If you have a partial hip replacement, the natural socket of your hip is left intact and only the ‘ball’ part of your joint is replaced. With a total hip replacement, both the ball and socket part of the hip joint are removed and replaced with components made from metal, plastic or ceramic. These components are called a prosthesis or artificial implant.
The anatomy of your hip
Your hip joint is a ball and socket joint. The ‘ball’ at the top of the thigh bone is called the femoral head. It fits inside the socket in your pelvis, which is called the acetabulum. The bones are held in place by ligaments which keep the ball firmly inside the socket. Muscles, such as the gluteal muscles in the buttocks, wrap around the joint, with tendons connecting the muscles to your bones.
Cartilage lines the inside of the ball and socket, helping the bones glide smoothly over each other. Your hip is designed to allow your legs to move and rotate, while supporting your body weight.
However, if your joint becomes damaged due to a condition like osteoarthritis or a serious injury, you may develop chronic hip pain or stiffness. This can make it hard to walk, sit, stand, climb stairs or go about your normal day-to-day activities. In this case, you might need a hip replacement.
Who can have a partial hip replacement?
A partial hip replacement – also called a hemiarthroplasty – leaves the natural hip socket untouched and just replaces the damaged or diseased femoral head.
This procedure is normally given to older patients who may be frail or in poor health. This is because it restores mobility without the stress of a longer, more complex surgical procedure. You will normally be offered a partial hip replacement if:
- Your hip socket is healthy and intact
- You have a fractured neck of femur/ femoral head (the ‘ball’ part of the thigh bone is broken). This may be due to a fall or traumatic injury.
- You are older, frail or less active
- You have avascular necrosis which is where the blood supply to the ‘ball’ at the top of the thigh bone is cut off, causing the bone to die in that area
What are the pros and cons of a partial hip replacement?
A partial hip replacement is typically a less complex surgical procedure with a faster recovery time and a lower risk of complications such as hip dislocation, when compared to a total hip replacement. This is why it may be favoured for older or frail patients. It is possible to walk almost immediately following a partial hip replacement, which lowers the risk of ‘decompensating’ which can occur very quickly in an older person who becomes bedridden.
However, over time the artificial ‘ball’ can wear away the natural cartilage in the hip socket so a partial hip replacement is not suitable for everyone. Your orthopaedic consultant will discuss the most suitable option for you.
Who can have a total hip replacement?
You may benefit from a total hip replacement if you are experiencing moderate to severe hip pain and stiffness which is interfering with your life. It may be preventing you from doing everyday activities and may even be affecting your sleep. The pain could be due to a degenerative condition like osteoarthritis, a hip fracture or other conditions such as rheumatoid arthritis which is an autoimmune disease. It is likely that you’ll already have tried less invasive treatments like painkilling injections, medication and physiotherapy. Normally, by the time you are offered surgery, such treatments will no longer be providing sufficient relief from your symptoms. Most people who have a hip replacement are suffering from osteoarthritis.
To assess whether you are suitable for a total hip replacement, your orthopaedic consultant will talk to you about your symptoms and how they are affecting your life, as well as assessing your overall health and factors like your weight (as obesity increases the risk of infection and can cause an artificial hip joint to wear out more quickly). Being overweight won’t prevent you from having surgery but your surgeon may recommend losing weight first.
What to expect from hip replacement surgery
Whether you are having a partial or a total hip replacement, it will be performed in hospital under either a general anaesthetic (which means you’ll be asleep throughout) or a local (spinal) anaesthetic (which means you’ll be numb from the waist down). With the latter you may also be given a sedative to help you relax and most often actually sleep through the procedure. Hip replacement surgery takes between one and two hours. Whilst carefully protecting the soft tissues (muscles and tendons) it entails making an incision into the back of the hip and removing the damaged sections of the joint. These are replaced with an artificial implant, which is carefully positioned. Once in place, the incisions are closed and you will be taken to the recovery room.
What is a Mako robotic arm assisted hip replacement?
A Mako robotic arm assisted hip replacement uses computer technology to create a detailed 3D image of your unique hip anatomy. The surgeon uses this to create an accurate pre-operative plan. During the surgery itself, a robotic arm is used to support the surgeon to achieve pinpoint precision. Mako is not used for a partial hip replacement, however, only for total hip replacements.
Frequently Asked Questions
Are there any complications from a hip replacement?
While hip replacements are performed routinely and are generally safe and highly successful, like all surgery they carry potential risks. These include blood clots, infections at the incision site, joint dislocation and nerve damage. Your orthopaedic surgeon will discuss any potential risks with you prior to surgery.
How soon will I be able to walk after a hip replacement?
Your surgical team will encourage you to begin standing and walking on the same day as your surgery and you will normally be able to go home in 24-48 hours.
Will I need physio after a hip replacement?
Yes we recommend a programme of physiotherapy to help you rehabilitate fully after a hip replacement and regain your strength, movement and function.
For more details about partial and hip replacements, and for information about Mako robotic arm assisted hip replacements, please contact us.
