Hip Surgery

Benefits

Types of hip surgery

Surgery for Hip fractures:

Normal treatment for a hip fracture is surgery however, your doctor may delay operating if you are unwell with another condition that requires treatment before your operation can take place. In roughly 50% of hip fractures, you will need a partial or complete hip replacement. For the remainder, the hip can normally be repaired with plates and screws or rods.

The type of surgery will depend on factors such as: the type of fracture, your age, your level of mobility before the fracture and the condition of the bone and joint. It is important to visit a doctor as soon as possible if you suspect a hip fracture. Evidence shows that prompt surgery and a rehabilitation programme that starts as soon as possible after surgery can help people recover their mobility faster.

Hip replacement:

Full hip replacement involves replacing the femoral “ball” at the top of the thighbone with a metal implant topped with a ball that is often coated with a metal alloy or ceramic material. In the pelvis, the socket is usually hollowed-out and a replacement socket made of high-density polythene (medical grade plastic), ceramic or metal alloy is inserted. Some prosthetic hips are fixed in position using acrylic cement; other prosthetics has a textured surface over which the bone grows and adheres to.

Revision hip replacement:

In most cases, artificial hips last around 15-20 years. However, they do eventually start to wear out and may need to be replaced using a procedure called a revision hip replacement.
Hip revisions are usually straightforward, although they do involve more complex techniques. After the procedure most patients regain pain-free mobility.

Complex revision surgery for hip replacement infections:

While most hip replacements can give years of improved mobility to patients, in a small minority of cases infections occur, often after several years of use. The treatment of these cases is more complex than standard revision surgery, because it is important to identify and control the infection at source. After this procedure most patients regain improved or pain-free mobility.

Depending on their type and source, infections can be treated using some or all of the following:

• debridement, where the infected area is cleaned out under surgery
• modular exchange, where one or more component of the artificial hip is replaced
• implant retention, where the femoral implant and/or acetabular module is retained and bearing surfaces are exchanged
• antibiotic treatment, to help prevent a recurrence of the infection

Risks Factors

All surgery comes with risk. In the case of surgery for hip fracture, the risks include:

• pressure ulcers (bedsores) as a result of an extended time in a bed or chair
• infection
• blood clots or deep vein thrombosis. Special stockings and blood thinning injections can help to reduce the risk of DVT
• bleeding
• bone fracture and need for fixation
• hip dislocation

Personal outcomes – what to expect

Each year, hip treatments enable thousands of patients to enjoy an active life, free of chronic hip pain.

Our patient-care process

• Once all of your diagnostic procedures are completed, we will be able to explain whether surgery is recommended.
• We will go through the procedures with you, covering the operation itself, the recovery process and the future prospects.
• Your orthopaedic surgeon will also explain the risks: these are small, but it is important for you to understand them.
• You can feel reassured that you will receive expert care from the start of the process, including your after-care.

Other useful information

Explanation of the hip joint on the Arthritis UK website

Read about hip replacement surgery on the NHS website and on the BoneSmart website.

Statistics about hip replacement surgery can be found in this Public and Patient Guide on hip replacements, published by the National Joint Registry. This gives detailed explanations about hip operations and their various outcomes, and is revised each year.