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The
following information aims to answer some of your questions
concerning Total Hip Replacement Surgery. You should, however,
always consult your surgeon if you have any concerns or queries
about your surgery.
What
is a Total Hip Replacement?
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hip replacement takes between 1-2 hours, and is performed
under a general anaesthetic (asleep) or spinal anaesthetic
(awake, but numb from waste down).
The
hip is a ball and socket joint. It is made up of a part of
the femur (thigh bone) called the head of the femur and part
of the pelvis (hip bone) called the acetabulum. The head of
the femur is the ball, the acetabulum the socket.
In
a Total Hip Replacement, the head of the femur is cut off
and replaced with a metal ball on a stem. The acetabulum is
made bigger, and replaced by a plastic cup.
Why
am I having a Total Hip Replacement?
The
usual indication for Total Hip Replacement is ongoing pain,
pain at rest or pain that wakes you at night, after the failure
of other more conservative treatments, such as medications, exercises, etc. This pain is most commonly
caused by Osteoarthritis of the hip joint.
This
can result from normal wear and tear over a person's lifetime,
or because of previous injury to the joint.
What
are the benefits of a Total Hip Replacement?
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Natural joint
Prosthetic joint
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successful operation will lead to a decrease in pain from
the hip joint. It will also allow the patient to experience
an increase in the hip's range of movement and increased mobility/function
of the joint.
This
enables the patient to retain independence in every day activities
such as showering, walking up stairs, shopping and gardening.
The
positive changes from the operation are not instantaneous;
they occur of a period of of weeks to months, and are complemented
by rehabilitation programs. Maximal effect may not occur until
more than a year post-operation. |
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| What
are the risks of a Total Hip Replacement?
As
with all surgery, there are risks involved with Total Hip
Replacement.
These
include general risks of surgery, such as reactions to the
anaesthetic used (please inform your doctor of any previous
problems with anaesthetics), excessive bleeding, clots in
the leg veins and lungs, heart attacks or strokes, and infection
(such as pneumonia, urinary tract infection, or of the wound
itself). Blood loss may lead to the need for blood transfusion,
which carries risks in itself (type-specific reactions, infection
etc.).
Surrounding
structures may be damaged during surgery. Some sensation may
be lost to the outside of the thigh. Damage to the femoral
artery, vein or nerve are extremely uncommon, but theoretically
possible.
Complications
specific to this operation include;
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dislocation;the
ball comes out of the socket. You will be taught how to
avoid this.
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Loosening;
the prosthetic ball becomes loose in its attachment to
the femur. This normally takes many years, but means the
joint needs to be replaced again.
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Serious
infection; the new joint sometimes (very rarely) becomes
infected. This requires an operation to clean out the
joint.
Please
feel free to discuss any concerns you may have about the procedure
with one of our medical staff.
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| What
will happen before the operation?
Once
your doctor/surgeon has decided a Total Hip Replacement is
suitable for you, he will explain to you in full the procedure,
why he/she recommends it, its benefits, risks and complications
so you can make a decision on whether to have the surgery.
You should ask questions if you have any.
You
must remember that you are under no obligation to have the
operation if you don't wish to do so, and that you have the
right to a second opinion.
Once
you and your surgeon agree to go ahead with the operation,
you will be asked to sign a form confirming you consent to
having the operation. You will then be put on a waiting list
for the procedure.
When
you approach the top of the waiting list, you will receive
a letter telling you the date of the operation. You will be
required to attend a Pre-Admission Clinic beforehand on a date specified in this letter. At this clinic,
you will be assessed by a team of medical and allied health
staff. We will do some tests (x-rays, blood tests, ECG etc.)
that make sure that you are fit for surgery, and begin planning
your rehabilitation and recovery, as well as address any other
issues which may arise.
At
some stage before the operation, you will be contacted by
a nurse from the orthopaedic ward and offered orientation
to accustom yourself before the operation.
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| What
will happen after the operation?
You
will usually be in hospital for a period of about two weeks
depending on your progress and recovery. During this time
you will have intravenous antibiotics (to decrease likelihood
of infection after surgery), and injections to decrease the
chance of clots forming in your legs. You will be closely
monitored on a daily basis by surgical and nursing staff.
Allied
Health Staff will help you start walking again (usually on
the second day after the operation), and assist you with any
aids or equipment that will help you maintain your independence
in hospital and once you go home. At first, you will experience
pain around your hip, but this can be controlled with medication,
and it will diminish with time.
Before
going home, you will also undergo a period of rehabilitation
at a specialised centre, such as St George's Hospital or the
Peter James Centre. This will happen about two weeks after your operation, but
sometimes, there is a long waiting list for these facilities,
and you might have to spend extra time in hospital. You will
be allowed to go home when the rehabilitation specialists
think that you will be able to manage. The amount of time
varies from person to person.
A
follow-up appointment will be scheduled at our outpatient clinic
approximately six weeks from the date of your operation. The
doctor will assess the speed of your recovery, and check your
post-operative x-ray to make sure the prosthesis is in good
position. Depending on your recovery, you will then be reviewed
at the discretion of your surgeon.
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