Hip surgery

Once upon a time, hip surgery was seen as a last resort.

Today, with improved techniques, better synthetic joints and excellent results, more and more patients are successfully treating their hip pain earlier with surgery .

 
 

Hip replacement

Total hip replacement is a highly effective procedure for patients with hip pain due to joint degeneration from a number of conditions.

Click on the following headings to read more.

+ Why do people have hip replacements?

People have hip replacements to relieve pain, restore function and improve quality of life.

The most common reason people have a hip replacement is osteoarthritis. Other reasons include inflammatory arthritis (e.g. rheumatoid or psoriatic), osteonecrosis, trauma and hip disorders of infancy and childhood (e.g. dysplasia and Legg-Calve-Perthes disease). Matthias has successfully performed hip replacement surgery in patients ranging in age from under 8 to over 80 years.

+ What does it involve?

The surgery involves replacing the damage hip joint with synthetic parts (called prostheses or implants). The synthetic parts allow the hip to move in multiple directions without pain. It takes about 2 hours to perform.

The hip joint can be approached from the back (posterior), side (lateral) or from the front (anterior). Matthias has extensive experience in all approaches, particularly with anterior hip replacement, which is becoming increasingly popular because of several advantages.

+ What could I expect after a hip replacement?

Patient satisfaction after hip replacement is extremely high.

You can expect to be up on your feet either the day of or the day after surgery. Time to full recovery varies from person to person, but most people are doing well with minimal discomfort by 3 months after surgery. You might not achieve full range of motion or be able to perform high impact sports.

More than 90% of hip replacements are working successfully, are pain free, and are without complication 15 years after surgery. The newer prostheses are lasting longer, and you could probably expect a new hip to last 20–25 years these days.

+ What would stop me having a hip replacement?

There are a few contraindications to hip replacement, including:

  • active infection (either in the hip or systemic)
  • pre-existing serious medical conditions (eg recent heart attack, unstable angina, severe anaemia)
  • skeletal immaturity
  • paraplegia or quadriplegia. Patients with morbid obesity are more prone to infection, so we need to balance the potential benefits of surgery against potential risks.

Revision hip replacement

Revision hip replacement involves removing part or all of your prosthesis and putting in new ones. This tends to be much more difficult than the first surgery because there is typically less healthy bone to work with.

+ Why do people have revision hip replacements?

Hip replacements need to be revised if:

  • the new joint wears out
  • the implanted parts of the new joint become loose
  • the head comes out of the socket (dislocation)
  • the implant breaks (implant failure)
  • an infection develops in the joint
  • there is significant bone loss around the implants or the bone breaks
  • the new joint is causing pain.

+ How likely is it that I will need a revision hip replacement?

Fortunately, the post-operative complication rate with hip replacement surgery is low, so revision surgery for problems with your new hip is unlikely.

However, you might 'out live' your first hip and need a second one. A hip put in today will probably last 20–25 years.

Hip arthroscopy

Arthroscopy is a form of minimally invasive surgery. It involves placing a thin telescope with a light source into the hip joint.

+ Why have hip arthroscopy?

As well as being able to look at the joint and investigate problems, Matthias can also perform various surgical procedures such as:

  • removing bits of bone or cartilage that have broken off and are floating around in the joint space
  • repairing or removing damaged tissue (e.g. labral tears)
  • resurfacing the joint.