The worn part of your hip joint is replaced with an artificial joint made of surgical quality stainless steel, a metal alloy or a ceramic. A plastic (polyethylene) liner is usually used. Some can be used with orthopaedic cement; others have a special coating that binds with the bone instead. Your surgeon will help you choose the most appropriate type of hip replacement for you.
Hip Replacement information:
A hip replacement is a major operation and usually takes approximately one hour.
The upper part of the thigh bone is removed
The natural hollow in the pelvis, called the acetabulum, is hollowed out further and a plastic cup is fitted into the hollow
A short, angled stem, with a smooth ball on its upper end to fit into the socket is secured into the canal of the thigh bone.
The plastic cup and the metal stem may be either press-fit or may be fixed with acrylic cement.
The layers of soft tissue, muscle and skin are stitched and clipped back together.
You are us usually in hospital for one to two nights. Before your surgery you will meet your anaesthetist, they will ask you questions about your health and previous anaesthetics, You will need to sign a consent form where the consultant will go through the operation with you and the risks of surgery. You will be measured for compression stockings before theatre and will need to wear these all the time unless you are instructed otherwise. These compression stockings help reduce the risk of blood clots.
Types of anaesthesia during surgery
There are two types of anaesthesia, general anaesthesia and local anaesthesia. They are often combined.
For hip replacements it is uncommon for general anaesthesia to be used alone. It is usually combined with a spinal anaesthetic or a nerve block. Side effects and risks of anaesthetic will be discussed with you by the anaesthetist.
Local anaesthesia are drugs having a numbing effect, they stop you feeling pain and other sensations in part of your body, but on their own do not cause any loss of consciousness. Types include the following:
- Spinal anaesthetic
A spinal anaesthetic will make you go numb from the waist down; you will feel no pain but will remain conscious. It is a local anaesthetic that is injected near the nerves in your back.
An epidural is similar to a spinal anaesthetic, a very fine plastic tube is inserted, and local anaesthetic can be given through this tube. It can also be used to continue pain relief for several days after your surgery.
Pain Control after a Hip Replacement
We aim for your pain to be at an acceptable level to allow you to move around after your surgery. The nursing team will be able to give you advice and support about pain relief there are many different forms and strengths of pain relief available. The anaesthetist will also discuss option for pain relief with you.
For a hip replacement you will be seen by an occupational therapist to discuss information with you about the sizes of your bed, chairs and toilets you have at home.
After a hip replacement there are certain movements of the hip that you will need to avoid for six weeks. We call these ‘precautions’ they aim to prevent your new hip from dislocating whilst the muscles around it heal.
There are three main precautions:
- Do not bend the hip more than 90 degrees.
- Do not cross you operated leg across the middle of your body.
- Do not twist your operated leg.
Following a hip replacement on the ward
Regular observations and pain relief
You will be encouraged to eat and drink
A physiotherapist will see you and start your exercise regime.
You will be assessed and may be helped out of bed to sit in a chair.
Wound dressing will be checked
Laxatives will be given as the pain medication may make you constipated.
blood test and an x-ray will be taken
If you have them drains or catheters will be removed.
Physiotherapy will continue throughout your stay, and you will be encouraged to walk with help.
You will be shown how to use your dressing aids and how to get on and off the bed.
Clexane injections (Blood thinner) will be given to help prevent blood clots. You will also be shown how to administer these injections before being discharged, as you will need to continue them upon discharge.
You will need to do the stairs with the physiotherapist and they will need to be happy with your mobility before discharged.
On discharge you will be sent home with the medication you need, and all the relevant information.