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.

Total Hip Replacement

Are you suffering with a painful and stiff hip that is letting you down? Do you feel pain at night and find it increasingly difficult to walk with catching or giving way? Perhaps your friends or family members have noticed you’ve started limping and you’re struggling to keep up when walking. Are you finding it harder to do simple things like put on a sock or tie a shoelace? 

Maybe you’ve had lots of physiotherapy, but now the hip is really holding you back. If you have wear and tear arthritis [osteoarthritis] throughout the hip, you may need a total hip replacement. 

How do I know if I need a hip replacement?  

Many people wonder, are they too young to have a hip replacement? You might even be thinking this yourself. You may know people who have had a hip replacement and wonder whether it’s the right thing for you. 

If you have a stiff and painful hip, or even a stiff hip with little pain, and it’s really letting you down, I’ll take you through a thorough assessment. I’ll examine you, watching how you walk, watching how your hip moves, and then we’ll carry out x-rays and sometimes an MRI or CT scan.  

I’ll be looking to see the degree of degeneration of your hip joint, and I’ll want to really understand what you’re struggling to do activity-wise, and what you want to be able to get back to doing. 

If you’ve tried many of the conservative ways of dealing with arthritis in the hip, such as injections and physiotherapy and osteopathy, and you’re still not able to get to be comfortable, then we may be talking about a total hip ‘arthroplasty’ (hip replacement surgery).  Many patients tell me that this surgery has helped given them back their lives.   

What happens during the hip replacement surgery?  

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 minutes and when you wake up, there’ll be a dressing on your outer thigh. 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. 

What can I expect after my total hip replacement?  

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. 

How long do hip replacements last? 

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.  

What can I expect to do with my hip after a hip replacement?  

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. 

When can I fly after total hip replacement? 

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. 

Are there any risks with total hip replacement surgery?  

As with all surgery, there are theoretical risks, although thankfully big post-op problems (such as blood clots, nerve damage and severe infections) are very rare. 

You might experience some pain, swelling in the leg, or bruising or stiffness. Most of these problems will settle with great rehab afterwards. 

How much does a hip replacement cost?  

***** prices and packages to be listed ***** 

I am often told by patients that their hip replacement surgery has given them back their life and mobility. They also realize how bad the hip was!  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. 

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

General complications of surgery
ENHANCED RECOVERY
Prevention of blood clots

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.

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