The Ins and Outs of Hip Replacement Surgery
It is not every day that you need to replace a part of your body. But then again, the ongoing joint pain that leads to joint replacement surgery should not be a regular occurrence either. Hip Replacement surgery (also known as Hip Arthroplasty) is a means to an end; a way to help you get rid of persistent joint pain and return to living a full life. It is very natural to feel a little apprehensive and possibly even intimidated as you head down this road. But you are not alone, in fact, you will join the ranks of some celebrities and elite athletes, such as Jane Fonda, Billy Joel, Luciano Pavarotti, Lionel Richie, Michael Rix, Kimon Mamacos, Paul Stevenson, Peter Lamond, Mary Jooste, and Arnold Schwarzenegger to name a few.
To help you prepare for this life-changing surgery, we at Cape Hip and Knee have provided some information about the procedure below.
When is Hip Replacement Needed?
Arthritic damage is the most common reason you may need a hip replacement. Any of the following conditions could also lead to the need for hip surgery: Osteoarthritis, Rheumatoid Arthritis and Osteonecrosis. You will know if you need a hip replacement, after a consult with one of our orthopaedic surgeons. After the surgery, you can expect a marked improvement in pain and stiffness and should be able to return to daily living and your usual sport and exercise, with certain limitations.
What Happens in Hip Replacement Surgery?
In total hip replacement surgery, the acetabulum (hip socket) and the head of the femur (ball) are replaced with an artificial joint. Modern artificial hip replacement joints are made from a combination of extremely durable materials including titanium, ceramic, hardened plastics and other metals. Adaptations of design to include bigger diameter heads and ceramic articular surfaces enable our active patients to return to sporting activities with a lower risk of wear and tear and dislocations.
Surgical Approaches to Hip Replacement Surgery
You will have the opportunity to discuss the various available approaches with your orthopaedic specialist before any surgery. Ultimately, no single approach is the right one and each approach has its associated risks and benefits. The surgery conducted will be dependent on many factors including the state of your health and the condition of your hip joint. The best approach for you will be decided based on your unique case following detailed discussion and diagnostics, as well as referencing the combined expertise of our top-ranked orthopaedic surgeons.
You can rest assured that advancements in medical technologies over time and refinement of surgical approaches means that our patients can now experience better outcomes with shorter recovery times and a lower rate of hip prosthesis failure.
The benefits and risks of the three approaches to hip replacement surgery:
- The Anterolateral Approach accounts for 40% of hip replacement surgeries. Over time it has been refined and has the least risk of major complications.
- The Posterior Approach accounts for 40% of all hip replacement surgeries. It is still highly used despite ranking highest in associated risks of damage to the sciatic nerve and dislocation.
- The Direct Anterior Approach accounts for 20% of all hip replacement surgeries. Reports show that it has the highest risk of possible infections, injury to the femoral nerves or lateral cutaneous nerve of the thigh, femoral fracture during surgery and early femoral component failure. However, this approach does lead towards earlier mobilisation which is something patients value highly.
Some Encouraging Stats Around Hip Replacement Surgery
Hip replacement surgery has a 95% patient satisfaction score. Along with cataract surgery, it is the top-ranking surgery when comparing the risk versus the reward. It also has a 94% survival rating.
The Risks of Hip Replacement
Total hip replacements do carry some risks. Although these are rare, they should be taken into consideration. Some of the associated risks include:
- Blood clots can form in the leg veins after surgery which do carry the risk of heart attack or stroke. Blood-thinning medication is prescribed to reduce risk.
- Infections can occur around the wound or in the deeper tissue near the new hip joint. Minor infections are treated with antibiotics, but a major infection near the prosthesis might require surgery to remove and replace the artificial hip joint.
- Fractures may occur during surgery when healthy portions of the hip joint might fracture. These fractures can be small enough to heal on their own, although larger fractures might need to be stabilised with wires, screws, and possibly a metal plate or bone grafts.
- Dislocation may occur when the ball of the new joint comes out of the socket, particularly in the first few months after surgery. However, modern surgical techniques and prosthesis design have virtually eliminated this risk.
- Changes in leg length are rare but occasionally a new hip makes one leg longer or shorter than the other. For a good clinical outcome, it is important that the correct leg length is achieved. As leading hip replacement specialists, we have developed and published a system (vertical measurement system) to ensure that the desired leg length correction is achieved in all cases.
- Loosening of the new hip replacement joint is rare but can occur when the prosthesis does not fix solidly to the bone or loosens over time. This is usually indicated by pain in the hip. Revision hip surgery might be required to resolve the problem.
- Nerves can be damaged in the area where the implant is placed, although this occurrence is also rare. Signs of nerve damage include numbness, weakness and pain in the hip.
Recovery After Hip Replacement Surgery
The objective of our orthopaedic specialists is to achieve the best possible outcome for you while inflicting as little surgical damage as possible at the operation site. This gives you the best opportunity for recovery in as short a time as possible, including an improved degree of mobility in your hip joint and reduction of pain.
Hip replacement surgery has seen big advances in recent years along with a decrease in hip replacement prosthesis failures. But even with these advances, it is still important that you are intentional and take care of yourself during recovery. This will help you to achieve the best outcome. As an added service to you, we also provide you with free home care and 24-hour emergency assistance from our team of experienced clinical nurses.
The initial few weeks after surgery are vital for your recovery. It is important that you know how to get mobile again and make the best recovery possible. Read more about preparing for surgery and home care here.