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Hip replacement surgery - an overview

If you suffer from long-term hip pain which doesn’t get any better over time, your consultant may recommend hip replacement surgery.

This may be because you’re suffering from one of the following incurable hip conditions:

  • Osteoarthritis (wear and tear to the cartilage)
  • Rheumatoid arthritis (an autoimmune disease)
  • Damage due to trauma (bone fractures leading to loss of blood supply)
  • Septic arthritis (infected joints)
  • Bone tumours
  • Paget’s disease (causes weakened and deformed bones)
  • Developmental dysplasia of the hip (a congenital condition)
  • Hip joint fractures (caused by osteoporosis)

Hip replacement surgery is a long-term solution for irreparably damaged hip joints. Many people experience continuous pain and an increasing loss of mobility. A hip replacement operation can bring a transformation in quality of life through release of pain and a regained ability to move about without discomfort.

This article on hip replacements is written by Jackie Griffiths, a freelance journalist who writes health, medical, biological, and pharmaceutical articles for national and international journals, newsletters and web sites.


What is involved in a hip replacement operation?

Most hip replacement operations are performed under general anaesthetic, but you could also choose to have an epidural, which means you’ll be conscious during the procedure but will not be able to feel any pain. Both your socket and the rounded ball at the top of the thigh bone (femur) will be replaced with artificial parts.

The surgeon will hollow out the socket in your hip, and remove the very top part of your femur. He also makes a short hollow tube down into your femur and inserts a slightly angled titanium alloy shaft with a ball attached at the top. A high-density polythene socket is placed into the hollowed-out socket so that the ball of the shaft in your femur fits snugly into it. Your hip joint is now totally replaced.

The artificial parts are fixed into your body using two different methods:

  • Special bone glue or cement – the metal shaft and plastic socket are both secured in place with a special glue.
  • Permeable material – the metal shaft and plastic socket have tiny holes all over them so that healthy bone can grow into, and fuse around, them.

Why have an operation?

There are many advantages to having the operation over just leaving the situation as it is:

  • It is one of the most reliable operations in the field of orthopaedic surgery with patients reporting a dramatic improvement in their quality of life. Many people become completely pain-free and find they can move again without difficulty.
  • Arthritis, and other damage to the hip joint that causes chronic pain, is incurable. It will never get better by itself and unfortunately is likely to gradually get worse.
  • Although hip replacements may result in some discomfort at the time it very quickly wears off, and within two - three weeks most patients report the pain has almost gone. This compares favourably to the never-ending pain of arthritis.
  • If you’ve found everyday movements quite difficult, after the hip replacement operation you should regain your former level of mobility, allowing you to partake in gentle exercise and leisure pursuits.
  • Many patients who suffer from arthritis of both hips, but who’ve only had a single hip replacement operation, ask for a second one as soon as possible.

Hip replacements are now classified as routine but as with all surgery, there are some risks. Most people do not experience any problems after undergoing the procedure.

Complications

  • Joint loosening. Approximately ten to fifteen years after the surgery, you may find the shaft of the metal implant becomes loose, leaving you needing a repeat operation.
  • Wear and tear of the plastic socket. Sometimes small particles from the implants become loose due to friction. This can cause inflammation in the surrounding tissue.
  • Infection. If the wound or new joint becomes infected, you may have to take antibiotics to get rid of the infection. Deeper, more serious infections may require further surgery.
  • Dislocation. Very occasionally the metal shaft at the top of your thigh bone can come out of the plastic socket in your hip. If this happens repeatedly you may need another operation.
  • Blood clots. Also, very rarely, blood clots can sometimes form in your leg veins due to reduced movement, but this is usually treatable with compression stockings, blood-thinning medication, and special exercises.

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Hip replacement surgery - an overview
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