Pre-operation planning screen. Implant optimal position for best range of movement to suit the patient.

X-ray of the pelvis showing both hips have arthritis. The space between the ball and socket is reduced on the Right. On the Left side the space is not seen (blue arrow) and the bone of the femur (ball) is contacting the bone of the socket.

X-ray of the pelvis after a Left Total Hip Replacement. The Uncemented implant restores the ball and socket joint.

Robotic Total Hip Replacement

Total Hip Replacement

Hip replacement surgery involves removing the damaged joint surfaces (i.e. the worn cartilage and bone), and replacing them with an artificial ball and socket joint.

Due to the engineering advances in recent years, the majority of patients find that after their hip replacement they experience significant pain relief and improvement in movement. This means that they find everyday functions such as sitting, walking and driving much more comfortable.

Results of surgery can be relatively quick but may take between 2 and 6 months depending on the type of surgery you have, your overall health and how well you rehabilitate.

How long the replacement hip lasts can depend on many factors, although it is true to say that most patients will never need to have another operation. The amount of activity you undertake may have a bearing on the life of the joint, as will your weight. Overall a replacement hip might be expected to last fifteen to twenty years.

Robotic Hip Replacement Surgery – improving accuracy

Robotic surgery has improved what we can achieve at the time of a total hip replacement.

The robot allows improved accuracy in measurement and placement of the new joint helping to control leg length and offset, whilst allowing control of socket position to reduce the chance of dislocation and implant impingement.

Using the Real Intelligence software the implant positions are tailored to fit your skeleton through a wide range of movement – paticularly difficult to achieve if there is a significant lower back stiffness from surgery or wear and tear.

I am a member of the Computer Assisted Orthopaedic Surgical Association, which is part of the British Orthopaedic Association.

Improving Outcomes

Faster surgery and recovery.

More accurate implant positioning – more chance of  joint lasting longer up to 25 years or more.

Less chance of leg length inequality and dislocation.

If you have a painful hip that’s holding you back, don’t struggle on, get in touch and book an appointment. 

Robotic Total Hip Replacement FAQ

Hip replacement surgery means a short stay in hospital – most people will tend to stay in hospital for around three days and two nights. On the day of the surgery, you’ll have a general or spinal anaesthetic and through the use of clever pain control you’ll be up and about on the same day.

This kind of ‘enhanced recovery’ means that with the guidance of a physiotherapist, you’ll be up and walking, just a few hours after surgery, and we’ll make sure that you’re very comfortable.

The operation lasts about 60 to 70 minutes and when you wake up, there’ll be a dressing on your outer thigh. Above this is a smaller dressing from the robotic array pin tracks.

You’ll been encouraged by the physiotherapists to start moving the ankle and bending the knee. Within hours you will be standing with support, and we will encourage you to start walking normally, initially with the use of a frame or crutches.

I always use absorbable sutures, which means you don’t need any stitches removing. We’ll generally meet again around two weeks after the surgery, and it’s really important that you embrace and engage with the rehabilitation that’s going to be guided by your specialist physiotherapist or osteopath.

Your hip replacement may be put in with a press fit “uncemented” implant which allows the bone to grow into the implant, sometimes a grout referred to as bone cement is used to fix the implants – a “cemented” procedure. Occasionally a “hybrid” replacement is used, which consists of a cemented stem and an un-cemented socket. The type of hip replacement you receive will be discussed with you prior to the operation.

You may occasionally need a blood transfusion due to blood loss during the operation.

You will be transferred to the recovery room where you will remain until Mr Jennings and the anaesthetist are satisfied that you have recovered sufficiently before you are transferred back to the ward.

You will have:

  1. A drip, (a fine tube) inserted into a vein in your arm that supplies fluids or blood.
  2. The dressing on your hip and a small dressing above the main incision.

Pain relief

Good pain relief is important and some people need more pain relief than others. It is much easier to relieve pain if it is dealt with before it gets bad.

Pain relief can be increased, given more often, or given in different combinations. You should ask for help when you feel pain.

For the first week, you can probably expect your hip is going to be feeling rather achy at nighttime, and you may need some painkillers to sleep. Quite often any discomfort recovers very rapidly. Most patients find hip replacement surgery much easier to get going than a knee replacement.

You’ll be able to be active using crutches for comfort, and after a few weeks, most of my patients will have been able to rid themselves of the crutches entirely. You’ll be working with your physiotherapist to strengthen the muscles around the hip and pelvis ensuring you can flex your hip fully.

I generally suggest that people take around six weeks off work, which gives sufficient time to recover and time to engage with rehab.

Returning to driving might take up to six weeks, and really this is the test of whether you can control the vehicle and perform an emergency stop.

It’s a good idea to liaise with your car insurer before starting to drive again.

A pervading myth that still lingers is that hip replacements don’t last very long, and therefore you should wait for as long as you possibly can before having one. Thankfully, this is no longer the case.

We now know that with new implant technology we can expect our hip replacements to last at least 20 years.

Additionally, the vast majority of patients are really glad they had the surgery. Over 95% of people who undergo hip replacement surgery have a really dramatic reduction in their hip pain and a very big improvement in flexibility getting them back to the activities they like to carry out.

You will make a rapid recovery and will see within a few days a change for the better in the range of movement and feel of the hip.

Most of my patients will be able to return to golf, tennis, and skiing. I’m often asked is it possible to run with a hip replacement? Whilst it may accelerate the wear of the replaced joint, we do know of some patients who were runners previously, who choose to return to running after replacement surgery. It’s probably a good idea to avoid football and contact sports, such as rugby or martial arts.

