Total Hip Replacement

As a procedure that is performed over 300,000 times annually in the USA and 7000 times in Ireland, total hip replacement is considered one of the most successful and cost-effective medical procedures available. It offers almost total relief to patients suffering from a number of orthopaedic conditions, including osteoarthritis, which is one of the most debilitating diseases in existence.

What is a Total Hip Replacement?

To best understand your total hip replacement surgery, it is important to know how you hip works.

Your hip is a ball and socket joint that allows you to move your leg in many different directions. The ball (Femoral head) is the upper end of the thigh bone that fits into the socket of your pelvis (Acetabulum). In a healthy hip a thick layer of smooth cartilage covers the ends of the bones. When it is in good working order, your hip helps you walk and move your leg easily and without pain.

When the cartilage wears away, the bones rub together causing the pain, stiffness and inflammation of arthritis. “Arthritis” is an inflammation of a joint causing pain, swelling, stiffness, a sense of instability and often deformity. Severe arthritis interferes with a person’s activities and limits his or her lifestyle. When your hip joint can no longer work as it should, Total Hip Replacement can relieve your pain and stiffness and improve your mobility. An artificial ball and metal stem replaces the worn head of the thighbone and a metal cup and artificial liner replaces the worn socket of your pelvis. Although the idea of getting an artificial hip joint may be intimidating, it is one of the safest and most effective surgical procedures.

Most of Mr. McKenna’s patients receive a cementless hip replacement. Cementless total hip replacements have rough surfaces, which allow your own bone to grow into them. Occasionally, a cemented hip replacement will be used. Mr. McKenna will explain this to you if it is necessary.

Your hip replacement joint also has smooth surfaces, like cartilage, that allow you to move easily and without pain. These are usually made from ceramic and plastic parts.

Your hip replacement can relieve your pain and stiffness, improve your mobility and restore your quality of life. For a short period after surgery, the healing of the soft tissues around your hip may limit your ability to perform various activities,. Therefore, you may need walking aids, such as a walker (Zimmer frame), crutches, or a cane. Most patients will not need restrictions on weight bearing or movement after their total hip.

Which Patients Should Have a Total Hip Replacement?

Total hip replacement is recommended for patients with arthritis who have severe pain and limited function, which significantly affects quality of life. Everyone’s pain is different, and the degree of pain sufficient to justify surgery should be decided by the patient and the Mr. McKenna together. While most arthritic hips are the result of degenerative arthritis (osteoarthritis), other conditions such as rheumatoid arthritis, avascular necrosis, trauma, prior surgeries and tumours can also be treated by total hip replacement.

The fortunate aspect of hip replacement surgery is that it’s never too late. Regardless of the stage of symptoms or conditions, hip replacement surgery is a highly effective means of handling any degenerative condition of the hip joint.

What is the Long-Term Prognosis of Total Hip Replacement?

On an individual basis, it is impossible to predict how long a hip replacement will last. With newer materials and techniques, the lifespan of hip replacements continues to increase. Over time, a certain percentage of patients having a total hip replacement will require revision surgery. Although uncommon, implants can develop mechanical problems such as loosening, fracture or wear and tear. Other problems such as infection or dislocation can occur, which may lead to the need for revision surgery. Regardless of this, 8 out of 10 hip replacements will last over 20 years.

Potential Medical and Surgical Complications

While Mr McKenna will attempt to fully explain the nature and purpose of hip replacement, its benefits, possible alternative nonsurgical methods of treatment, the risks involved, and the possible complications, he cannot guarantee or assure that complete restoration of function will be achieved as a result of your hip replacement. The risks and potential medical and surgical complications include, but are not limited to the following: infection (1-2%), clot formation in the leg or lungs (venous thromboembolism), paralysis, dislocation, persistent pain, stiffness, instability, limp, weakness, breakage of bone or parts, leg length difference, uncontrolled bleeding, nerve injury, blood vessel injury, delayed wound healing, wear, loosening, pressure sores and death. Anaesthetic risks are also present as well as the risk of needing a blood transfusion.