There are many conditions which require a hip replacement. The most common is osteoarthritis. Osteoarthritis simply means that the cartilage of the hip joint has worn out, resulting in the head of the thigh bone/femur (ball) and the acetabulum of the pelvic bone (socket) rubbing together. This is very painful and stops you being able to move your hip as you once did.
A THR involves removing the damaged ball and socket of your hip joint and replacing them with an artificial ball and socket. These can be made of metal, plastic or ceramic. The artificial joint is either fixed to the bone with special cement, or has a surface that new bone will grow into.
After the operation you will feel some pain and discomfort, which will be helped by medication.
You will be offered pain relief every few hours which may include a combination of regular pain relief such as paracetamol as well as stronger opioid based painkillers. It is a good idea to take these regularly in the first 48-72 hours. After this you may be able to reduce the dose or frequency of some of these medications.
You may have the following:
- Small drainage tubes coming from your wound
- A drip to replace lost fluids
- An oxygen mask
All will be removed as soon as possible after surgery. Unless you have been told otherwise by a doctor or a physiotherapist, you can move as you feel comfortable after your total hip replacement. You should avoid sudden or awkward movements. You should move your hip slowly and in a controlled way so that your muscles can support your hip fully as you are moving.
After your operation, you should have relief from your pain, which should improve your ability to walk.
- All operations have risks
- A hip replacement is a major operation and will place the body under stress
- Any underlying illnesses may worsen due to the operation
- Pain The hip will be sore after the operation but will usually improve over the first few months. However a degree of ongoing pain or discomfort can occur, and in some cases be permanent.
- Bleeding There will be blood loss during the operation. A blood transfusion is occasionally required.
- DVT (deep vein thrombosis) is a blood clot in a vein due to the surgery. It can cause leg swelling and pain. Stockings and blood thinning medication will reduce your risk. Starting to move your legs early is one of the best ways to prevent blood clots from forming.
- Loosening and wear of the hip replacement The implants are designed to last many years (10-20 years), but in some cases they fail earlier and require replacement surgery.
- Altered leg length The operative leg may appear shorter or longer than the other side. This can be for a number of reasons. Patients usually adjust to this but occasionally a shoe raise is required.
- Joint dislocation A further operation is usually required to relocate the hip, it may be followed by the application of a hip brace or rarely if the hip keeps dislocating, a revision operation may be necessary.
LESS COMMON RISKS (Less than one in every one hundred hip replacements)
- Infection The operation is performed under sterile conditions and you will be given antibiotics at the time of the operation. Despite this infections may still occur. This requires a course of antibiotics. Rarely, surgery to washout the hip replacement or revise the replacement is required.
RARE RISKS (Much less than one in every one hundred hip replacements)
- PE (pulmonary embolism) is when a blood clot moves to the lungs and affects your breathing. This can be fatal.
- Major nerve damage It is normal to have a numb area around the scar. Larger nerves can also be damaged leading to temporary or permanent weakness (footdrop) or altered sensation in the lower leg.
- Bone damage If a bone is broken or weakened during the insertion of the hip replacement further metalwork may be required to stabilise it, either at the time of surgery, or at a later operation.
- Blood vessel damage The vessels around the hip may be damaged which would require further vascular surgery.
- Death This very rare complication may occur after any major operation.