Hip Replacement

Hip replacement means surgical replacement of all or part of the hip joint.

The hip joint is made up of two components. The thigh bone (femur) which consists of a shaft with a bony ball at the top. This ball fits into the socket in the pelvic bone, which is part of the bone that makes up the pelvic frame at the bottom of your torso. The joints called a “ball and socket” joint.

Total hip replacement consists of replacing both surfaces by what is known as implants. The thigh bone implant is made up of a stainless steel stem. This consists of a metal ball on the end of a long stem which is secured into the centre of the shaft of the thigh bone after the top end of this bone has been removed . The socket is replaced by a plastic mould which is cemented in and receives the steel ball of the thigh bone.

Partial hip replacement is when the steel ball is inserted into a normal bony socket which has not been damaged.

The main reasons for the replacement of the hip joint are for relief of incapacitating pain which has not responded to medical treatment, and to improve joint function and mobility. the commonest conditions where these indications occur are osteoarthritis and rheumatoid arthritis. Less common conditions include gout, and Pagets Disease.

The operation is generally reserved for people over the age of 65, and is rarely performed in patients under the age of 50. The problem with younger patients is that they are more likely to return to a more active lifestyle and there is a much more likelihood of the implants loosening. This usually becomes a problem 5 to 15 years after the operation.

A young rheumatoid patient who just wants relief of pain an average hip movement would be considered suitable for operations whereas a young 45 year old labourer who wants to return to active work would not be suitable as the end result in later life could be worse with the worry of repeated operations.

Replacing the hip joint a second time is surgically difficult and the results are generally not as good. Approximately 90% of patients over the age of 65 have successful results lasting 5 to 15 years with an average of at least 10 years.

After operation, activities which can cause problems include heavy manual labour, jogging and competitive sports.

Overweight should be controlled both before and after the operation.

The operation is not performed if infection is present, either in the joint or elsewhere in the body.

The factors which diminish the chances of success include :-

paralysis or permanently weakened muscles supporting the joint caused by a stroke or polio,

extreme joint destruction through previous infectious diseases.

Joint infection as well as overactivity can cause loosening of the artificial joint.

After the operation is performed and for the rest of the person’s life, any infection is whether mild or not should be treated immediately with antibiotics. Infection via the blood stream is always a danger to the hip. If any surgery, dental for example, is contemplated, then antibiotics should be given to cover the risk of blood borne germs getting into the hip joint. Check with your doctor before undergoing any dental procedure, even the simple filling of teeth.

Infections involving the upper respiratory tract, the lungs, the kidneys, the bladder and skin infections, should be treated vigorously with antibiotics.

After the operation physical rehabilitation is necessary to ensure the strengthening of the muscle supporting the joint. Your will be given a series of simple exercises to do should be kept up for life.

A vigorous exercise may loosen the joint common sense is needed to control the enthusiasm associated with your new found mobility and freedom from pain.

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