily activities in spite of medical treatment, can also seek hip replacement surgery.
By replacing the patient’s hip joint with an artificial joint, the operation gives pain relief, increased movement and a return to normal daily activities.
Hip replacement surgery may be dependent on other co-existent pathologies.
The operation completely removes the damaged joint structures. Then, the upper end of the femur and the hip are prepared so that a component consisting of a stem and a metallic sphere can be set on the first, and a cupola on the latter.
There are two types of prosthesis: cemented, on which the components are set into the bone using methyl methacrylate, and non-cemented. A combined solution - a hybrid prosthesis - can be used, the final choice depending mainly on the patient’s age, overall condition and bone quality.
The risk of post operative infection may occur, requiring pre-operative antibiotic prophylaxis.
Risks:
• Vascular
• Deep vein thrombosis
• Pulmonary embolism
• Neurological
• Infection
• Instabilities (dislocation)
• Dissymmetry
• Rotational deviations
• Rigidness / limitation
• Pain
• Intra- and post-operative fractures
The day after the surgery, you will be asked to try to sit, or even walk for a short time with the help of walking aids. A physiotherapist will provide assistance with exercises to accelerate recovery.
Before you leave the hospital, you and your carer will be given some advice about care of the new hip.
Frequent exercise is necessary to regain use of the joint and muscles.
The physiotherapist will recommend exercises for strength and mobility and show you how to use the walking aids.
As the therapy progresses, you will gradually increase the weight on the leg, until you are able to walk without any support.
During the next six months, we recommend you follow these guidelines:
• Do not flex the operated hip over 90º. When sitting, you should not bend forward to pick up anything.
• Avoid sitting on low chairs, benches or toilets where your knees are higher than the hip.
• Avoid crossing your legs or placing the operated leg across the mid-line of the body.
• Avoid lying on the operated side of your body. You may lie on the opposite side, however, if you place a pillow between your legs.
• Avoid driving.
• Avoid lifting heavy weights.
• Avoid heavy housework.
• Avoid bending to touch your feet or put shoes on.
You should have regular check-ups, including X-rays.
Full recovery occurs three to six months after surgery, depending on the kind of surgery, overall health and recovery profile.