Hip replacement is a surgical procedure in which the hip joint is replaced by a prosthetic implant, that is, a hip prosthesis. Hip replacement surgery can be performed as a total replacement or a hemi (half) replacement.
The hip joint is a ball (head of femur) and socket (acetabulum) style joint that is able to move in the following motions ;
- Flexion: forward and upwards movement of the thigh
- Extension: backwards movement of the thigh towards the rear of the body
- Abduction: movement of the thigh away from the midline of the body
- Adduction: movement of the thigh towards the midline of the body
- Internal rotation: rotation of the thigh towards the midline of the body
- External rotation: rotation of thigh away from the midline of the body
The majority of hip replacement surgery is due to osteoarthritis (OA) when conservative management has failed to relieve symptoms. OA is a degenerative condition that can be thought of as ‘wear and repair’. The body attempts to make bone and repair the smooth ends of the joints (articular cartilage) that may have thinned and become rough over time causing pain. Unfortunately, this repair process is not quick enough to fix all the roughed surfaces. Occasionally, the bone repair process will produce osteophytes – bony outgrowths at the edge of the joint – as the body tries to spread the load through the joint, which can catch or block movement in the joint and cause pain.
If the OA is advanced and conservative management has not worked with the hip causing so much pain that it stops you doing your normal day-to-day activities then you may be referred to an orthopedic surgeon by your GP for a review. A hip x-ray will determine the level of OA.
If pain is over-riding and stopped you being able to do your normal day-to-day activities and an x-ray confirms OA then an orthopedic surgeon may suggest a total hip replacement (THR). During THR procedure the surgeon will replace the ball and socket component of the joint with a prosthesis (artificial limb), therefore, eliminating the arthritic joint pain.
Unless instructed otherwise by the medical team, it is common for the hospital physiotherapists to start rehabilitation immediately with bed exercises such as lifting a straight leg up in the air and getting you up out of bed and mobile. Occasionally, due to the severity of OA in the joint, a surgeon may only decide to replace either the ball component or the socket component. For the surgeon to be able to reach the hip joint they may have to cut through the muscles surrounding the hip joint.
Following surgery pain may or may not be present as the arthritic joint has now gone. If pain is present it will feel different to the OA hip pain and this will be the tissues in the body healing, the same as when any trauma to human tissue occurs, this is normal. In addition to being sore there will some weakness around the hip joint as the muscles will have been cut to gain access to the joint which themselves need time to heal. It is natural initially to find activities more difficult but with time all activities should return to normal.
Hip OA advice
If suffering from hip OA who may wish to make some adaptations that may prolong the existing joint and assist with pain.
- Pace yourself better e.g. if going shopping for one hour, you may want to sit after 20 minutes for a quick rest to avoid pain building and then repeat at 40 minutes.
- Raise the seating height making it easier to get up off the chairs and to sit back down again.
- Pain relief regularly to manage your pain.
- Try and strengthen the hip as much as possible before any possible surgery – a physiotherapist can help with this
A physiotherapist will teach you exercises to help strengthen your hip and explain what should and should not be done after the operation. They’ll teach you how to bend and sit to avoid damaging your new hip.
Really there is no bad time to see a professional if you have pain. Here at Joints and Points, we offer private physiotherapy and talking therapy services and a free 20 minute consultation, for those who are struggling with physical or mental health related issues. We do not operate on a waiting list and aim to see you withing 48 hours.
If you need help or advice, our physiotherapists and sports therapist’s at J&P are here to help get you back to health. Contact us to book an appointment, or find out more.
0151 345 6823 – Office Number firstname.lastname@example.org – Office email