Everything you need to know before your Total Hip Replacement: Helping you to make an informed decision.

Miss Charlotte Barker
MSK Associate
Published at: 13/11/2023

Everything you need to know before your Total Hip Replacement: Helping you to make an informed decision.

Why is a total hip replacement required?

The hip is a ball and socket joint. The surfaces of these components are covered with articular cartilage, which is a smooth material that prevents friction, allowing the bones to move easily.

When the hip joint has become worn or damaged, the mobility becomes reduced and symptoms arise such as: severe pain, swelling and stiffness. An artifical implant can be used as a replacement, to restore pain-free function of the hip. A range of tests can be conducted to accurately diagnose osteoarthritis of the hip and other conditions that require joint replacement, both in the lab and through forms of imaging (e.g. X-Rays and MRIs). These tests can be useful in assessing the condition of the bone and soft tissue of the hip. If your hip is worn, it can be replaced with an artificial implant to allow you to carry out your daily activities comfortably.

Preparing yourself for a total hip replacement.

Eating well before and after your total hip replacement will promote the recovery process. Incorporating regular sources of protein into your diet prevents muscle loss from occurring. You will also be encouraged to increase your collagen intake prior to surgery, as this will promote wound healing. It is vital that complications are prevented before and after a total hip replacement. This is why it is imperative that you avoid picking up an infection in the weeks leading up to your total hip replacement. Infections, both minor and severe, can increase the risks of surgery, therefore, the procedure would be postponed if an infection occurs, until it has been treated. Finally, it is recommended that you have a rehabilitation programme prepared for after your total hip replacement, to allow you to begin your physiotherapy as soon as possible.

Picking the right surgeon for you.

It is advised to do your research on the total hip replacement surgery, before going ahead. Different surgeons utilise varying approaches to the procedure, ultimately determining the circumstances of the total hip replacement, in both pre-operative and post-operative cases. Identifying the material of the implant that will be used may influence your choice, whether that be metal, ceramic or plastic. Furthermore, understanding which surgical approach will be applied and the impact that it has on the recovery process and wound management its crucial.

Frequently asked questions.

Can anyone undergo the total hip replacement procedure?

It is important to note that not everyone is a candidate for a total hip replacement. Factors such as: age, weight, activity level, and overall health, strongly influence whether a patient is fit to undergo the procedure. Thorough medical examination from your doctor/consultant, including clinical evaluation and detailed imaging, will determine this.

How does a hip replacement last?

The total hip replacement surgery is an extremely common procedure. An artificial hip joint is designed to last for a minimum of 15 years. According to the National Joint Registry only 7 in 100 hip replacements need further surgery after 13 years – most hip replacements last much longer.

Are there any alternative treatment options?

It is understandable that a total hip replacement surgery is not everyone’s first choice, and there are a variety of conservative options that can be implemented. Deciding which method will work best for you will depend on the severity of joint damage, specifics of your medical condition and your personal circumstances. Speaking with your doctor/consultant will allow you to see whether injections (Lipogems, PRP, Arthrosamid, BMAC, Stem cells) or physiotherapy can alleviate your symptoms and prolong the need for surgical intervention.

What risks are involved with the procedure?

Like any surgery, there are potential complications associated with undergoing a total hip replacement. Whilst this is unlikely, some risks that may occur are infection (this may be at the site of the wound, or within the deeper tissues around the hip joint). There is the possibility of dislocation, particularly in the first few weeks. Modern surgical techniques reduce this risk significantly, but following post-surgical advice is important. Periprosthetic fractures are broken bones around the implanted joint. Whilst rare, these can occur in the first weeks after the procedure, as well as years after a successful total hip replacement. It is important to be able to identify that: pain or swelling around the hip or thigh, pain when bearing weight on the affected side, or noticing a deformity of the injured leg, are symptoms of a potential periprosthetic fracture and seeking immediate treatment would be advised. Occasionally, patients may experience an altered leg length, where the leg on the operated side may be longer or shorter after the total hip replacement surgery. If patients do struggle to adapt, a raised shoe can be provided.

What can you do to prepare yourself for surgery?

If you are overweight, aiming to lose weight before your procedure will reduce the stress placed on the hip joint. Ensure this is done gradually, as losing weight rapidly will lead to a sudden reduction in muscle mass as opposed to fat reduction.

If you smoke, attempting to give this up in the months leading up to your surgery will improve your post-operative outcome. Smoking can hinder your healing and increase the risk of complications.

Organising your home for your return is strongly recommended. For example it is beneficial to have prepared meals, accessible facilities for daily use or family/friends ready to support you.

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