For patients suffering from arthritis a Hip Joint Replacement is highly effective at eliminating pain and restoring mobility. Below are answers to common questions about this procedure.

 

Before Surgery

Where will my surgery be performed?

St Georges Hospital.  You will receive a preadmission pack prior to your scheduled date that contains information and directions on when and where to go.

Do I need to stop any medications prior to surgery?

Please advise if you are taking medications that affect your bleeding tendency (eg. warfarin, clopidogrel, dabigatran and others (check with your family doctor). These will need to be discontinued at least 5 day prior to surgery unless otherwise advised. Please contact (03)3660422 for further direction. Other medications should be taken as normal.

Do I need to borrow a set of crutches?

We will provide you with a pair of crutches that will assist you during your postoperative recovery. Arrangements will be made with you to pick these up from the consulting rooms prior to your admission date.

 

The Day of Surgery

How long prior to surgery do I need to avoid food or drink?

You will need to stop eating and drinking (other than water) 6 hours prior to your surgery. You should stop drinking water and chewing gum 2 hours prior to your surgery.

What type of Anaesthetic is given?

You will be offered a general anaesthetic (GA) or a ‘spinal’. The choice will be made following discussions between you and the anaesthetist prior to your surgery.

A ‘spinal’ involves placing an injection into your lower spine. This numbs your legs only. Other sedative medications are given that are highly effective at ensuring you ‘sleep’ during the procedure and have no memory of the operation.

How long will the operation take?

The surgery takes 60-90 minutes. You will be monitored in recovery for ~1hr until you are awake and comfortable, after which you will return to the ward.

Where will my surgical scar/s be?

An incision, typically around 6 inches long, is made over your buttock.

What are the expected benefits of surgery?

Hip replacement surgery has a well deserved reputation for making a significant difference to those suffering from the pain and reduced mobility associated with an arthritic hip. Success rates in excess of 90% are expected

What are the risks of surgery?

While surgery has an excellent chance of successfully relieving your symptoms some risks do exists.

These include:

  • Wound infection

Signs of an infection include redness and/or discharge from the wound.  Antibiotics are required. If severe an operation to surgically clean the area may be necessary. In rare circumstances (1%) the implants made need to removed and replaced.

  • Blood Clots

Using ‘foot pumps’, aspirin and encouraging mobilization as quickly as possible after surgery reduces the risk of blood clots after joint replacement surgery (< 3%). Blood clots that form in the leg can dislodge and travel to your lungs – this can be life threatening. Please advise us if you have a blood clot previously, as we will take extra precautions. If you suddenly get short of breath post surgery please advise us as soon as possible.

  • Differences in leg length

During surgery we endeavour to keep your leg lengths equal. Often this involves correcting a difference noted pre-operatively. Rarely (1%), due to technical factors, patients may be left with a difference in leg lengths that requires a foot orthotic to balance.

  • Dislocation

Artificial joint replacements can dislocate if you flex and internally twist your hip.  There are many ways to avoid this including avoiding low chairs. Most people quickly adapt to these restrictions. If your hip does dislocate (1% chance) it will need to be reduced in hospital. If your hip dislocates repetitively (>3) changing or re-orientating your implants will need to be considered.

  • Foot Drop

Hip replacement surgery is typically performed next to the sciatic nerve. Occasionally it loses function post surgery leaving patients with a ‘foot drop’. In most cases this recovers but 1 in a 1000 patients may be left with a permanent weak and numb foot.

  • Implant longevity

The implants we use are expected to last for 20+ years. Occasionally they wear out faster than anticipated and we are required to replace parts of the bearing surface or the implants themselves.

  • What type of implant will be used?

Many options exist. Some are impacted directly into the bone while others are held in position with bone cement. A number of different bearing combinations are also available ranging from hard plastic, to metal and ceramic.  The shape and strength of your bone will be taken into account when choosing the best combination.  I can explain the rationale behind each choice with you.

 

After Surgery

How long will I stay in hospital?

It is expected you will be in hospital for 3 to 5 days.

Will I need crutches afterwards?

Yes. While it is safe to put weight through your leg all people will require either crutches or a walking frame after surgery. Most people are able to wean themselves from these supports in the first few weeks after surgery.

How long do I leave the wound dressing/s on?

Each wound will be covered with two dressings. Directly on your wound will be a thin piece of perforated tape (‘mefix’). This should be left on until the 2-week visit or until it falls off spontaneously. The outer dressing (that has a clear edge and an absorbent center, called ‘opsite’) should cover the wound for at least the first 3 days.

When will I be assessed following surgery?

The first post-operative appointment will be 2 weeks after your surgery. The aims of this visit are to check on your progress and assess the wound. A second visit is planned 6 to 8 weeks following surgery.

When can I return to driving?

You may return to driving once you can safely and comfortably stand on your operated leg (typically 4-6 weeks).

When can I expect to return to work?

Most people with office jobs can return to work between 4-6 weeks post surgery. Often this will be part-time initially. For more manual jobs time off work is likely to involve an 8-12 week period.

What sports can I participate in following a hip replacement?

Many sports including cycling, golf, tennis, skiing are possible with a hip replacement and patients are encouraged to return to their favourite sports. However repetitive high impact activities such as long distance running are preferably avoided.