Total Hip Replacement

Total Hip Replacement is realistic long term solution for symptomatic hip arthritis not improving with alternative modalities of treatment or hip injection

WHAT CAN YOU EXPECT AFTER THE HIP REPLACEMENT

One must realize that not all your hip pain may disappear after your surgery.  Immediately after surgery, the gnawing severe pain may disappear but may be replaced by surgical pain.  This may last up to 6-12 weeks but should lessen over time.  Pain medication may still be needed because of this. You may experience occasional pain in your new hip after walking and other activities.  The relief of this type of pain is individual, depending on the severity of any pre-operative deformity in your hip, on the state of your muscles, and so on. Remember your surgeon replaced only the damaged joint surfaces but could do nothing to the muscles, ligaments and other soft tissues equally damaged by the “joint” disease.

POST-OPERATIVE COMPLICATIONS

Total hip replacement success rate is around 90%. As with all major surgical procedures complications can occur, although everything possible is done to minimize the risks.  It is important that you understand the following before undertaking your joint replacement surgery. This is not intended to be a complete list of all the possible complications, but these are the most common:

• Anaesthetic risks – will be discussed with you by your anaesthetist.
• Between 10 – 30 in a 100 chance of Deep vein thrombosis (DVT) – a blood clot in the calf despite preventative measures.
• 1 in a 100 chance of Pulmonary Embolism – blood clot in the lungs.
• Less than 1 in a 100 chance of infection.  This can occur whilst you are still in hospital.  Others may not become apparent for months or even years after the surgery.  If your hip replacement gets infected, part or all of it may need to be removed.  It is usually possible to have a good result from revision surgery.  If this fails it can lead to having the hip replacement removed and replacing it with a scar tissue ‘joint’.  This is the way hip osteoarthritis was treated before hip replacement was invented.  With a stick and a shoe raise most people would eventually be able to walk comfortably.
• Infection can spread from other areas.  Your surgeon may want to make sure that you take antibiotics if you need surgical procedures on your bladder or bowel.  It is important to let your dentist know that you have had a joint replacement, as some dental procedures may require you to take antibiotics to reduce the risk of germs spreading to your joint replacement.
• Loosening – This is a major reason replacement joints fail.  A loose joint replacement causes pain, and eventually it will need a further operation to revise the joint.
• Dislocation – Between 3-6 in a 100 chance of dislocation in the first year.  Just like your real hip, an artificial hip can dislocate if the ball comes out of the socket.  There is a greater risk in the first 12 weeks after surgery, before the tissues around the hip have fully healed, but there is always a risk.  A hip that dislocates frequently may need revision surgery to make it more stable.  The occupational therapist and physiotherapist will instruct you very carefully how to avoid activities and positions, which may cause the hip to dislocate.
• Damage to nearby blood vessels and nerves is very rare but may sometimes happen.
• Less than 1 in a 100 chance of fractures to the thigh / hip socket bone.  This can occur during surgery.
• You may sometimes find your leg is a little longer or shorter than it was before your operation and a shoe raise may be required.
• 2-3 in a 1000 chance of death.  The commonest causes are blood clots on the lungs, stroke or heart problems.