Hip replacement

Why might I need a hip replacement?

Over time, the surfaces on the hip joint can start to wear. This can be caused by osteoarthritis or a previous injury to the hip.

Osteoarthritis is painful as joints become stiff and inflamed when the smooth lining between the joints gets damaged or wears away. Without the protection of this lining, the rough surfaces of your bones rub together as you move, causing the pain that is all too common to sufferers.

Simple, everyday things like going for a walk or even getting dressed become difficult. There’s no cure for osteoarthritis and it can get worse with time. However, joints can be replaced successfully, improving mobility and reducing pain. 

What happens during hip replacement?

• A variety of anaesthetic techniques can be used. Prior to your operation the anaesthetist will discuss these options with you
• Your surgeon’s choice of prosthesis will be based on several factors such as your age, your level of activity and your current condition
• Both cemented and uncemented replacements are used at Nuffield Health Hospitals
• If you have concerns be sure and ask your surgeon about his prosthesis choice and the reasons behind it
• Your surgical wound will be closed with stitches, staples or steri-strips.

After your hip replacement surgery

• Once your hip operation is over, you’ll be taken to the recovery room where you will wake from the anaesthetic
• Your wound, blood pressure and pulse will be checked carefully
• You will have a large dressing covering your wound
• Be sure to let our nurses know if you are in any pain
• You may have a small tube coming out of your wound, this is to drain away any excess fluid from the inside of the wound
• You may also have a drip (infusion) going into your arm. This will keep you hydrated until you are able to drink, and it can also be used to give you pain relief
• When you are stable and comfortable, a nurse will take you back to your room.

Back in your room

• Once back in your room, our nursing team will continue to check on you to make sure you are recovering well
• Try not to touch or disturb your dressings as this can introduce infection
• If you notice any bleeding or have any pain, don’t hesitate to speak to one of our nurses
• After you’ve recovered from the effects of the anaesthetic, you can have something to eat and drink
• While you are in bed, you may have help with the circulation in your legs, in order to prevent blood clots (DVT)
• The first day or so you could wear boots on your legs that are inflated with air
• You will also wear support stockings to help your circulation and may have daily injections or tablets to help prevent blood clotting that may continue for up to 6 weeks
• We may encourage you to move your legs if you are able
• You may have some deep breathing exercises to do, to help prevent any chest problems after surgery
• The day after surgery you will have an X-ray of your new hip to check its position
• Don’t forget to wash your hands with soap after going to the toilet at any time.

Getting up for the first time

• We understand that you may be anxious or worried about getting up, but we will do all we can to help and reassure you
• Don’t worry, a member of our team will be there to help you, whenever you are ready
• The reason for getting you moving is to improve your circulation and avoid stiffness
• You may be feeling tender and sore, but you can get pain relief medication to deal with any discomfort
• Once out of bed, you will continue to wear support stockings to help your circulation
• Physiotherapists will work with you during your stay to help give you the best start with your new joint.

Going home after a hip replacement

• A physiotherapist will give you some exercises to help get your new hip moving and these are important to help you make a good recovery
• You may have to use crutches or a walker
• When you are able to walk up and down stairs, you can go home
• You won’t be able to drive, so you will need someone to come and take you home from the hospital
• It’s usual to return to see your Nuffield Health consultant as an outpatient after your operation
• You may also need to have stitches removed
• You’ll be given information about these appointments before you are discharged
• We’ll also give you some pain relief medication to take with you
• When you get home, will be tired and should rest. However, it’s also important to gradually increase your physical activity each day, so you should continue with the exercises the physiotherapist showed you
• These will help to reduce stiffness and strengthen your legs
• To help you regain mobility, it’s recommended that you take any pain relief medication we have prescribed
• Continue taking this until you are pain free.

So you don’t damage your new hip and to help your wound heal, you may be asked to follow a few restrictions for the first six weeks of your recovery:

• Avoid bending your new hip beyond 90 degrees
• Avoid rolling your leg towards the other leg
• Avoid crossing your legs
• Avoid twisting on your new hip when standing
• Use the shower instead of the bath
• Keep wearing your support stockings - you may have to do so for four to six weeks.

Most people make a good recovery and return to normal activities following hip revision. As with any surgery there can be complications:

• Pain
• Bleeding
• Infection of the surgical site (incision)
• Scarring
• Blood clots (DVT - deep vein thrombosis)
• Difficulty passing urine
• Chest infection
• Heart attack
• Stroke.

Specific complications of hip replacement might include:

• Split in the femur
• Nerve damage around the hip
• Damage to the blood vessels around the hip
• Infection in the hip
• Loosening of the replacement
• Bone forming in muscles around the replacement
• Dislocation
• Leg length difference.