For comfort and happy everyday life, the hip joint needs to be well functioning. This often means that the treatment for trauma, chronic inflammation, degenerative conditions and moderate to severe osteoarthritis can require major surgery.
Hip surgery is used to treat:
- Hip fractures
- Moderate to severe hip osteoarthritis
- Worn out, or infected, hip replacements
Some conditions, like mild osteoarthritis, can be managed with lifestyle modification and advice, or minimally invasive treatments such as PRP therapy and painkilling injections, which may delay the need for more complex surgery.
If you do need surgery though, there is the option for a partial or total hip replacement, depending on your individual circumstances.
Hip surgery helps people who are experiencing moderate to severe hip pain and usually results in a positive impact on the quality of your life.
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Benefits
Before going down the route of surgery, it is likely that your doctor will want to explore less invasive techniques. These might include:
- Orthotics – these can help prevent strain and further injury, and promote recovery
- Injections – Platelet rich plasma (PRP) injections (from the patient’s own blood) have been shown to improve mild to moderate hip osteoarthritis symptoms for up to 2 years. Alternatively, an anti-inflammatory steroid mixed with long-lasting local anaesthetic can help to reduce chronic pain or swelling. In addition, at the same time, often an injection of hyaluronic acid can mimic the lubricating action of synovial fluid, which is depleted in hip osteoarthritis.
- Physiotherapy – this has proved effective for the treatment of hip pain caused by inflammation, strains or bruising
The benefit of undergoing hip surgery is the prospect of a life free from chronic pain. After the initial recovery period, you should be able to resume many of the activities you love and live a full and active life.
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
FAQ’s
Are there any ways of minimising the risks of hip surgery?
You will be given antibiotics to minimise the risk of infection and blood thinners to minimise the risk of blood clots after surgery. Your doctor will discuss other ways of minimising the risk of complications.
Am I too old for hip surgery?
Age is not normally a barrier to having hip surgery, providing you are in a reasonable state of health and readiness for surgery. Talk to your doctor who will carry out an assessment.
How will I manage if I live alone?
Significant numbers of older people who have surgery live alone. Sometimes a friend of relative might be able to come and stay with you for a while until you are back on your feet. Or it might be possible to arrange for home help, or a stay in a rehabilitation unit.
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.
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If you are experiencing pain in your pelvis, hip, knee or ankle, or are suffering from a sports injury, seek specialist help to get you back to living your life. Contact can be made direct, or through your GP.
Email:
enquiries@carrothersorthopaedics.co.uk
Phone:
+ 44 (0) 1223 667 376.
