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Hip replacement primary

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From £13,680

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Hip replacement primary

Hip replacement primary

Hip replacement surgery is one of the most successful operations of modern medicine.

In recent years both operative techniques and engineering procedures have advanced, relieving patients of hip pain and stiffness.

If you have extensive damage or are suffering the effects of arthritis in your hip joints this does not mean that you have to live in pain. Your consultant surgeon may well advise you to consider surgery.

Over time the surface on your hip joints can start to wear. This can be a result of osteoarthritis or a previous injury to the hip joint.

The lining of the hip protects the surfaces of your bones. Without this protection the surfaces of the bones rub together as you move. This causes the pain.

Joints can be replaced successfully, improving mobility and reducing pain.

Surgery involves replacing the arthritic hip joint with an artificial joint. The replacement joint is also known as a prosthetic joint.

The socket in the pelvis, known as the acetabulum is excised and an artificial hemispherical prosthetic socket, commonly known as a cup, is then inserted into the pelvis.

The ball part of the joint, the head of the femoral bone, is removed. A prosthetic stem is then inserted into the femur (thigh bone). A new ball is then attached to this stem to create the new ball and socket joint.

The new socket and stem are held in place either by a special material attached to the surface of the prosthesis which allows your own bone to grow onto this surface and fix it in place, or else a surgical cement is used to glue them in position. This is very similar to that used in dental surgery to fix metal fillings in place.

The ball, stem and socket can be made from a variety of materials such as metal, plastic and ceramic.

We only use prosthetic components with a proven track record. The hip prostheses we use are the best in class with a long and reliable track record of success. Our surgeons have visited the design centres for these prostheses and learnt the specific surgical techniques for their insertion.

Prior to surgery there are a number of things that take place to ensure the operation proceeds as smoothly as possible and you are well prepared following discharge from hospital back home with your new hip.

We offer a rapid recovery programme for hip patients having joint replacement or other reconstructive or remedial surgery.

FAQs

You will be provided with a carbohydrate drink to take the evening before and six hours before your planned surgery.

You are usually admitted on the day of your operation. Your surgeon and anaesthetist will see you prior to your operation and answer any last minute questions/concerns you may have.

The anaesthetic we prefer to use for your surgery is that of spinal regional anaesthesia. This has been shown to reduce the amount of blood loss during surgery and possibly reduce the complications from blood clots following your surgery. It also avoids the insertion of a tube into your throat which is required with a general anaesthetic. This can give you a sore throat for a few days following surgery. Nausea, drowsiness and headaches which are common problems with general anaesthesia are also avoided.

The spinal anaesthesia involves injecting a small amount of anaesthetic into the fluid surrounding the spinal cord in the lower back. This induces a short acting loss of sensation (numbness) in your lower limbs which allows the operation to take place pain free. The feeling returns to your legs after a few hours, after the operation has been completed.

This process is undertaken in the anaesthetic room and then you are then moved to the operating room next door. Sedative medication is also administered at this time if needed.

The anaesthetic will be discussed preoperatively with your anaesthetist. If there are any contraindications to undergoing a spinal anaesthetic then you will be offered a general anaesthetic.

The surgery itself is undertaken in a specially designed operating theatre to reduce the risk of infection. This is known as a laminar air flow theatre.

You will be placed on your side on the operating table and held there with specially designed supports placed on your back and front of your pelvis. Your skin is then shaved if necessary and disinfected prior to surgery, again to reduce the risk of infection.

At the end of the operation local anaesthetic is injected into the tissues around the hip joint, to reduce post operative pain.

A routine hip replacement is usually performed in 1-1 ½ hours. You will spend some time in the theatre recovery room prior to being transferred back to the ward. The whole process of leaving and returning to your ward usually is about three hours.

Once at home following discharge from hospital you should keep your wound dry until your stitches/skin clips have been removed. These will usually be removed about ten days following your surgery.

If any redness develops around your scar, or it continues to leak fluid, you should either consult your GP or your surgeon for advice.

