Hip replacements are one of the most common types of surgeries performed by surgeons across the UK today. According to the National Joint Registry (NJR), over 100,000 hip replacement surgeries were performed in England in the 2017/2018 period.
The largest of the ball and socket joints in our bodies, hip joints are susceptible to wear and tear, injury and becoming arthritic. The best solution to alleviate constant pain and discomfort in the joints can often end up being hip replacement surgery.
Surgery can remove parts of the hip joint that are damaged or diseased before replacing them with a prosthesis – artificial parts that allow you to regain movement and eliminate pain. The prospect of a hip replacement can be a daunting one at first; however, you are not alone in going through this process.
With that said, it is perfectly normal to have questions about the process. Should it be through the NHS or done privately? What can you do to prepare for surgery? How does the actual surgery work? And what will the recovery process entail?
In this article, the team at Better Healthcare will walk you through the hip replacement process – from preparation to surgery, and through to recovery – to ensure you know what to expect from a hip replacement.
When is hip replacement surgery required?
If you are experiencing mobility issues and/or constant pain as a result of the wear and tear in your hip joint, then you may benefit from hip replacement surgery (often referred to as a total hip replacement surgery). There can be several underlying reasons behind this pain and discomfort – with the most common reason being osteoarthritis that has caused hip joint cartilage to break down and wear away.
Rheumatoid arthritis, an autoimmune disease, is another common cause of hip problems as it prompts the immune system to mistakenly attack the cells that line your hip’s as well as other joints. Other reasons can include:
- Hip fractures – from a fall or accident
- Ankylosing spondylitis (inflammation)
- Septic arthritis
- Bone dysplasias (disorders causing atypical bone growth)
Hip pain and discomfort resulting from one or more of the above conditions may be able to be treated with the likes of steroid injections or physiotherapy. However, if you are finding that the pain is persistent, then you are likely a candidate to receive a hip replacement.
Who is eligible for hip replacement surgery?
The decision regarding whether or not to recommend you for surgery will be made in conjunction with your GP. Once they have decided that this is the best way forward, you will be referred onto an orthopaedic surgeon. Either the consulting surgeon or one of their team, will assess the problem and determine if surgery is the best course of action.
You may be offered surgery on the NHS if:
- the pain is severe, the joints become stiff or swell, and you experience a reduction in mobility
- hip pain affects your day-to-day life and makes activities feel impossible – such as cleaning, going out, getting in or out of the bath and/or sleeping
- pain and discomfort prevent you from working or having a normal social life – often causing depression
- you are well enough to cope with the surgery and the rehabilitation process
Hip replacement surgery is primarily for those who are over the age of 60 and less active – ensuring there is less stress on the artificial hip joint and that it will last for the intended 15 years without revision surgery. However, younger people may also be able to benefit from a hip replacement.
Successful surgery can alleviate some or all of the above complications and effects of living with hip discomfort and pain. For many, a hip replacement can be completely transformative – allowing them to feel as if they can live their life again.
NHS or private treatment?
The NHS Constitution sets out that patients have the right to receive consultant-led treatment approximately 18 weeks after referral (known as the referral to treatment pledge, or RTT). However, there can be several factors that affect this wait time – such as your choice of hospital and surgeon. You can consult the waiting times, as well as reviews from patients, of your local hospital(s) by visiting the NHS ‘Find services’ page on its website and putting in your details.
If you want to reduce the waiting time, you could choose to go private; however, prices for a hip replacement tend to range from £10,000 to £15,000. This will likely not include other additional costs – such as travel and accommodation. The main benefits of going private would be reduced waiting times and the ability to have full freedom over your choice of hospital and surgeon.
Preparing for surgery
There are a number of considerations and preparations that should be made before you head into your surgery.
Firstly, make sure to ask the hospital for any information packs or documents that can help you understand the before and after of your operation. They may also be able to provide you with access to an occupational therapist, or physiotherapist, who will be able to offer you advice on the rehabilitation and recovery process. If you have not been offered access to such a professional, try and ask if you can see one.
In preparation for the surgery, it is important to stay as active as possible to ensure that your hip muscles are as strong as they possibly can be. This can include some light exercise (such as going for regular walks or having a swim) during the time between referral and treatment. Keeping your hips as active and as strong as possible can aid in the speed of the recovery process.
Other considerations include how you will get home from the hospital and managing around the home.
