Total Hip Replacement

Total hip replacement is a well-established surgical option designed to alleviate severe pain caused by advanced hip arthritis. In earlier stages, non-surgical approaches—such as pain relievers, anti-inflammatory drugs, physiotherapy, and steroid injections—may provide relief. While steroid injections can ease discomfort in mild to moderate cases, total hip replacement is recommended when arthritis becomes debilitating, offering significant pain relief and improved mobility.

Anaesthetic Options for Your Surgery

For your hip replacement procedure, anaesthesia is a critical consideration. Most operations are performed under regional (spinal) anaesthesia combined with sedation, which numbs the lower body and keeps you comfortable throughout the procedure. In some instances, general anaesthesia—where you remain unconscious—may be used instead. The final decision is made after a thorough preoperative assessment and consultation with the anaesthetist, ensuring that you experience no pain during surgery.

The Surgical Procedure: What to Expect

At Manchester Hip and Knee Surgeon, every detail of the surgical process is carefully managed:

  • Pre-Operative Preparations: Antibiotics are administered before the surgery begins to lower the risk of infection.
  • Accessing the Hip: A carefully planned incision is made along the side of the hip, allowing the surgeon to expose the joint.
  • Removing the Damaged Bone: The damaged femoral head (the ball portion of the hip joint) is removed.
  • Implanting New Components:
    • A polyethylene liner is securely fixed into the hip socket using bone cement.
    • A metal stem is inserted into the femur.
    • A metal or ceramic head is then attached to the stem.
  • Closure and Pain Management: The incision is closed with metal clips, and a local anaesthetic is applied around the hip area to aid postoperative comfort.

Immediate Postoperative Recovery

After your surgery, the focus shifts to recovery and pain management. You will be provided with appropriate pain relief as you wake from the anaesthesia. Physiotherapists will assist you with gentle walking and specific hip exercises to promote mobility, often using crutches or similar aids initially. An X-ray is performed to verify that the new hip components are correctly positioned, and many patients can return home within a few days.

Recovery After Hospital Discharge

Your rehabilitation journey continues once you leave the hospital. It is important to keep up with prescribed exercises to strengthen the muscles surrounding your new hip. Typically, skin clips are removed about two weeks after surgery, and the hip generally settles within six to eight weeks. A follow-up appointment, usually around eight weeks post-surgery, allows your surgeon to assess your progress and ensure your recovery is on track.

Long-Term Expectations and Activity Guidelines

Most patients can resume their daily activities after recovery, albeit with some precautions. For the first three months, it is advisable to avoid high-impact or repetitive activities that might stress the new hip joint. When well-cared for, the replacement hip usually provides lasting benefits for approximately 15 years in 90% of cases, enabling you to enjoy an active lifestyle.

Understanding the Risks and Complications

As with any surgical procedure, total hip replacement carries potential risks. Some of the significant complications include:

  • Infection (around 1%): Even with strict sterile techniques and the use of antibiotics, infections can occur. Superficial infections (affecting only the skin and soft tissue) are generally manageable with antibiotics and minor surgical cleaning, while deeper infections may require removal and later replacement of the implant.
  • Bleeding: In cases of considerable blood loss, a transfusion might be necessary.
  • Deep Vein Thrombosis (DVT) and Pulmonary Embolism: Blood clots can form in the leg veins and, if dislodged, travel to the lungs. Preventative measures include blood thinners, compression stockings, calf exercises, and staying well hydrated.
  • Dislocation: The new joint can occasionally slip out of place. This risk is minimized by following physiotherapy guidelines, though dislocations may sometimes require repositioning of the joint.
  • Nerve Injury: Rarely, injury to the sciatic nerve can occur, potentially causing leg weakness or foot drop.
  • Limp or Leg Length Discrepancy: Postoperative limping may develop, and the operated leg might be slightly longer or shorter than the other. Both issues can often be addressed through targeted physiotherapy.
  • Persistent Pain: Up to 10% of patients might experience ongoing discomfort due to scar tissue formation or nerve sensitivity, which may necessitate further management through a pain clinic.
  • Wear and Loosening: Over time, components can wear out or loosen, sometimes leading to the need for revision surgery.
  • Other Rare Complications: These can include fractures or other unforeseen issues during recovery.