Following your hip replacement, you should expect a reasonably quick return to your lifestyle and activities without the pain and aching that you experienced prior to the hip replacement. Specific concerns commonly include the following:

When can I sleep on my side/stomach?

We usually advise you to sleep on your back for the first four weeks following your surgery. Following this period sleeping positions are unrestricted.

When can I get in a car and when can I drive?

Following your hip replacement you can sit in a car when you are discharged from hospital. We recommend however that you avoid travelling in cars with low fitting seats for at least four weeks following your surgery.

We advocate avoiding driving until four weeks after your surgery. You need to ensure that you can perform an emergency stop and hold your foot on the brake (and clutch) for at least 10 seconds.

When can I cross my legs or bend down at the waist?

You should avoid crossing your legs or bending down at the waist for the first four weeks following your surgery

When can I have sexual intercourse?

Sexual activities can usually be resumed within four weeks after your surgery. Any concerns with this should be discussed with your treating surgeon.

When can I resume sporting activities, dancing or gardening?

This depends upon the sporting activity in question. Swimming can be resumed once the wound is healed, as can activities such as walking, golf and dancing.

Gardening activities that avoid bending at the waist can be resumed once the wound has healed. You should avoid bending down as mentioned above for four weeks following your surgery.

Activities that involve impact stresses on the joint such as jumping, jogging and contact sports should be avoided following your hip replacement.

Further information can be found in the link below:

http://orthoinfo.aaos.org/topic.cfm?topic=A00356

Hip replacement surgery is a major operation. Complications albeit rare can occur. You should be aware of these risks prior to consenting for your operation. The statistics quoted are national figures.

General complications related to surgery

Deep vein thrombosis (about 3%): this is a blood clot in the deep veins of the legs, and/or thighs. Rarely part of this blood clot can dislodge and travel to and become lodged in the lungs causing a pulmonary embolism (less than 1%). This is a serious and potentially fatal condition.

We try and reduce this risk by using special equipment during your operation to regularly and intermittently gently squeeze the calf muscles of your other leg. This is known as a flowtron gaiter. Post operatively you will receive blood thinning medication and will be given TED stockings to wear.

Urinary problems: occasionally you will have problems urinating after surgery. This may necessitate insertion of a temporary urinary catheter, which is usually removed when you are up and fully mobile – usually a few days at most.

Nausea, loss of appetite and constipation: these are common after surgery. They usually resolve after two or three days. Stool softeners may be prescribed if you develop constipation.

Cardiorespiratory complications such as a heart attack, stroke or chest infection (less than 1%): prior to your surgery your fitness to undertake the hip surgery will be assessed to try and reduce this risk.

Complications due to hip surgery

Dislocation (less than 1%): the ball can dislocate from the socket. The highest chance of this happening is in the first six weeks following your operation until all of the tissues around the hip joint have healed. Your physiotherapist will guide you on how to reduce this risk following your operation.

Deep infection (less than 0.1%): following your operation occasionally the wound can leak some fluid. This usually settles after a few days. A superficial infection can occur which usually responds to oral antibiotics. Infection however can sometimes occur deep in the hip joint itself around your new hip prosthesis. This may occur at any time after your operation, sometimes many months or years after your operation. If this deep infection does not respond to antibiotics there is a risk that you will need to undergo a further operation to replace this infected hip.

Nerve injury: this is very rare (less than 1 in 1000). It may result in foot weakness (foot drop) necessitating the use of a special splint.

Leg length difference: sometimes the surgery will result in a slight difference in your leg lengths. This can be disabling and require the use of an insert in your shoe to equal your leg lengths out. We minimise this risk and carefully check your leg lengths intraoperatively.

Fracture of the thigh or pelvis (less than 1%): this rare complication can be treated during the operation but may require you to walk using crutches for several weeks after the operation to allow the fracture time to heal.

Ankle swelling: this is very common and usually takes several months to resolve.

Squeaking: audible noises following a hip replacement have a prevalence which ranges from 0.66% to 7.0% in published articles. The audible noise usually develops more than a year after surgery. There are multiple factors associated with this.