About hip replacements
Posted on 21 August 2012
Our expert Dr Ockie van Zyl is a leading orthopaedic surgeon, specialising in knee and hip replacements. He supports Mediclinic Panorama and Mediclinic Cape Town.
I suffer from agonising hip pain. Could a hip replacement help?
‘Hip replacement surgery is usually suggested if you experience chronic hip pain that is so severe that you struggle to perform normal daily activities and movements,’ says Dr Van Zyl. ‘The most common cause of chronic hip pain is osteoarthritis, which is inflammation in the hip joint due to the bone and cartilage gradually wearing away over many years’ use. A hip replacement can also relieve chronic hip pain caused by rheumatoid arthritis or if the bone has died owing to poor blood supply,’ he says. Your doctor may suggest non-surgical treatment such as anti-inflammatory medication or exercise first, but if this doesn’t relieve the pain, hip replacement surgery will likely be the best option.
What does hip replacement surgery involve?
The hip is a ball-and-socket joint, with the top of the thighbone fitting snugly into a round hollow in the pelvis, called the acetabulum. During hip replacement surgery, the orthopaedic surgeon will first remove the damaged or inflamed bone and cartilage from the joint. The acetabulum is then relined with a smooth artificial lining and the ball of the thighbone is replaced with a metal or ceramic knob attached to a short metal stem. The stem is inserted into the upper end of the shaft of the thighbone and either fixed to the bone using a biocompatible cement-like substance or allowed to attach through bone regrowth. The surgery is performed under general anaesthesia and usually takes between two and four hours. You will have to stay in hospital for a few days afterwards for observation.
How long will it be before I’m back on my feet again?
Total recovery time varies, but patients usually regain full mobility about six months after surgery. ‘You will be able to stand up the day after surgery already, using crutches to help with support. While still in hospital, a physiotherapist will help you to start with gentle movements and rehabilitation exercises,’ says Dr Van Zyl. During the first two to three months after surgery, you should be especially careful not to strain or overuse your hip to allow the artificial joint to attach properly to the bone. ‘It’s best to use crutches for the first 4–6 weeks after surgery,’ advises Dr Van Zyl.
Will I be able to participate in sport or physical exercise after a hip replacement?
Hip replacements are meant to improve mobility and return you to an active lifestyle. Low-impact exercise such as walking, gentle hiking, swimming, golf or cycling should be a pleasure. However, high-impact activities such as running or squash, or contact sport like rugby or soccer should rather be avoided. I’ve heard about complications after hip replacement surgery.
Should I be concerned?
‘Blood clots may develop after hip replacement surgery, but with the use of medication these can easily be prevented. There could also be a risk of post-operative infection, but it’s rare: it happens in less than 0.1% of hip replacement surgeries,’ says Dr Van Zyl. ‘Your medical team will monitor your post-operative recovery closely and there is no reason to be concerned when you have to have a hip replacement,’ he says.
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