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Hip Replacements

Introduction

Hip replacement surgery is one of the most important surgical advances in modern medical history, and has one of the highest success rates of any procedure. Over 15,000 of these surgeries are completed each year in Australia and New Zealand alone.

As one of the body's primary load-bearing joints, the hip is prone to injury and degradation over time, including osteoarthritis, rheumatoid arthritis and trauma arthritis.

Hip replacement surgery involves replacing all or part of the damaged ball-and-socket joint with an artificial joint, with the goal of reducing pain, restoring mobility and generally improving joint function.

When is surgery necessary?

Hip replacement surgery, also known as hip arthroplasty, is recommended when other non-surgical treatments (e.g. physiotherapy and medication) have failed to yield satisfactory results.

Usually, conditions such as those listed below can be a sign that surgery should be considered by a hip surgeon:

  • Significant swelling around the hip joint
  • Thinned or absent cartilage lining
  • Narrow or irregular joint cavity
  • Bone spurs or thickening around the joint edges

The decision to operate

Dr. Letchford will perform a physical examination, assess your medical history and use x-rays and scans to determine whether your condition warrants surgical treatment.

The decision to operate will come out of a balanced, objective assessment of the potential benefits and risks of this treatment path. And as you will be the one undergoing surgery, he will make every effort to ensure that you have the information needed to choose how to proceed.

Helping you understand your options

Prior to making the choice to undertake a surgical treatment, you and Dr. Letchford will discuss:

  • Your ideal outcome
  • What risks and benefits you may face as a result of surgery
  • What will be seen as a result of your surgical treatment

You will only be recommended surgical treatment by Dr. Letchford if you both come to an agreement regarding the realistic chance of surgery improving your particular symptoms.

About the procedure

What it involves

While every patient and operation is different, the general procedure for a hip replacement takes a few hours and will follow this general outline:

  • You will be given either general anaesthesia (put to sleep), spinal (waist down) or local (only one area) based on the anaesthetist's recommendation.
  • An incision is made over the hip, buttock or thigh area.
  • Some muscles and ligaments are separated or temporarily detached to expose the pelvis and hip joint.
  • The head of the femur (ball) is either re-lined with metal or replaced with a prosthetic stem and ball. Special cement may be used to ensure solid attachment.
  • The acetabulum (socket) is re-lined with a metal, plastic or ceramic prosthesis.
  • The hip surgeon will test the physical motion of the new hip joint.
  • The new joint is smoothed flush with the existing bone structure.
  • The whole area is re-constructed and closed up. A drain may be inserted to remove fluid build-up.

Hospital stay and recovery time

In-patient stay:          Average 3-7 days
Walk (with stick):      Within 2 weeks (ideally)
Walk (unaided):        By 6 weeks (usually)

Possible risks and complications

All surgery has potential risks; however Dr. Letchford will only proceed if you and he believe the benefits outweigh the risks.

Fortunately, hip replacement surgery has a low rate of severe complications in healthy patients. If you suffer from additional conditions, Dr. Letchford will work with you to determine whether your system is robust enough for an operation.

Some examples of possible complications, in descending order of likelihood, include infection, blood clots, wound or scar irritation, unequal leg length, increased pain, nerve damage, dislocation, failure of the joint, heart attack, stroke or death.

You can rest assured that everything possible will be done to minimise the possibility of complications or side effects developing.

Pre-operative checklist

Prior to your arrival at our premises for surgical treatment, you and Dr. Letchford will need to take some actions to make your pre and post-surgery experiences as smooth as possible.

  • What you’re taking - At least 10 days prior to undergoing surgery, it’s wise to stop taking any anti-inflammatories or blood-thinning medication you may be on – as well as any natural or herbal supplements.
  • Routine examination - You’ll be required to undergo a regular medical check-up to ensure that your overall health is suitable for undertaking surgical treatment. This will also determine any possible health issues that may result in further complications, for example body weight-related matters or infections.
  • Dental considerations - Dental procedures may introduce bacteria into your bloodstream, leading to a chance of infection. To minimise this risk, it’s advised that you have any dental work carried out well in advance or after any surgical treatment. It’s also possible that you’ll be required to take preventative antibiotics for a few months or years after surgery, to minimise the risk of infection.
  • Additional check-ups and blood tests - You will undergo regular blood work to ensure that your overall bodily health supports your ability to undergo surgery. If the need arises, you may also undergo a heart check or other scans.
  • Preparing your home - To ensure that you are comfortable and as mobile as possible when you return from surgery, it’s wise to prepare your home in anticipation of your limited mobility. It’s a good idea to rearrange your furniture to allow for ease of movement – and arrange for people close to you to help you with any household tasks you may find difficult.
  • Smoking - We strongly encourage you to stop smoking for as long a period of time as you can prior to undergoing surgery. This is because it can encourage the formation of blood clots, and lessen the body’s ability to oxygenate and circulate blood.

Recovery, rehabilitation and precautions

  • Preventing injury or dislocation

After your surgery, try to take things slowly. Use a walking aid and try to avoid stairs. Try not to cross your legs, turn your feet strongly inwards or outwards, or bend your hips more than 90 degrees. You may also be advised to sleep with a pillow between your legs.

  • Preventing infection

Keeping your wound dry and well dressed is very important. Make sure you change your dressing as instructed, and keep an eye out for any changes, including fever, chills, tenderness, excessive fluid, or increased pain.

  • Preventing blood clots

Our team will give you pressure bandages and anti-clotting medication to minimise the likelihood that blood clots will form. Contact a doctor immediately if you experience any unexplained pain or shortness of breath post-surgery.

  • Staying nourished

It’s possible that your appetite may lessen post-surgery. Eating a healthy, well-rounded diet and maintaining high fluid intake will give your body the best possible chance of recovering quickly.

  • Exercise and physiotherapy

You will be appointed a physiotherapist who will help you to understand what kinds of exercises you need to do to regain strength and mobility, and explain what you can and can't do with your new hip. It is important that you ease yourself back into light daily activity as soon as you can.

Further information

If you require more information on what you can expect from a hip replacement surgical treatment from a hip surgeon on the Gold Coast, feel free to visit the American Academy of Orthopaedic Surgeons website and consult their resources.