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Hip Replacement Surgery

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Introduction

Hip replacement is a common operation in which an Orthopaedic surgeon will replace the worn or damaged hip (both ball and socket of the hip) with an artificial joint.

 

Usually your GP or Physiotherapist will consider sending you to an Orthopaedic surgeon if you have already exhausted other non-operative pathways such as extensive Physiotherapy, painkillers, walking aids and injections.

 

A clinician will consider a hip replacement surgery for you when there is considerable damage in the hip joint due to ongoing arthritis and when the symptoms (pain) present even when you are resting coupled with significantly reduced function.

Conditions Associated With Hip Replacement

  • Hip fracture.
  • Septic arthritis.

Prior To The Operation

Your hospital will arrange a face-to-face pre-operation class to explain what to expect during and after surgery. It is also important that you stay as active as you can. A Physiotherapist can help you with personalised strengthening exercises targeting your hip and buttock muscles, and there is strong research evidence that the stronger you are before the surgery the better the outcome of the surgery (Gill & McBurney 2013; Rooks et al., 2006).

After Your Procedure

Hip replacement is considered as a major surgery, and national average for hospital stay is about 3-5 days. You will be under the care of a multidisciplinary team at the hospital which consists of your Surgeon, Ward Nurse (who deals with pain management side), Physiotherapist (deals with progression of your mobility and exercises) and Occupational Therapist (they help you by assessing your home environment and may help you have some assistive aids to help with daily activities).

 

Most people can walk unassisted 6 weeks after surgery however this will vary significantly based on your baseline function levels. Nonetheless, it is important that you adhere with home exercises during this time. Most hospitals will give you an advice leaflet which contains all home exercises. You may also be referred to an outpatient department to see a Physiotherapist where they will progress your walking and exercises. You can start driving after 6-8 weeks however this will be clarified and confirmed. Please ensure it is fully safe to return to driving before attempting to. Full recovery can take up to 2 years.

Post-Surgical Complications

These are rare but can include:

 

  • Infection to the wound or implant.
  • Hip dislocation.
  • Break in the bone during or after the operation.
  • Injuries to blood vessels and nerves.
  • Leg length difference.

 

To avoid infection, be sure to keep the wound and dressing clean and dry – especially after a shower. Keep an eye on the wound, if it starts to swell, become red and hot, see your GP and monitor your temperature as infection can raise your temperature.

 

To prevent deep vein thrombosis, stick to the advice given by your Nurse at the hospital, use your stockings as advised and keep active. If you start to develop severe pain with or without redness in your calf muscles please contact your GP surgery.

Additional Resources

Arthritis Research UK hip replacement information leaflet – click here.

 

NHS information of hip replacement – click here.

References

Gill, S. D., & McBurney, H., (2013). Does exercise reduce pain and improve physical function before hip or knee replacement surgery? A systematic review and meta-analysis of randomized controlled trials. Archives of physical medicine and rehabilitation94(1), 164-176.

 

Rooks, D.S., Huang, J.I.E., Bierbaum, B.E., Bolus, S.A., Rubano, J., Connolly, C.E., Alpert, S., Iversen, M.D. and Katz, J.N., (2006). Effect of preoperative exercise on measures of functional status in men and women undergoing total hip and knee arthroplasty. Arthritis Care & Research: Official Journal of the American College of Rheumatology55(5), pp.700-708.

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