Suite 8 Ground Floor, Lenmed Ethekwini Hospital and Heart Centre, 11 Riverhorse Road, Riverhorse Valley, Durban
Suite 8 Ground Floor, Lenmed Ethekwini Hospital and Heart Centre, 11 Riverhorse Road, Riverhorse Valley, Durban
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If your hip has been damaged by arthritis, a fracture, or other conditions, common activities such as walking or getting in and out of a chair may be painful and difficult. Your hip may be stiff, and it may be hard to put on your shoes and socks. You may even feel uncomfortable while resting.
If medications, changes in your everyday activities, and the use of walking supports do not adequately help your symptoms, you may consider hip replacement surgery. Hip replacement surgery is a safe and effective procedure that can relieve your pain, increase motion, and help you get back to enjoying normal, everyday activities.
Hip replacement surgery is one of the most successful operations in all of medicine. Since the early 1960s, improvements in joint replacement surgical techniques and technology have greatly increased the effectiveness of total hip replacement.
The most common cause of chronic hip pain and disability is arthritis. Osteoarthritis, rheumatoid arthritis, and traumatic arthritis are the most common forms of this disease.
This is an age-related “wear and tear” type of arthritis. It usually occurs in people 50 years of age and older and often in individuals with a family history of arthritis. The cartilage cushioning the bones of the hip wears away. The bones then rub against each other, causing hip pain and stiffness. Osteoarthritis may also be caused or accelerated by subtle irregularities in how the hip developed in childhood.
This is an autoimmune disease in which the synovial membrane becomes inflamed and thickened. This chronic inflammation can damage the cartilage, leading to pain and stiffness. Rheumatoid arthritis is the most common type of a group of disorders termed “inflammatory arthritis.”
This can follow a serious hip injury or fracture. The cartilage may become damaged and lead to hip pain and stiffness over time.
An injury to the hip, such as a dislocation or fracture, may limit the blood supply to the femoral head. This is called osteonecrosis (also sometimes referred to as “avascular necrosis”). The lack of blood may cause the surface of the bone to collapse, and arthritis will result. Some diseases can also cause osteonecrosis.
Some infants and children have hip problems. Even though the problems are successfully treated during childhood, they may still cause arthritis later on in life. This happens because the hip may not grow normally, and the joint surfaces are affected.
There are several reasons why your doctor may recommend hip replacement surgery.
People who benefit from hip replacement surgery often have:
– Hip pain that limits everyday activities, such as walking or bending
– Hip pain that continues while resting, either day or night
– Stiffness in a hip that limits the ability to move or lift the leg Inadequate pain relief from anti-inflammatory drugs, physical therapy, or walking supports
The surgical procedure usually takes from 1 to 2 hours. Your orthopaedic surgeon will remove the damaged cartilage and bone and then position new metal, plastic, or ceramic implants to restore the alignment and function of your hip. In a total joint replacement both the ball and the socket portions of the hip are removed and replaced by artificial new components. After surgery, you will be moved to the recovery room where you will remain for several hours while your recovery from anesthesia is monitored. After you wake up, you will be taken to your hospital room or discharged to home.
The success of your surgery will depend in large measure on how well you follow your orthopaedic surgeon’s instructions regarding home care during the first few weeks after surgery.
Medications are often prescribed for short-term pain relief after surgery. Many types of medicines are available to help manage pain, including opioids, nonsteroidal anti-inflammatory drugs (NSAIDs), acetaminophen, and local anesthetics. Your doctor may use a combination of these medications to improve pain relief, as well as minimize the need for opioids.
You may have stitches or staples running along your wound or a suture beneath your skin. The stitches or staples will be removed approximately 2 weeks after surgery. Avoid getting the wound wet until it has thoroughly sealed and dried. You may continue to bandage the wound to prevent irritation from clothing or support stockings.
Exercise is a critical component of home care, particularly during the first few weeks after surgery. You should be able to resume most normal light activities of daily living within 3 to 6 weeks following surgery. Some discomfort with activity and at night is common for several weeks. Your activity program will include physiotherapy which will help restore strength and mobility to your hip.
The complication rate following hip replacement surgery is low. Serious complications, such as joint infection, occur in less than 2% of patients. Major medical complications, such as heart attack or stroke, occur even less frequently. However, chronic illnesses may increase the potential for complications. Although uncommon, when these complications occur they can prolong or limit full recovery.
How Your New Hip Is Different
You may feel some numbness in the skin around your incision. You also may feel some stiffness, particularly with excessive bending. These differences often diminish with time, and most patients find these are minor compared with the pain and limited function they experienced prior to surgery. Your new hip may activate metal detectors required for security in airports and some buildings. Tell the security agent about your hip replacement if the alarm is activated.
There are many things you can do to protect your hip replacement and extend the life of your hip implant. Participate in a regular light exercise program to maintain proper strength and mobility of your new hip. Take special precautions to avoid falls and injuries. If you break a bone in your leg, you may require more surgery. Make sure your dentist knows that you have a hip replacement. Talk with your orthopaedic surgeon about whether you need to take antibiotics prior to dental procedures. See your orthopaedic surgeon periodically for routine follow-up examinations and x-rays, even if your hip replacement seems to be doing fine.
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