03 January 2020
The hip joint can withstand repeated motion and a fair amount of wear and tear. This ball-and-socket joint is the body's largest joint, and fits together to allow fluid movement. Whenever you use the hip – every time you walk or even shift position in your seat – a cushion of cartilage helps prevent friction as the bone moves in its socket.
With all this regular use, and people living for longer, it may come as no surprise to find that the number of hip replacements being performed is increasing. So Shahnaz Fraser of Spire Norwich Hospital spoke with Consultant Trauma and Orthopaedic Surgeon, Mr Ben Davis about this common procedure and why it may be a good solution for some patients suffering from hip pain.
Mr Davis, why would someone need to have a hip replacement?
It is mostly down to the genes we inherit. The quality of the cartilage, which forms the bearing surface of our joints, and the shape of the hip joints varies from person to person. In some people the cartilage wears out at a young age, and in others it seems to last forever! Certain types of injury can also lead to arthritis developing. Once symptoms have started from the hip, patients can control symptoms with pain relief and physiotherapy. But if these treatments stop working, then surgery may need to be considered as an option. The average age of a person who needs a hip replacement is 65, but we treat people over this age, and much younger patients too.
So what are the symptoms they would be experiencing?
Most patients will have lived with pain and loss of function for some years before reaching the point of needing a new hip.
Typically, patients complain of groin and thigh pain, but also back pain and pain to the knee and below. Some patients only complain of pain at the knee and undergo investigations and treatment to their knee joint before the correct diagnosis of hip arthritis is reached. The pain often leads to disturbed sleep, and tends to get worse with increased levels of activity. Day-to-day activities, such as putting on socks, housework or gardening become painful or more challenging. Patients may also notice that they’re limping or walking unevenly. In very bad cases, they become unable to walk more than a few steps as the hip joint seizes up completely.
What else could cause hip problems?
There are many structures around our hips that can also cause pain and affect its function. Inflammation in the tendons and soft tissues (bursitis) commonly lead to patients seeking treatment. Referred pain from problems in the lower back is also common, as well as from conditions such as hernias.
What does a hip replacement involve?
The removal of the damaged hip joint and insertion of a new artificial joint is a common procedure, but there are different methods of performing it. All types of total hip replacement involve removing the ball of the hip joint, putting a new lining in to the hip socket and a new ball to go in the new socket. Many factors determine which type of hip replacement is used and how the procedure is performed. The surgeon will discuss and explain the options available and the merits of each technique. However, the overall function and outcome of all the different types of hip replacement are the same.
And will a hip replacement last a lifetime?
It’s a common misconception that “they only last 10 years.” It’s true that the younger a patient is when the replacement is performed the greater the chance of it wearing out, which is why it is better to wait for as long as reasonably possible before having surgery. The vast majority of patients that have a hip replacement will never need to have it changed.
And how long would it take to recover after surgery?
The patient is likely to stay in hospital for two or three days, during which they will receive physiotherapy. Most patients are able to go back to work, or their normal day-to-day activities within six weeks, although manual work may take a little longer. Recovery continues for around a year, and the majority of patients can forget they even have an artificial hip. Keeping active both before and after surgery is of great benefit.
What are the risks?
All operations have risks associated with them and the surgeon should explain all of these prior to surgery. Hip replacements are commonly performed and are one of the most successful operations carried out on the human body.
Is there any alternatives?
There are very few alternatives to hip replacements when treating hip arthritis other than pain and activity management.
If you are experiencing pain or reduced function in your hip it’s important that you see your family GP in the first instance. Or call 01603 255 614 to make an appointment with Mr Ben Davis, Consultant Trauma and Orthopaedic Surgeon.
All surgery carries an element of risk and the content of this page is provided for general information only. It should not be treated as a substitute for the professional medical advice of your doctor or other healthcare professionals.