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Total Hip Replacement

Structure of the Hip Joint

The hip is a ball and socket synovial joint, which forms a connection from pelvic bones to the lower limb, allowing for stability and weight bearing. They are multiple aetiologies which lead to a hip  joint being severely damaged. Even constant and repetitive strains can lead to severe injuries involving the knee ligaments and tendons.  A damaged and arthritic hip limits movement and mobility of an individual, affecting the psychosocial lifestyle of the affected patient.

What is a Total Hip Replacement?

Total hip replacement is a procedure in which the damaged  bone is removed from the hip joint and replaced with metal alloy/ ceramic components. This artificial components allows the hip to restore its normal articulation with the pelvic bone without the pain.

Hip replacement has become necessary for your arthritic hip: this is one of the most effective operations known and should give you many years of freedom from pain.

Once you have arthritis which has not responded to conservative treatment, you may well be a candidate for total hip replacement surgery.

What are the causes of a painful and arthritic hip?

  • Fracture from trauma or accident
  • Increased stress e.g., overuse, overweight, etc.
  • Avascular necrosis (loss of blood supply)
  • Infection
  • Overweight- additional weight puts extra force through your joints which can lead to arthritis over a period of time
  • Autoimmune conditions resulting in inflammation e.g., Rheumatoid arthritis

How is a Total Hip Replacement Performed?

  • An incision is made over the hip to expose the hip joint
  • The hip bone is removed and the acetabulum ( socket) is prepared
  • The acetabular component is then inserted into the socket. This is sometimes reinforced with screws
  •  A liner which can be made of plastic, metal or ceramic material is then inserted inside the acetabular component.
  • The femoral component is then inserted into the femur
  • The real femoral head component is then placed on the femoral stem. This can be made of metal or ceramic.
  • The hip is then enlocated again, for the last time.
  • The muscles and soft tissues are then stitched closed carefully.


What are the risks and complications of a Total Hip Replacement?

Complications can be medical (general) or specific to the hip

  • Medical Complications include those of the anaesthetic and your general well being. Almost any medical condition can occur, so this list is not complete.

List of possible complications include:-

  1. General (including anaeshetic related risk) :-
  • Allergic reactions to medications
  • Blood loss requiring transfusion with its low risk of disease transmission
  • Heart attacks, strokes, kidney failure, pneumonia, bladder infections
  • Complications from nerve blocks such as infection or nerve damage
  • Serious medical problems can lead to ongoing health concerns, prolonged hospitalization or rarely death

2. Procedure related risk :-

  •  Infection
  • Dislocation
  • This means the hip comes out of its socket. If  a dislocation occurs it needs to be put back into place under anaesthesia.
  • Blood clots (Deep Venous Thrombosis)
  • Damage to nerves or blood vessels
  • Leg length inequality
  • It is very difficult to make the leg exactly the same length as the other one. Occasionally the leg is deliberately lengthened to make the hip stable during surgery. There are some occasions when it is simply not possible to match the leg lengths. All leg length inequalities can be treated by a simple shoe raise on the shorter side
  • Wear
  • All joints eventually wear out. The more active you are, the quicker this will occur. In general, 80-90% of hip replacements survive 15-20 years.
  • Fractures (break) of the femur (thigh bone) or pelvis (hipbone)
  • This is rare but may occur during or after surgery.