Hip arthritis is a very painful and disabling condition. Typically, the smooth lining of the hip joint (cartilage) is lost, resulting in the painful rubbing of bone on bone.
Non-Surgical Treatments
The non-surgical treatments for hip osteoarthritis are limited. Weight loss is very important. Physiotherapy can also help to strengthen your hip joint muscles and maintain your range of motion. Appropriate use of painkillers is vital; starting with Paracetamol as required, increasing to more regular usage, and ultimately with the addition of an anti-inflammatory under the guidance of your family doctor. Hip replacement is only recommended when the level of pain is affecting your quality of life.
Surgical Treatments
Total Hip Replacement
A total hip replacement is when the socket of the hip joint (the acetabulum) and the top of the femur (the femoral head) are replaced with a new socket and head (a ball in socket joint). By replacing the bone rubbing on bone, the pain should be alleviated. Thankfully, 95% of patients are satisfied with their hip replacement operation. However, there is a 5% (or 1 in 20) risk of a complication with hip replacement surgery.
Complications of Total Hip Replacement Surgery:
Infection is a potentially very serious complication and can occur in 1% of patients. We will take all possible steps to limit your infection risk. It is important that you tell us of any infections you may be carrying, such as a urinary tract infection, tooth abscess or painful in-growing toe nails. All infections need to be treated prior to surgery.
Dislocation occurs in 1 – 2% of patients. This is when the ball pops out of the socket. We spend a lot of time showing you the correct way to move, dress, etc. Crutches are very important for the initial six weeks, to help you balance and avoid putting all your weight through the new hip.
Venous Thrombosis (leg clots) which can travel to your lungs (pulmonary embolus) occur in less than 1% of patients. We give you compression stockings to wear for four weeks and prescribe Aspirin 150mg daily to take for 4 weeks, and encourage early active movement to reduce the risk of a clot.
Leg Length Discrepancy (one leg longer than the other) can occur after hip replacement. Typically the arthritic hip shortens the affected leg, and on occasion, it can be difficult to restore it to equal length. Heel lifts on shoes are sometimes necessary to equalise your leg lengths after surgery.
Wear and tear of your new mechanical hip joint eventually happens over time, at a rate of 1% per annum. So 20 years after your hip has been replaced, there is a 20% risk the hip implant will have been revised because of wear of the bearing surfaces.
Revision Hip Replacement
Revision hip replacement is when part or all of your prosthetic hip needs to be revised or replaced. Failure typically arises from normal wear and tear of the implant over time. Other reasons for revision surgery are if the hip replacement was unstable (causing recurrent dislocations), loose in the bone (causing residual ongoing pain) or if the implant became infected and needed to be removed.
