Hip replacement

What is a hip replacement?

A hip replacement is a type of surgery that replaces damaged parts of your hip with man-made parts. The operation can help reduce your hip pain and improve how you are able to move around.

Your doctor might recommend a hip replacement if you have severe hip damage that interferes with your life, and other treatments have not helped.

During hip replacement surgery, damaged bone and cartilage (tissue at the end of the bone that cushions the joint) are removed from the hip joint. These are replaced with man-made parts, for example, metal or plastic.

Hip replacement surgery usually takes 1 to 2 hours. You will need a general anaesthetic, which makes you fully unconscious, or a spinal anaesthetic, which numbs the lower half of your body.

A hip replacement is also known as hip arthroplasty or a total hip replacement.

What happens during hip replacement surgery?

During your hip replacement surgery, the damaged bone and cartilage are removed from the hip joint. These are replaced with parts made from metal, plastic or other materials.

There are different types of hip replacement:

• A partial hip replacement only replaces the ball on the end of the thigh bone. A ceramic or metal ball attached to a stem is attached to the bone.
• A total hip replacement means the ball of the hip and the socket of the hip joint are both replaced.
• Sometimes just the surface of head of the hip is replaced, rather than the whole ball.

When is a hip replacement recommended?

Your doctor may recommend a hip replacement if you have:

• osteoarthritis
• rheumatoid arthritis
• pain following a hip injury
• an injury that affects blood supply to the hip
• hip disease from birth
• hip pain that has lasted a long time and
  • you find it difficult to move
  • pain has not improved with medicines, physical therapy or walking supports
  • you find it difficult for you to look after yourself and carry out your daily activities

The most common reason in Australia for hip replacement surgery is osteoarthritis. A hip replacement can reduce pain, improve mobility and improve quality of life.

What are the risks and complications of hip replacement surgery?

Hip replacement surgery is considered safe and effective. However, complications can include:

• infections
• blood clots (deep vein thrombosis, or DVT)
• hip dislocation, especially in the first few months after surgery
• one leg feels shorter than the other
• nerve and blood vessel injury
• swelling and stiffness
• continued pain

Should I have a hip replacement?

There could be alternatives to having surgery such as continuing with physical therapy and adding new methods of pain relief or trying hip resurfacing therapy. It is best for you to discuss these options with your doctor.

To help you decide, here are some questions you might want to ask your surgeon:

• What are the alternatives to surgery?
• What are the different surgery options? For example, is ‘minimally invasive’ hip replacement suitable? This technique reduces cutting of the tissue around the hip.
• What are the possible complications and how likely are they?
• What can I expect during recovery?
• How much improvement can I realistically expect?
• How long will my new hip last?

What should I expect after hip replacement surgery?

You will probably spend a few days in hospital after the surgery. You will usually go home after 3 to 5 days, and sooner in some cases. Most people will be encouraged to walk with the help of a walking support soon after surgery. You will be advised on how to take care of your new hip and how to avoid hip dislocation.

Recovery is different for everyone and you will need to do rehabilitation, including physiotherapy and occupational therapy, to strengthen the new joint and improve flexibility.

Most people can do light activities after around 6 weeks. After around 3 months you should be able to get back to most of your normal activities. For some people, it takes up to 12 months to feel the full benefits of the hip replacement.

Your surgeon will let you know what activities you can do after your surgery, but you will likely need to avoid high impact sports.

How long does a hip replacement last?

Hip replacements last at least 10 years for 9 in 10 people who have a hip replacement. Joint replacements eventually need to be redone (this is called revision surgery). The younger you are, the more likely you are to need revision surgery.

Doing all your exercises as your health ream instructs, and keeping to a healthy weight will help you recover and increase the lifespan of your new hip.