After any significant surgery, our risk of blood clots is increased, and so we recommend that for at least six weeks you should avoid long haul flights, but certainly it’s a good idea to use compression stockings whenever you’re flying.

X-ray of the pelvis showing both hips have arthritis. The space between the ball and socket is reduced on the Right. On the Left side the space is not seen (blue arrow) and the bone of the femur (ball) is contacting the bone of the socket.

X-ray of the pelvis after a Left Total Hip Replacement. The Uncemented implant restores the ball and socket joint.

FAQs

Simple pain relief such as paracetamol and anti-inflammatory medication such as ibuprofen can help control the pain of arthritis. Using a walking stick on the opposite side can help offload the joint. Regular moderate exercise can help reduce some stiffness and often physiotherapy can strengthen weaker muscles. 

Weight loss is very useful if you are overweight. If these are not helpful then injection of steroid may reduce pain and stiffness for several months. We tend to limit the number of injections as they can be damaging in the long term. 

A total hip replacement is used to replace a damaged or worn hip joint to restore functional range of movement and reduce pain. The ball and socket hip joint is removed and replaced with an artificial ball and socket (prosthesis). 

The majority of patients find that after their hip replacement they rapidly experience significant pain relief and improvement in movement. This means that they find everyday functions such as sitting, walking and driving much more comfortable than before. 

Most patient experience some degree of stiffness which may be associated with pain in the groin. Some people will not feel pain in the groin or may even feel pain in the knee (referred pain). 

The decision to carry out surgery is only made after a thorough consideration of the symptoms you are suffering, the likely risks and benefits of surgery and an evaluation of whether other treatment without surgery would be appropriate. 

Other treatments include: exercise, taking pain killers including non-steroidal anti-inflammatories (NSAIDs), physiotherapy with muscle strengthening and corticosteroid injections. Self-help measures such as losing weight can also be beneficial. 

Simple pain relief such as paracetamol and anti-inflammatory medication such as ibuprofen can help control the pain of arthritis. Using a walking stick on the opposite side can help offload the joint. Regular moderate exercise can help reduce some stiffness and often physiotherapy can strengthen weaker muscles. 

 

To reduce the risk of hip dislocation your physiotherapist will teach you how to safely move about and get in and out of bed. They will also show you which movements to avoid during the early recovery period. 

You will be given advice on dressing and toileting. 

Before discharge you will be shown how to get in and out of a car and you will safely negotiate the stairs. 

It is advisable to sleep on your back, though you may sleep on your operated side with a pillow between your knees to prevent your leg from turning in. 

For the first 6 weeks you can only have a walk-in shower or strip wash sitting on a high stool. You should not attempt to have a bath until you are 6 weeks from surgery. 

Do not be frightened to resume normal sexual relations, being careful not to force your hip into an uncomfortable position. 

Usually you can drive for six weeks after hip replacement surgery. 

If you are confident walking without crutches and able to enter a car unaided then a return to driving may be reasonable from 4 weeks after surgery. 

Always check with your car insurance company before getting back on the road. It is important that in an emergency you are able to stop the car safely. 

Usually, but not always, the arthritis will tend to cause more stiffness and pain. Arthritis is not life threatening but will affect quality of life and can be debilitating. 

If you have arthritis of the hip you will have a rapid clinical assessment eliciting details of your difficulties and level of discomfort. You will require imaging of your hips to assess and plan surgery. All patient will undergo X-ray assessment but other scans may be required to confirm the diagnosis. You will be taken through all the available treatment options and your treatment will be tailored to your individual case and needs. 

 

Hip replacement is carried out under a general or spinal anaesthetic. 

The operation lasts from 60 to 90 minutes. An incision is made at the side of the hip in order to gain access and replace the damaged joint. 

The latests techniques are used to reduced pain and discomfort and enhance your rapid recovery from surgery. (enhanced recovery) 

Your treatment will be aimed at early mobilisation. This will serve to dramatically reduce your risk of blood clots and will help you promote good muscle function and recovery. 

After surgery you will probably feel a little tightness but should not feel significant pain. You will see a steady and rapid return of mobility once the surgical discomfort subsides. Depending on the pre-surgery condition you may feel a slight difference in posture that will rapidly improve with physiotherapy. 

As your muscles become stronger you will be able to go up and down stairs in a normal fashion (usually 4-6 weeks). 

This is variable and depends on the nature of your work. Most patients return to work 6 weeks after their operation. Some more physically demanding jobs may require longer off work. 

Most patients are able to return to a high level of activity following hip replacement surgery. Repetitive loading and impact such as running may be possible but is more likely to wear your joint more rapidly. Activities that involve deep bending of your hip, such as certain yoga movements are best avoided. After 3 months (riding, golf, doubles tennis) should be fine. 

 

There is an extra risk of blood clots in the legs (DVT or deep vein thrombosis) after major hip surgery up to 6 weeks following operation. During this time long haul flights should be avoided. 

Shorter flights may be contemplated with much less risk. 

You should always consider using appropriate precautions including good hydration, regular movement /exercise, use of compression stockings when flying. 

Many of my patients tell me that their knee replacement surgery

has been life-changing

has been life-changing

and they’d wished they’d had it done sooner. Patients who do best, are patients that do a little bit of ‘pre-habilitation’ work to strengthen before their surgery, and really embrace the post-op physio rehab making sure they do their daily exercises.

Talk To An Expert Now

Talk To An Expert Now

If you’re somebody who’s struggling at the moment with pain or being active, please do book in to see me.