Hip replacement surgery (pokanga hope) involves removing damaged parts of your hip and replacing them with new parts made of metal and plastic.
- Hip replacement surgery is carried out if pain from severe arthritis or another injury to your hip stops you from doing your day-to-day activities, and there are clear changes to the joint that surgery will correct.
- It is only offered when other treatments such as physiotherapy and occupational therapy haven’t helped with pain and mobility.
- People who actively participate in their care before and after surgery are likely to have a better recovery.
- There are many things you can do to take part in your care, starting from before your operation, during your stay in hospital and when you get home after discharge.
- You can improve the outcome of your surgery by getting yourself as fit and healthy as possible beforehand. This may include stopping smoking, exercising, eating a balanced diet and limiting or avoiding alcohol.
- If you are overweight, weight loss is especially helpful and may mean you no longer need surgery.
What is hip replacement surgery?
A total hip joint replacement is an operation to replace a damaged or diseased hip joint. Your hip joint is made up of the head of the femur (ball) and the acetabulum (socket). In the majority of hip replacements, both the ball and the socket are replaced with metal and plastic components.
(WebMD, US, 2019)
What are the alternatives to hip replacement surgery?
Hip replacement surgery is usually only offered when alternatives to it have not worked for you. These include regular exercise, losing weight, physiotherapy or occupational therapy, and pain relief medicines.
Learn more about the alternatives to hip replacement surgery.
When is a hip replacement considered?
Hip replacement surgery is usually recommended if you have severe arthritis of your hip that causes disabling pain and when other treatments, such as physiotherapy haven't helped reduce pain or improve mobility. The most common reason a hip needs replacing is osteoarthritis of the hip. You may be offered hip replacement surgery if:
- you have severe pain, swelling and stiffness in your hip and your mobility is reduced
- your pain is so severe that it interferes with your quality of life and sleep
- everyday tasks, such as shopping or getting out of the bath, are difficult or impossible
- you're feeling depressed because of the pain and lack of mobility
- you can't work or have a normal social life.
You'll also need to be well enough to cope with both a major operation and the rehabilitation afterwards.
Is a hip replacement right for me?
To decide whether a hip replacement is right for you, talk with your doctor about the risks and benefits of the surgery. Also, find out what you can do if you choose not to have surgery. The following summary is a guide. Also see Is a hip replacement right for you?
What are the benefits of having hip surgery?
The aim of hip surgery is to relieve pain, reduce stiffness and improve your ability to walk. Over 90% of people experience dramatic pain relief and improved hip function with a new joint and more than 90% of hip replacements last beyond 10 years.
Are there any risks to having hip surgery?
As with all surgeries, complications sometimes occur with hip replacement surgery. Smoking, obesity or some illnesses may increase your chance of complications. Complications include the possibility of blood clots or deep venous thrombosis (DVT) of the veins in your legs or pelvis, bleeding, infection, one leg being longer than the other, damage to arteries and nerves in your leg and bone fracture during or after the operation. Though uncommon, when these occur they may delay or limit your full recovery.
Preparing for hip replacement surgery
The better prepared you are for surgery, physically and emotionally, the quicker you will recover from it. Recovery from surgery is not the same for every person. Some people recover faster than others depending upon their age, health status, personal motivation and response to rehabilitation. The following video gives a good explanation about how to prepare for surgery and what to expect during and after the operation.
(Ministry of Health, NZ, 2015)
Recovering from hip replacement surgery
Many district health boards (DHBs) have introduced a new way of caring for people who need a hip or knee joint replacement. This is called ERAS –Enhanced Recovery After Surgery. The ERAS pathway of care starts when you and your doctor decide that you need surgery and continues through to your rehabilitation at home or in the community. The approach covers a number of evidence-based interventions that aim to ensure you:
- are in the best possible condition for surgery
- have the best possible management during and after your surgery
- participate in the best possible rehabilitation after surgery.
You are encouraged to be a partner in your own care. The sooner you get out of bed and begin to walk, eat and drink after your operation, the quicker and more comfortable your recovery will be. You return home earlier to your normal life, work and play. All going well, you are likely to return home after 2 to 4 nights in hospital. Read more about ERAS.
How can I be involved in my surgery?
Research has shown that people who actively participate in their own care before and after surgery are likely to have a better recovery. There are many things you can do to take part in your care, starting from before your operation, during your stay in hospital and when you get home after discharge. Your ERAS booklet will give you more details but here is a summary of what to expect and the sorts of things you can do.
|Hip surgery||What to expect and things you can do|
|Before your surgery||What to expect
Things you can do
|While in hospital||What to expect
|Discharge||What to expect
Total hip replacement: a guide for patients ERAS, Ministry of Health, NZ
A checklist for patients having hip or knee replacement surgery ERAS, Ministry of Health, NZ
|Dr Bronwyn Lennox Thompson is a senior lecturer & Academic Coordinator, Postgraduate Programmes Pain & Pain Management, Orthopaedic Surgery & Musculoskeletal Medicine, University of Otago Christchurch. Her main interest areas include resilience, daily coping choices, and knowledge translation from research to clinic.|