Osteoarthritis is the underlying disease leading to a patient needing a hip replacement in approximately 90% of cases.
Osteoarthritis is a disease of joints that leads to the cartilage in the joint deteriorating (wearing out) and the usual cushioning effect of the cartilage is lost. The process is gradual but at times pain can develop quite quickly.
The number one symptom of arthritis is pain. The most common site of hip pain is in your groin, but the pain can also be felt in your thigh, buttock, and on the outside of the hip. Oddly hip pain can at times be felt in the knee.
Hip pain is common at night, and at rest and is not only seen with exercise. Stiffness of the hip is also common with the progression of arthritis. This stiffness can make it difficult to put on shoes and socks and to cut your toenails.
Underlying conditions that can lead to the hip needing to be replaced include osteonecrosis (where the bone in the head of the femur has died), congenital hip disease, (now very rare in Australia), rheumatoid arthritis, or other types of inflammatory hip disease. All conditions lead to the cartilage wearing out and the treatment is generally very similar no matter what the underlying diagnosis.
There are no medications that can cure arthritis. Drugs such as anti-inflammatory medications and painkillers such as paracetamol can help to control the pain. Increased weight can put more load on your arthritic joint and increased weight is also a risk factor for failure of your hip if you undergo surgery. It is very important to try to keep your weight down. Exercise is to be encouraged to help with weight loss and to maintain a level of fitness. Swimming and cycling are often less painful than walking. Hiking poles can help decrease the load through your hip when walking and are recommended.
Nearly all hip arthritis is treated by a total hip replacement (THR). THR is where a cup is placed inside the pelvis and a stem inside the femur; and a new hip joint is formed (see picture). THR is a very successful operation and has excellent results in people of almost any age. Hip replacement can be done in teenagers and even into your 90s. Most people can return to near normal activity following a THR. Everyone’s journey is different, and your individual circumstances will be considered and discussed during your consultation. Ultimately the choice of whether to proceed to surgery or not is yours to make.
Usually patients are admitted on the same day of the operation and are walking that day or the next. Patients usually leave hospital 2-4 days after the surgery. At discharge you will be mobile on crutches, able to get in and out of bed and shower. You will go home with pain relief. Physiotherapy can usually be arranged at your house.
Admission to a rehabilitation facility is possible but being used less and less. Your dressing is removed at 10 days. This can be done by you or a family member.
There are usually no stitches to be removed. Mobility improves gradually. Generally you can expect to be walking short distances unaided by 1-2 weeks. By 4 weeks it is usually safe to drive and by 6 weeks you should be able to perform most activities. Improvement can occur for up to 3 months.
Your expected individual journey will be discussed in further detail with you at your consultation.
Robotic assistance (Mako) during joint replacement surgery is becoming more common. The operation is still very similar and is performed using the same surgery and implants. The robot assists in accurate preparation of the bone and implantation of the components.
All surgery carries risks. There are the general risks of the operation and specific complications. Specific risks of THR include infection, dislocation, and long-term loosening. All of these are rare, and it is worth noting that over 90% of hips are still working 20 years post-surgery. Once you have decided to consider surgery, these risks will be discussed in more detail at your consultation.
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Prince Charles Hospital
Rode Rd, Chermside, Brisbane 4032
Monday – Friday 8.30am to 5.00pm
Ph: 07 3139 4481
Fax: 07 3139 4043
CAR PARKING FACILITIES
A multi-storey public car park is located at the western end of the main hospital building. Visitors should enter The Prince Charles Hospital via the Rode Rd entrance (please refer to the map of the hospital), and follow the signs to the public car parking facility.