Are you considering hip replacement surgery?

Your hip joints are one of three sets of weight-bearing joints that carry you around all day. So if you’re experiencing hip pain or discomfort, unsurprisingly, it can have a big impact on your quality of life.

Hip pain can have several different causes. When the cause is a chronic (long-term) condition like arthritis, many patients eventually consider a hip joint replacement. About 70,000 people have this operation every year in the UK and the vast majority enjoy a successful outcome.

How arthritis causes hip pain

Arthritis is a common cause of hip pain, most often osteoarthritis or rheumatoid arthritis.

Osteoarthritis predominantly affects people over the age of 40. It happens when cartilage in your joints — smooth padding that protects the ends of your bones — wears away.  Over time, the reduced amount of cartilage causes your bones to rub against each other, causing pain, loss of movement and stiffness. It can also result in bone spurs growing on affected bones.

Overuse is a factor in developing osteoarthritis, so if you’re very active or have a physical job you have a higher chance of developing it. Family history and obesity are also risk factors, and women get it more than men.

Osteoarthritis typically starts gradually and gets worse over time. Symptoms can include:

• A cracking sound when bending your joints (known as crepitus)
• Instability
• Swelling in the joint
• Pain and stiffness in the joint that becomes worse over time
• Pain in the groin area if your osteoarthritis is in your hip

Rheumatoid arthritis is an autoimmune disease, which means it's caused by your immune system mistakenly attacking your healthy tissues. In this case, your joint linings (synovia) come under attack, causing joint pain and stiffness. It usually affects the same joint on both sides of your body.

Researchers are currently trying to work out what triggers rheumatoid arthritis. Symptoms can include:

• Feeling tenderness, stiffness or pain in your joints; starting with your smaller joints eg wrists or hands
• Having pain or stiffness in both your left and right joints
• Joints feeling particularly stiff in the morning

When to consider hip replacement surgery

If arthritis in your hip is advanced and treatments such as medication aren’t enough to manage your symptoms, hip replacement surgery is an option. It can give you a new lease on life, relieve pain and make daily activities comfortable again.

Signs that you might need hip replacement surgery include:

• Difficulty getting out of the car
• Difficulty putting shoes or socks on
• Pain in the night that forces you to take painkillers so you can get back to sleep
• Pain in the groin, thigh and knee that needs regular pain relief
• Struggling to walk more than a quarter of a mile

The surgery involves taking out the affected joint and replacing it with a prosthetic one. Your new joint can be made from plastic, metal, ceramic, or a combination of all three. The prosthetic joint gets bonded to your bone using special acrylic cement or a similar material.

The operation takes about an hour and a half and is performed under a general anaesthetic.

Mr Rakesh Kucheria is a Consultant Orthopaedic and Specialist Hip and Knee Surgeon at Spire Thames Valley Hospital. He says: “The results of a hip replacement are excellent and patients usually wake up after the operation without pain, and a high percentage of my patients do very well.”

Preparing for surgery

Before you come to hospital for surgery, we’ll make sure you know what to expect.

We recommend that you keep active in the run-up to your surgery. The better condition your muscles are in, the smoother your recovery will be. You may see a physiotherapist who will advise you on the types of activity that can help, such as walking, swimming or specific exercises. You’ll also have a pre-operative assessment appointment to make sure you’re fit and healthy enough for surgery.

Make sure friends and family know when your operation is. If possible, arrange for somebody to collect you after the surgery and be around to help you around the house for a few days afterwards. It’s also a good idea to get your home ready too. Make sure any trip hazards are out of the way and important things — such as your telephone — are in easy reach.

Recovering from surgery

You’ll be cared for in hospital for three to five days after your surgery and when you go home, you’ll need crutches or walking sticks for a few weeks.

You’ll be told about the type of exercises you can do to help your recovery and your hospital may have an enhanced recovery programme. This rehabilitation programme aims to get you back to full health as quickly as possible.

You’ll need to be careful and avoid pivoting or twisting your affected leg or bending the joint beyond 90 degrees for six to 12 months after your surgery. We’ll be on hand to give you advice on how to carry out daily activities while protecting your joint as it heals. 

Most people make a good recovery and will enjoy a new lease on life after their surgery.