You can make this easier for yourself by planning out your meals in advance – such as stocking up on frozen ready meals or non-perishables (such as tins of soup). You will also want to arrange your home so that it is easy for you to move around and ensure items that you use frequently are within easy reach (such as your TV remote control, telephone and medicine).
You will want to arrange for a family member or friend to help you around the home in the weeks directly following surgery. If that’s not possible, then you could always arrange for home care or live-in care. Better Healthcare offers both of these services for those recovering from hip replacement surgery.
The hip replacement surgery process explained
Despite all of the preparation and waiting required, most hip replacements last just an hour or two – often between 60 to 90 minutes. They are either carried out under a general anaesthetic (where you’ll sleep through the surgery) or an epidural (numbing of the lower body).
The surgeon will make an incision to allow them to remove the problematic ball and socket joint before replacing it with an artificial one. This prosthesis can be made from a number of different materials, including:
- plastic (polyethene)
- metal-on-plastic (metal ball & plastic socket – most commonly used)
- ceramic-on-plastic (ceramic ball & plastic socket)
The new joint’s components are held in place either by being cemented (where it is secured to the bone using an acrylic cement) or uncemented (the bone grows around the joint to keep it in place).
Your surgeon will discuss the considerations of the different combinations with you and will suggest a type of joint that best suits you and your lifestyle.
The aftermath of surgery
Due to the relative safety of hip replacement surgery, the main worry for recipients is the rehabilitation and recovery process. Hip replacement recovery times can vary from person to person and can depend on the type of procedure. However, the recovery process will begin on the same day.
Once the operation is complete, you’ll be returned to the ward either awake or asleep (depending on the anaesthesia used in the surgery). After being kept lying flat on your back, ensuring that your hip stays in the correct position, you may be able to have some drink or food within a couple of hours of returning to the ward and regaining consciousness. However, you may be kept to a liquid diet for the rest of the day.
You should be able to walk around a few days after the operation with the help of a walking aid such as crutches or a walking frame. If you had minimally invasive surgery or are on an enhanced recovery programme, you may be able to walk around on the same day of the procedure. As such, you will be expected to stay in the hospital for anywhere between 3 to 5 days.
You’ll feel uncomfortable at first – with tiredness, swelling and pain being common initial side effects of the procedure. You will likely be provided with injections to prevent blood clots from forming in your legs, medication to help ease the pain and some antibiotics to help prevent any infections from occurring.
An occupational therapist or physiotherapist will see you and show you how you should move while recovering as well as exercises to perform that can aid in the recovery process. A doctor will also advise you on how to take care of the incision area – such as keeping it dry to prevent infection.
On the day following the surgery, you should have returned to eating your normal diet (if you haven’t already), and you may be taken off of an IV in favour of orally delivered pain medication.
The road to recovery
After you’ve been discharged, you’ll likely feel fatigued. Understandably, many people are also unsure of what to do when they’re discharged after a hip replacement.
During this recovery time, it’s essential to keep doing your exercises and keep yourself moving in the ways instructed by your therapist. This will help keep the blood flowing in your legs which helps with the hip replacement recovery process and can also prevent blood clots.
With that said, it’s also important to not push yourself too much. An injury or fall can end up loosening the joint – causing pain and a feeling of instability as if the new joint is unstable. If this happens, you will require revision surgery – which will extend the rehabilitation and recovery process.
As a result, this does mean that you will need someone at home to help you get through the first couple of days and weeks as you continue on the path to recovery. Home care and live-in care – services provided by Better Healthcare – can help you cope during the difficult days and weeks ahead as you adjust.
With that support around you, it’s likely that you’ll be able to be somewhat active again within 3 to 6 weeks – perhaps being able to move around without a walking aid or being able to drive – and fully recovered within 10 to 12 weeks.
Getting help around the home
Better Healthcare Services is best placed to provide you with the proper care and support required while recovering from hip replacement surgery.
Our bespoke service ensures that you can specifically request the amount of support required in your own home from one of our qualified carers. Whether it’s an hour or two a day for the first week, or if it’s live-in care for the next month, Better Healthcare can offer you a personalised, hands-on service to ensure the road to recovery is relaxing and stress-free.
Our carers can help you cook meals, aid you in getting in and out of the bath, assist with shopping and provide light to moderate housekeeping.
To find out more about how our carers can help you during your hip replacement recovery, simply call us on 0800 668 1234 or get in touch with your local Better Healthcare Services office today.
This post is not health advice and should not replace professional advice tailored to your specific circumstances. It is intended to provide information of general interest about current healthcare issues.