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Hip replacement surgery

Hip replacement surgery is a common procedure to replace a damaged hip joint with an artificial one.

Hip replacement may be recommended after a hip fracture, for wear-and-tear from osteoarthritis, or because of pain and stiffness from rheumatoid arthritis.

Around 66,000 hip replacements a year are carried out by the NHS in England and Wales.

Hip

What happens during hip replacement surgery?

Hip replacement surgery can be performed traditionally or by using what is considered a minimally invasive technique. The main difference between the two procedures is the size of the incision.

During traditional hip replacement surgery, you are given a general anaesthetic to relax your muscles and put you into a temporary deep sleep. This will prevent you from feeling any pain during the operation. A spinal anaesthetic may also be given to help prevent pain if a general anaesthetic is not used.

The doctor will then make a cut along the side of the hip and move the muscles connected to the top of the thighbone, called the femur, to expose the hip joint. Next, the ball portion of the joint is removed by cutting the thighbone with a saw. Then an artificial joint is attached to the thighbone using either cement or a special material that allows the remaining bone to attach to the new joint.

The doctor then prepares the surface of the hipbone - removing any damaged cartilage - and attaches the replacement socket part to the hipbone. The new ball part of the thighbone is then inserted into the socket part of the hip. A drain may be put in to help drain away any fluid. The doctor then reattaches the muscles and closes the incision.

While most hip replacement operations today are performed using the traditional technique of one 20cm to 25cm (8in to 10in) cut along the side of the hip, in recent years some doctors have been using a minimally invasive technique. In the minimally invasive approach, doctors make one to two cuts from 5cm to 12cm (2in to 5in) long. The same procedure is performed through these small cuts as with the traditional hip replacement surgery.

The small cuts are thought to lessen blood loss, ease pain following surgery, shorten hospital stays, reduce scar appearance and speed healing.

However it's important that the surgeon is highly skilled in this technique. Research has shown the outcomes may be worse than with traditional hip replacement surgery if done by a doctor that is not very experienced with this minimally invasive approach.

What happens after hip replacement surgery?

You will probably stay in the hospital for four to six days and may have to stay in bed with a wedge-shaped cushion between your legs to keep the new hip joint in place. A drainage tube (catheter) is likely to be placed in your bladder to help you pass urine. Physiotherapy usually begins the day after surgery and within days you can walk with a walker, crutches or a cane. You will continue physiotherapy for weeks to months following the surgery.

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